HPQ191110.1177/1359105313490314Journal of Health PsychologyAnstiss and Lyons
Article Journal of Health Psychology 2014, Vol. 19(11) 1358–1370 © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1359105313490314 hpq.sagepub.com
From men to the media and back again: Help-seeking in popular men’s magazines David Anstiss1 and Antonia Lyons2
Abstract Men’s help-seeking behaviour for health issues is apparent in advice columns in men’s magazines. This study discursively analysed men’s help-seeking letters and expert replies within two international and popular men’s magazines, Men’s Health and For Him Magazine or FHM. Findings showed that the texts reinforced hegemonic ideals. Letters positioning men as self-reliant, independently knowledgeable, stoic and avoiding associations with femininity were positively reinforced in expert replies, while other types of positioning were responded to with condescension or ridicule. Results suggest the policing of boundaries by ‘experts’ around unacceptable/acceptable enactments of masculinity, which may have implications for if, how and when men seek help from experts.
Keywords help-seeking, hegemony, magazines, masculinity, men’s health
Introduction Courtenay (2000) has theorised that enactments of masculinity are based on power differentials and gendered social inequality, and are implicated in men’s participation in unhealthy or risky behaviour and their rejection of healthier practices. Hegemonic masculinities, specifically, are understood as patterns of practice that sanction men’s dominance over women (Connell and Messerschmidt, 2005; Lee and Owens, 2002), positioning men as superior to women and femininity as well as certain groups of men as superior to other groups of men (Courtenay, 2000). From this perspective, femininity and non-hegemonic masculine practices are marginalised and subordinated (Connell and Messerschmidt, 2005),
and men who fail to enact hegemonic practices or do not avoid stereotypical feminine associations may be described as weak and less masculine, and subject to criticism (O’Brien et al., 2009). Health, health behaviours and health care are traditionally aligned with femininity and are therefore devalued within hegemonic masculinities (Courtenay, 2000; Lyons, 2009). Men who acquire power and privilege through 1The
University of Waikato, New Zealand University, New Zealand
Corresponding author: David Anstiss, The University of Waikato, Private Box 3105, Hamilton 3240, New Zealand. Email: [email protected]
Anstiss and Lyons enactments of hegemonic masculinities (albeit unconsciously) may therefore reject admitting weakness or vulnerability regarding their physical (or emotional) health or any need for help (Courtenay, 2000). However, while hegemonic masculinities are positioned as normative, few men fully enact them although many are complicit in supporting them, and therefore, they remain an ideal standard of masculinity (Connell and Messerschmidt, 2005). Multiple versions of hegemonic masculinities exist (Connell and Messerschmidt, 2005) and can be expressed through different vehicles (Ricciardelli et al., 2010). However, some research shows that men participating in potentially hegemonic-violating behaviours manage this in ways that maintain their status in competitive hegemonic hierarchies. For example, older, rural New Zealand men have been found to negotiate dual (and competing) positions as masculine and also health-care users, maintaining their dominant status by positioning women as frequent and trivial users of health care and repositioning themselves as more honourable and legitimate users (Noone and Stephens, 2008). Likewise, younger men have been found to construct their health practices as legitimate through positioning themselves as independent, autonomous and in control of their bodies (Tyler and Williams, 2014). Research on men’s drinking behaviours also highlights how men ‘trade competence’ in one masculine arena for another, such as not drinking excessively (a traditional masculine behaviour) because of their sporting commitments (De Visser et al., 2009) or professional employment (Willott and Lyons, 2012). Men’s help-seeking behaviours are apparent in the abundance of questions submitted to advice columns in men’s magazines (Spalding et al., 2010). Magazines, in return, have catered to men’s help-seeking while also retaining conventional definitions of masculinity (Stevenson et al., 2000). Research suggests that men’s magazines are an arena rife with hegemonic reinforcement. For example,
1359 Spalding et al. (2010) found that advice in top-selling men’s magazines tended to revolve predominantly around sex and modelling (heterosexual) sex as a top priority and entitlement in men’s lives using hegemonic tenets of power, control and the objectification of women (Spalding et al., 2010). Ricciardelli et al. (2010) found that men’s magazines offer varying forms of hegemonic masculinities depending on the magazine’s target audience. Despite displaying differing forms of masculinity, each magazine advertised how the reader could attain superiority over women and other men through vehicles of sexual dominance, status symbols and muscularity (Ricciardelli et al., 2010). However, within this arena of hegemony and subordination, men do display anxiety regarding problems within their submissions to advice columns of men’s magazines, rather than enacting more traditional and invulnerable portrayals (Alexander, 2003). The current research was designed to explore the ways in which men participate in helpseeking regarding health-related issues within an arena that actively encourages hegemony, namely, popular men’s magazines. Men’s magazines have been instrumental in establishing a collective understanding of men’s social and health practices in the public domain (Stibbe, 2004) and are a site in which masculinities are performed and have the potential to influence consumers’ behaviours and attitudes (Alexander, 2010; Lyons et al., 2006). Advice pages in men’s magazines arguably provide social norms about masculinities (Spalding et al., 2010), providing guidance for some readers (Currie, 2001). Thus, advice pages provide a site in which it is possible to explore one specific instance of help-seeking by men within a hegemonic masculinity context. These letters, and their replies, also may allow some insight into culturally dominant help-seeking practices within anonymous settings and the ways in which multiple subject positions might arise and be negotiated by men and the people who reply to them (Jackson, 2005).
