What to make of modern medicine’s attention to men

Women have long been subject to intrusive biomedical interventions. And the control that modern medicine exerts over women’s bodies has been the focus of much feminist activism. Men are usually seen as the perpetrators rather than victims of this medical control. The history of the Boston’s Women’s…

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Ageing men are seen as an especially lucrative niche sector. Sean MacEntee

Women have long been subject to intrusive biomedical interventions. And the control that modern medicine exerts over women’s bodies has been the focus of much feminist activism. Men are usually seen as the perpetrators rather than victims of this medical control.

The history of the Boston’s Women’s Collective and the book Our Bodies, Ourselves occupy a central place in the story of the women’s liberation movement. This history reveals that biomedical knowledge and practices are far from being gender neutral. On the contrary, they have served to pathologise pregnancy, sexual “dysfunction”, and other “conditions” that exclusively or disproportionately affect women.

Until recently, such a narrative of biomedical control has been lacking in the burgeoning literature on men and masculinities. But there’s now growing awareness of how men’s bodies and lives have also been subject to biomedical control – albeit of a different kind and order.

As in the case of women, there are a number of factors contributing to the biomedicalisation of men.

First, the pharmaceutical and biotechnology industries have “discovered” a growing potential market of the aged. Ageing men are seen as an especially lucrative niche sector because marketers of new medical treatments recognise that post-war male baby boomers tend to be cashed up. Many will pay for procedures that enhance their appearance and performance, potentially prolong life, or mask the effects of ageing.

An internet search will reveal an abundance of advice and products targeted exclusively to men. And because these treatments are marketed directly to consumers via the internet, they’re not easily regulated.

Meanwhile, biomedicine itself is expanding its categories to newer populations, including men of all ages and social groups. For example, “growth hormone deficiency” is increasingly seen as a problem requiring medical intervention; this can be seen as a manifestation of a general process of rationalisation and (bio)medicalisation in modern societies.

And the recent attention to men’s health, in government enquiries, organisations such as the Australasian Men’s Health Forum, and numerous information sources has no doubt contributed to men having more encounters with the institutions of biomedicine.

These developments bring some benefits, such as encouraging more men to visit their doctors regularly to undertake tests for prostate cancer and other conditions. But they also engender consumer demand for interventions that, in some cases, serve to medicalise problems that would be better dealt with outside the institutions of biomedicine.

The biomedicalisation of men can be seen as a recent manifestation of “bio-power” as described by Michel Foucault. It’s one aspect of a wider transformation of human life that is under way in the name of “human betterment”.

It’s no coincidence that the medicalisation of men is occurring during a period of the radical deregulation of health care. The “direct-to-consumer” advertising of an increasing array of new biomedical treatments, including those marketed to men, is congruent with the neoliberal political project. More and more, individuals are being called upon to express their agency in the market of medical treatments – a trend often portrayed as enhancing consumer choice.

We need to ask what such choices mean in the context of deregulated health care dominated by biomedical knowledge and practices. Which groups of men benefit and which groups are disadvantaged?

While recently co-editing the book Aging Men, Masculinities and Modern Medicine, I was struck by the disproportionate attention given by researchers in the field of men’s health to issues such as erectile dysfunction, sexual enhancement, and testosterone treatments.

This is not to say that these issues are not important to some men. But such a focus obscures the workings of biomedical power and diverts attention from issues of arguably greater concern to the majority of men. Those issues include loneliness, mental health problems, and concerns about changes to one’s health and to one’s social status as one grows older and is no longer able to work.

Questions about the politics of knowledge and political economy, in particular, have been neglected in recent research on masculinities, health and medicine. I would like to see more work exploring why certain fields of research are given more attention than others, and who benefits and who is disadvantaged as a consequence.

Alan Petersen’s most recent book, Men, Masculinities and Modern Medicine (edited with Antje Kampf and Barbara Marshall) is published by Routledge.

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14 Comments sorted by

  1. David Thompson

    Research Officer In Men's Health at University of Western Sydney

    It really is great that you have provided this perspective, Alan. The other side of the current situation in men's health where the major focus is on getting men to engage in more health-building activities (like going to the doctor proactively etc, getting problems checked, exercising more etc) is what happens when they do do those things.
    The health service is overall not especially interested in the social approach to health and wellbeing, being entirely geared up towards 'solving immediate health…

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  2. Kate Rowan-Robinson

    Kate Rowan-Robinson is a Friend of The Conversation.

    Registered Nurse/Sexology Student

    Mens health is an area that has been sadly lacking. Health services that are aimed directly at men, providing a holistic service by a trusted health professional would make a massive difference to the well being of men in our community. And it goes well beyond sexual performance.

    During my short stint as a practice nurse I found it incredible how many men were on ED drugs such as Viagra, Cialis or Levitra, but had other health problems they were reluctant to either seek treatment for or comply…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Kate Rowan-Robinson

      Many good points, Kate. What you say about erectile dysfunction is a strong argument against the ED clinics which treat nothing else, and focus on selling pharmacological solutions.

      GPs, even with their limited time available, at least can take an overall look at health, and screen for diabetes and depresssion etc.

