Often symptoms that cannot be seen visually or confirmed by a test, can be discredited by those around us and even medical professionals. Stigma around chronic pain is high; we are too often brushed off, our symptoms not taken seriously or viewed as though the pain is just in our head.
Interestingly, stigma around chronic illness is prevalent in both genders in different ways; where women are more likely to face stigma from medical professionals, men are more likely to face stigma from society and from their own perceived beliefs which our society has taught them.
Men are less likely to seek help
Men are far less likely to report chronic pain symptoms than women, as stated here, “women are more likely to report chronic pain than men (34.3% vs. 26.7% in a nationally representative sample in the US)” While there are various theories about how chronic pain affects men and women differently, this doesn’t necessarily mean that men are experiencing less chronic pain; they are simply less likely to seek help for it.
Men often feel that they need to appear masculine and strong, worried that chronic pain shows weakness within them. This study states that, “The social construction of masculinity acts as an important influence on health and illness, and one that may both prescribe and limit men’s lives.” Essentially the traditional, stereotypical ‘role’ of a man needing to be masculine can get in the way of men feeling that they can’t reach out for help.
Instead of trying to treat their chronic pain, men are more inclined to hide how it’s affecting them. This study explains this aptly saying, “Adherence to patriarchal masculine characteristics, such as superiority, independence, self-reliance and dominance, may also act as a barrier to men appropriately accessing and using health services.”
The stigma that surrounds chronic illness as a whole and the lack of pain education of medical professionals is enough to put someone off from seeking help. When you combine that with the feeling that having a chronic illness is less masculine, things become even more difficult.
Having chronic pain can affect an individual’s ability to work, to function, to exercise and to perform sexually. Men often feel that they ‘should’ be able to do these things, and that not having that ability is ‘embarrassing’ or ‘not manly’.
This self-stigma is often worse than the stigma they may receive from doctors or loved ones; it’s a sense of catastrophizing and distorted self-perception that can be devastating. This study focused on fibromyalgia in males and found that, “The respondents flagged the reason for not going to an HCP (health care provider) right away was due to the potential of misdiagnoses or dismissal of male FM patients, citing a general societal belief that a man needs to seem strong and “tough it out.”
Stigma impacts both men’s physical and mental health
Even when men do have a diagnosis, they often try to outwardly minimize how it is affecting them in order not to appear ‘weak’. This study on gout in men, which is a type of arthritis, found that, “shame, embarrassment, and stigma lead to trivialization of the impact of disease despite its severity.”
Often this inclination to ignore symptoms, can mean that their physical health deteriorates.Conditions that could have been controlled instead progress and worsen. The gout study explains that, “These experiences may lead to undertreatment of gout because of lack of disclosure of symptom severity and lack of expectation of treatment effectiveness, which in turn could contribute to the development of progressive gout.”
This doesn’t only affect physical health, but also has an impact mentally. Stress of trying to keep up with their usual ‘role’ can cause anxiety and depression, in turn fuelling the pain and stress cycle. Anxiety about letting other people see their pain can mean that men in this situation feel incredibly alone.
Older generations of men are more likely to seek treatment
Men in older generations who have grown up with this intrinsic role of masculinity are often more inclined to be affected by this reluctance to ask for help, although interestingly as these men age and view themselves as old, anxieties about asking for help seem to lessen.
This study concluded that, “aging and retirement seemed to lessen men’s anxieties about the implications of arthritis and reduce concerns about meeting societal expectations about strength and independence.” Older men are more likely to reach out for help, to accept chronic pain and other health issues, as they view it as a regular part of aging.
Male stigma in the doctor’s office
In the doctor’s office, stigma as a whole around chronic illness can result in poor medical treatment; when we factor in this male stigma, this poor treatment is often amplified.
Sometimes doctors will struggle to understand what a man is going through because even if they do attend an appointment, they are less likely to go into detail about what they are struggling with. This does not imply that this is the man’s fault, instead it’s about how doctors are taught to treat chronic pain patients both male and female: it’s their job to diagnose and treat pain patients accurately and with compassion. This study explains that, “health system staff may need resources to better understand the narrative of male patients, in order to more accurately interpret symptom descriptions and nonverbal messages” Doctors may be reluctant to diagnose a man with a chronic illness which is thought of as a ‘woman’s illness’ as explained here.