Method We assumed that letters to advice columns are written by readers themselves and not fabricated by editorial staff, as stated by the magazines. Postal and email addresses are provided for readers to send in their questions; published questions are often given with the writer’s mode of communication (whether by email, website or post). We do not know whether, or in what ways, the letters were edited for publication or how specific letters were chosen. Jackson (2005) argues that such issues are irrelevant since readers, including researchers, will read and interpret letters independent of the letter’s source. Readers may thus adopt or reject the positions taken by the letters and replies regardless of their authenticity (Jackson, 2005).
Men’s magazines Four international men’s magazines with letters and advice columns were initially selected for analysis, namely, For Him Magazine or FHM (Australian edition of UK magazine), Men’s Health (Australian edition), GQ (British edition) and Ralph (Australian edition). However, the focus of this analysis was on help-seeking for health-related issues; therefore, letters within GQ and Ralph – which focussed exclusively on sexual performance and fashion – were excluded from the data set Four months of magazines were collected over the Christmas period (November 2009-February 2010), providing 8 magazine issues in total. Description of the readership of each magazine are provided in Table 1, while descriptions of the advice columns are provided in Table 2 and discussed more fully in the following. FHM. Australia’s FHM focusses on women, drinking, sport and humour, using images of women as its primary selling point (Woods, 2009). FHM had three advice columns, Bionic Health, Life Coach and Love and Lust. Each included three to five letters and replies per issue. Letters were one to two sentences long and replies were
Journal of Health Psychology 19(11) Table 1. Male reader demographic data for each men’s magazine analysed.
Circulation (men and women) Readership (men and women) Male readers only Age (years) 14–24 25–34 35–49 50+ Socio-economic quintile AB C D E FG Work status Full-time Part-time Unemployed Education Tertiary education
38% 37% 21% 5%
22.5% 26.9% 33.2% 17.3%
16% 28% 24% 19% 13%
32.9% 24.7% 22.4% 11.7% 8.4%
65% 15% 20%
68% 13.0% 18.1%
Socio-economic quintiles (courtesy of Roy Morgan Research) are worked out by assigning survey respondent’s a score according to their status in the following fields: education, level of income and occupation. The frequency distribution of the scores is divided into five equal groups (quintiles): AB being the highest and FG the lowest. Sources: FHM International (2007), ACP Magazines (2009), Plunkett (2009) and Pacific Magazines (2011).
generally one paragraph long. Bionic Health typically occupied a double-page spread and included topics ranging from health to general workings of the body, dreaming, excessive sweating and acne. Life Coach followed a similar pattern. In these columns, readers’ questions were passed on to external experts and replies published among the commentary of the page’s editor. Men’s Health. The Australian Men’s Health, based on the US edition, presents articles on health, fitness, nutrition, sexuality and lifestyle. This magazine aims to model a high standard of physical attractiveness while also
Anstiss and Lyons
Table 2. Average lengths of letters and their replies, by magazine and column, across a 4-month period. Magazine
Letters and replies (number of texts)
Average letter length (number of words)
Average reply length (number of words)
Bionic Health Life Coach Love and Lust: FHM angels (November, December 2009) Love and Lust: Ask Sabrina (January, February 2010)
Various Various Jen, Steph, Anna and Eleanor
23 6 11
32 26 35
105 141 129
Men’s Health Compass
Dave the Barman Muscle Guy
The Doc is In/ Medicine Man Ask Men’s Health Girls in the Office
Dave the Barman Paul Haslam – lecturer in Human Movement at the University of Technology in Sydney Dr John Orchard – physician, works closely with the Sydney Roosters, Australian Football League and Cricket Australia Jacqueline Hellyer – sex therapist, relationship coach and tantra teacher Matt O’Neil – founder of body shape management website SmartShape.com.au Dr Steve Trumble – general practitioner Various Jannah, Hannah and Alyssa
encouraging the maintenance of all-round healthy lifestyles. Men’s Health has been criticised for potentially encouraging anxiety, eating disorders, compulsive exercising (Corner, 2000) and reinforcing notions of hegemonic masculinities in men (Crawshaw, 2007). Men’s Health included eight advice columns within two separate sections, labelled ‘Compass’ and ‘Manual’. Compass contained six advice columns, namely, Dave the Barman, Muscle Guy, Sports Doc, Sex Coach, Belly Burner and Medicine Man. Each advice column had an ‘expert’ who provided replies (e.g. academics, medical doctors) and was typically a quarter-page
column, containing between two and four questions/replies, headed with a photo or sketch of the advice giver. The remaining three-quarters of each page were taken up by articles relating to the topic of the subsection. Readers’ letters were represented by short questions (one to two sentences), while replies consisted of one to two short paragraphs. Manual contained two advice columns: ‘Ask Men’s Health’, half a page of questions with answers given by the editor and relevant experts, and ‘Girls in the Office’, typically three-quarters of a page with a panel of three women answering letters in regard to sex and relationships.
