Show Notes for Episode Twenty-Three of seX & whY: Issues Surrounding Men’s Health, Part 2

Host: Jeannette Wolfe Guests: Peter Baker – Director of Global Action on Men’s Health Twitter: @pbmenshealth @globalmenhealth

Dominick Shattuck has a PhD in psychology and does Global Health Work at Johns Hopkins Bloomberg School of Public Health

https://www.linkedin.com/in/dshattuck/

Main topics discussed:

Challenges and barriers associated with optimizing men’s mental health and the role of men in reproductive health-related issues.

Men’s mental health is important not just for men but for the health of communities. Maladaptive coping mechanisms such as substance use disorder and aggression can impact gender-based violence, sexual and reproductive health, and the well-being of children. Part of tackling gender-based violence needs to include helping men better manage anger and stress.

Barriers to mental health for men

From a young age, many boys are taught to suck things up and not show signs of physical or emotional weakness. They also may struggle to find words to adequately articulate their emotional state or to appropriately label the challenges which they are experiencing. This may be further confounded by social media in which most posted photos portray men as carefree and perfect which can leave the viewer feeling inadequate and questioning their masculinity. Today many men may also have decreased contact with their extended families and thus may miss out on many of the informal connections and conversations that have historically helped men cope with common life challenges.

We then discussed some unanticipated and potentially detrimental consequences of “gender blind” policies. For example, due to concern of exclusivity, there has been a decrease in what historically were Men’s Only spaces. These closures can be costly for men who already have a fragile support system and who relied on these organizations to help them connect and bond with other men. Dominick then talked about the importance of code switching for men (using different communication styles with different audiences) and that in the ideal world we would create opportunities for men to become more proficient in the different roles they play (i.e. father, husband, employee etc) by exposing them to spaces with different audiences like men’s only, couples, and mixed gender gatherings.

Peter also brought up that mental health related depressive symptoms may just look differently in men. Consequently, many men and their health care professionals, may not be aware that some of the symptoms that men are describing (such as increased alcohol consumption) are often flags for depression.

Next, we discussed what roles men can play when it comes to areas surrounding reproductive health and reproductive justice. Dominick talked about some of the work he has done for a task force funded by the US Aid for use in low and middle-income countries to help better define these roles. He described a three-pronged framework- men as potential clients (i.e. work around condom use and vasectomies), as supportive partners to women, and as advocates for change. Messaging this framework so that men understand that these issues are not just relevant for women is critical. Peter also believes that this is an area in which Men’s Advocacy Groups can likely help so that women are not shouldering this load alone.

One of the take home moments for me was a story Dominick shared about the first time in his entire life that he had a talk with a medical doctor about family planning was when he was in the urologist’s office getting his vasectomy. I embarrassingly admitted that as an ER doctor when I am speaking to a male patient about condom use it is usually in the context of me treating them for an STD and my focus is primarily on preventing future infections not future babies. Made me realize that even in my speciality there are some opportunities.

Here are links to some of the information we discussed.

Mental Health Survey

Here is the article about Dominick’s work and his commentary related to the Covid Trends and Impact Survey. This is an online survey on Facebook that has surveyed millions of people across the world. Dominick’s study focused on over 12 million participants in 115 countries from May 2021 to Sept 2021 and found that 37% of men reported feelings or depression and 34% of anxiety with younger men reporting higher levels than older ones. These numbers were similar to the percentages of anxiety and depression reported by women. Men also reported that getting more resources on how to maintain their mental health was one of their top priorities surrounding the pandemic. Their findings were somewhat atypical because outside of Covid, women are typically much more likely to report symptoms of anxiety and depression and men are much more likely to under-report their symptoms, suggesting that COVID has caused significant suffering for men. Interestingly, it also hints that COVID may have helped some men to be more open to the concept of counseling and mental health related services.

Post-partum Depression in Men

Interestingly, when we think about post-natal depression, we tend to think it is something that only happens to newborn mothers, but Peter suggests that it is also relatively common in men. As this shocked me, I dug around a little.

Per this JAMA article about 10% of men suffer from postpartum depression but the rate can be as high as 1 in 4, 3-6 months after birth.

Factors that might contribute to postpartum depression in men

Decreasing testosterone
Lack of sleep (and sex)
No longer being partner’s primary focus
Stress of feeling they must provide for partner and child
Feeling guilty that they should be happier with their new child
Postpartum depression in their female partner

Again, interestingly, fathers are usually not asked questions about their own coping

Here is a summary of the paper we discussed that helped a hyper-masculine profession - offshore oil workers - change their culture surrounding safety.

Take home points

We need more data that analyzes sex and gender differences in medical conditions. One area that Peter feels is particularly understudied is the economic cost associated with ignoring key aspects of men’s health. Having better numbers around these costs could help elevate the issue amongst researchers and policy makers
When we talk about mental health, as there are both sex-based biological factors and gender based sociocultural expectations that contribute to it, there are different, often significantly different, challenges associated with the optimization of mental health for men compared to women. As a result, depression in men often goes unrecognized and undertreated and this can contribute to the increased rates of isolation and suicide in men.
Tackling men’s mental health related issues requires a multi-prong approach including education and the intentional creation of different types of sociocultural accepted spaces where men can seek support and learn coping skills.
When considering men’s role in reproductive health, Dominick shared a three-prong framework. Men as clients, men as supportive partners to women and men as advocates for change. The use of effective messaging to engage men in these issues is critical especially as to this point reproductive health has been considered a “women’s issue” in which men have by and large been excluded.
Finally, there is a need to bridge many Men’s and Women’s Health Advocacy Groups more effectively. As the health of a community is dependent upon the health of all its members, these groups share a lot of common goals and there is significantly opportunity for greater coordination.

Thanks for listening to seX & whY, Jeannette

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