What can be done about this stigma?
Fundamentally the system needs to change. Medical professionals need more in depth and accurate education about chronic pain conditions and appropriate treatments. They need training in how to approach patients who present with chronic pain as well as how to treat men specifically. This study states that, “HCP (Health care provider) education and training need to move beyond the traditional sense to better incorporate comprehensive men’s health, including content in pathophysiologic, psychosocial, communication and treatment considerations relevant to the needs of male FM (fibromyalgia) patients”.
No one, regardless of gender, should fear seeking medical help. No one should be brushed off or dismissed, made to feel less than or left to suffer in pain that could be reduced or even cured. Whether someone is male or female, gender fluid or non-binary; however, somebody identifies, they are valid and this needs to be understood in all walks of life. Gender should not influence the right we have to good health care.
Education must also begin in schools, starting from the younger generations so that they understand chronic pain and not only that, so that boys grow up into men who understand that emotions are valid, that masculinity is fluid and that everyone is an individual, without this pressure from society to fit into a certain role simply because of the gender they were born into. By educating children about how to be compassionate, how to be comfortable being who they are and how to understand chronic illness, mental illness and disability, we are actively creating a more supportive society without stigma.
We can also educate ourselves; it’s never too late to learn about chronic pain and the science behind it. Whether we’re trying to get a general understanding, learning to support someone we love or seeking insight into our own condition, there are blogs, articles, studies and videos online that can help us to self-educate.
Self-stigma can be tackled through this self-education, by building confidence through counselling and mindfulness techniques and connecting with others who understand what you may be going through.
Support groups and charities do amazing work to break down this stigma and raise awareness; there may be support groups within your community that you can join to find people who really understand what you are going through. You can often find support online through social media, people from across the world who are going through the same struggles as you.
Battling stigma is something that we can all get involved in. The more people speak out and tell their story and even the story of others, the more awareness will be raised. You could speak to those around you, speak up at work, write a blog or an article, make a video or run an event to talk about the gender bias in chronic pain conditions.
Being there for others without judgement is something that every single person can do to fight stigma. Raising your voice if you hear someone using stigmatizing language and explaining why this is wrong, can make a bigger impact than you think; what you think might be a small action can mean the whole world to someone else, and can encourage others around you to follow suit.
Although as a society as a whole we are growing in understanding and acceptance of chronic illness, there is still a lot of work to be done to break down this stigma. Nobody should be left to feel alone in their chronic pain or feel unable to seek treatment. Nobody should be dismissed when they do get up the courage to seek help for their pain. More access to appropriate treatments and support is vital so that we can show people that they can be chronic pain free, and that they don’t have to suffer in silence.
- The Medical Journal of Australia, James A Smith, Annette Braunack-Mayer, Gary Wittert,(2006), “What do we know about men’s help-seeking and health service use?”
- D. Andrew Tompkins, J.Greg Hobelmann, Peggy Compton, (2018), “Providing chronic pain management in the “Fifth Vital Sign” Era: Historical and treatment perspectives on a modern-day medical dilemma”
- Journal of Clinical Rheumatology, Volume 17, Issue 1, p 1-6, Lindsay, Karen MBChB; Gow, Peter MBChB, MD, Vanderpyl, Jane PhD., Phillip MBChB, MD; Dalbeth, Nicola MBChB, MD, (2011), “The Experience and Impact of Living With Gout: A Study of Men With Chronic Gout Using a Qualitative Grounded Theory Approach”
- Generations, Number 1, pp. 78-81, Lisa Gibbs, (2008), “Men and Chronic Arthritis: Does Age Make Men More Likely to Use Self-Management Services?”
- American Journal of Men’s Health, Daenuka Muraleetharan, MS, Ana Fadich, MPH, CHES, Colin Stephenson, Whitney Garney, PhD, MPH, (2018), “Understanding the Impact of Fibromyalgia on Men: Findings From a Nationwide Survey”
Please note: This article is made available for educational purposes only, not to provide personal medical advice.