      Australia has generally been free of the sort of pharmaceutical marketing that is everywhere in the US. It seems that the ED clinics have found a way around this. They also promote a message that "potency" is everything in having a good life and relationship. Not a healthy message.

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    2. David Thompson

      Research Officer In Men's Health at University of Western Sydney

      In reply to Kate Rowan-Robinson

      There are several reasons why men's health receives less funding that women's health and these include: uncertainty about what exactly men's health entails in policy decisions; adherence to old stereotypes that work against males in policy makers; lower levels of advocacy about male health; and many others.

      The provision of funding for male health as part of the 2010 National Male Health Policy directed $3 million to men's sheds which is a sign of progress. It is important to understand why Men…

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    3. David Thompson

      Research Officer In Men's Health at University of Western Sydney

      In reply to Kate Rowan-Robinson

      There are several reasons why men's health receives less funding that women's health and these include: uncertainty about what exactly men's health entails in policy decisions; adherence to old stereotypes that work against males in policy makers; lower levels of advocacy about male health; and many others.

      The provision of funding for male health as part of the 2010 National Male Health Policy directed $3 million to men's sheds which is a sign of progress. It is important to understand why Men…

      Read more
    4. Chris O'Neill

      Telecommunications Engineer

      In reply to Kate Rowan-Robinson

      "During my short stint as a practice nurse I found it incredible how many men were on ED drugs such as Viagra, Cialis or Levitra, but had other health problems"

      Bear in mind that ED is very, very common. I have a rule-of-thumb hypothesis that the percentage of men of a certain age with ED is equal to their age.

      "men who have "tangible problems with tangible effects and tangible solutions" are more likely to seek help when they know something can be fixed with one visit to a GP and a pharmacist…

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    5. Kate Rowan-Robinson

      Kate Rowan-Robinson is a Friend of The Conversation.

      Registered Nurse/Sexology Student

      In reply to Chris O'Neill

      Thanks for your considered replies, everyone.

      Sue, I agree with you on stand-alone ED clinics. It would be preferable if their could be a referral system, just like there is to any other service.

      David, thank you for mentioning the Men's Shed movement. It was on my mind as I was typing my first reply and it has been incredibly valuable to mens health. Health care needs initiatives to ensure a safe environment for men to be able to share their problems without concern. Building rapport with…

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Kate Rowan-Robinson

      Kate - I agree with your overall thrust (so to speak) - but visiting a GP with an ED issue is likely to be a much more satisfactory consultation than going to a stand-alone ED clinic (where one is guaranteed to get a pharmacological solution).

      Many GPs know the person and their families long-term, and know about work and marital issues, blood pressure, diabetes etc etc. WHen this relationship exists, each consultation need not be long and detailed, because the knowledge is cumulative. Certainly no body of professional is perfect, but GPs do tend to have the most "holistic" view of their patients, amongst health service providers.

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    7. Sue Ieraci

      Public hospital clinician

      In reply to David Thompson

      Don't we need to know what everyone means by "men's health"? Is it only those conditions that occur only in men (prostate enlargement, testicular cancer, for example), or those conditions that occur more commonly in men?

      If it includes the latter, then there is certainly a lot of expenditure on coronary disease and chronic obstructive pulmonary disease.

      SHouldn't we fund health care according to overall population morbidity, rather than gender?

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    8. David Thompson

      Research Officer In Men's Health at University of Western Sydney

      In reply to Sue Ieraci

      Depends how long you've got Sue.

      No seriously, this is a good question. What is men's health and why is it important? OK, well, our view is that health is about the factors and contexts in which people (in our case, our interest centres on the contexts of men and boys) live, work and play and that health is a dynamic state shaped by many factors in a male's life. So it's more than about what diseases mmen suffer from and more than why they have lower life expectancy. That's the pathological view…

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    9. David Thompson

      Research Officer In Men's Health at University of Western Sydney

      In reply to Sue Ieraci

      "Shouldn't we fund health care according to overall population morbidity, rather than gender?"

      Yes, we should. But the difference between genders is something in the order of 6:1 in terms of (government) funding though slowly improving.

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    10. John Harland

      bicycle technician

      In reply to David Thompson

      With respect, that sounds like total nonsense, David.

      Can we have some figures on the ratio of spending on women's health relative to overall health spending? That is far more indicative than the ratio of specifically female to specifically male medicine.

      Also, we should separate out that proportion that relates directly to pregnancy and childbirth, because that is spending on pediatric welfare, not specifically on the women bearing the children.

      But how do we deal with the diseases of…

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  3. John Harland

    bicycle technician

    We will know we have arrived when "how-to" videos of older men checking themselves for prostatic enlargement screen alongside videos of young women checking for bumps in their breasts.

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  4. Chris O'Neill

    Telecommunications Engineer

    "While recently co-editing the book Aging Men, Masculinities and Modern Medicine, I was struck by the disproportionate attention given by researchers in the field of men’s health to issues such as erectile dysfunction, sexual enhancement, and testosterone treatments."

    Did you notice how the opposite applies (at least until recently) when it comes to the diagnosis and treatment of Prostate Cancer? There is a difference, of course, in that Urologists are normally not researchers and their work is surgery. And I guess the products you researched mainly did not include much surgery.

    It just shows that people including professionals place varying importance on issues depending on their circumstances.

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