Journal of Health Psychology 19(11)
Table 3. Average lengths of letters and their replies, by theme. Theme
Letters and replies (number of texts)
Average letter length (number of words)
Average reply length (number of words)
Pain and injury Fitness General health Psychological health Nutrition
20 13 11 3 3
30 25 23 30 26
82 106 123 101 103
Analytic approach and procedure Discourse analysis was employed to analyse the printed letters and replies in advice columns. This approach aims to explore peoples’ constructions of self, as well as social action (Potter and Wetherell, 1995). We were particularly interested in specific subject positions apparent in the texts with regard to health and helpseeking. Discourse analysis views language as functional, achieving certain ends, such as not only sharing information but also persuading and legitimising (Elliot, 1996). It also views discourse as dependent on situation and contextually embedded (Potter, 2003). Discursive patterns sustain social bonds and power structures that confirm and reconfirm that the world is the way it is through circulation and repetition (Parker, 2005). Discursive patterns (or ‘discourses’) also provide subject positions for speakers and readers (Davies and Harre, 1990), who can resist, take up or reposition themselves in relation to the provision of these positions. Discourse analysis is ideal for investigating how discursive patterns and shared understandings of the world circulate and construct realities within society (Parker, 2005). For each magazine, all readers’ published letters or emails and their replies were copied word-for-word into a desktop word processor. Texts were grouped into themes to divide the data into more manageable clusters. The themes (followed by the number of letters/replies in parentheses) were pain and injury (20), fitness (13), general health (11), psychological health (3) and nutrition (3). Twenty-seven letters could not be coded into one of these themes due to their general or odd nature (e.g. ‘How
much further have humans got to evolve?’ (Men’s Health, November, 2009)) and were excluded from further analysis. A final database consisted of 47 letters and their replies. A discourse analysis was then conducted (Willig, 1999), and themes were read and reread; subthemes, patterns, metaphors, collections of sayings, figures of speech and common phrases were identified. Recurring predominant discursive patterns and practices were identified and then considered in terms of subject positions (Davies and Harre, 1990).
Results Five themes across the two magazines were identified, as shown in Table 3. The majority of the letters concerned pain and injury issues; the minority concerned psychological health and nutrition advice. The remaining letters and replies were discursively analysed, with a focus on the ways in which men sought help regarding health-related issues. Three discursive practices were identified across the five themes, which we have labelled as follows: (1) using medico-scientific jargon, (2) demonstrating stoicism and (3) distancing the feminine. Each of these practices is described in detail in the following, using quotes from the texts.
Using medico-scientific jargon In both help-seeker letters and expert replies, the use of medico-scientific jargon was evident. For help-seekers, this language positioned them as knowledgeable, demonstrating their ability – and right – to self-diagnose. Expert replies frequently appeared to come from a biomedical
Anstiss and Lyons position, although they did not always employ the jargon of the medico-scientific realm. Help-seeker letters were more varied and ranged from its very explicit use to its complete absence. Employing medico-scientific jargon appeared to be an effective way for men to communicate problems to experts and evade speculation of self-diagnoses. In response, experts’ replies reinforced this discourse by describing bodies in biomechanical terms and discussing issues in biomedical ways, which functioned to prioritise medical knowledge over lay opinion as shown in extract 1: Extract 1: Sports Doc (Dr John Orchard), Men’s Health, December 2009 I have chronic lateral (a decade) and medial (two years) tendonitis in both elbows as a result of weight training and mountain biking. How do I resolve this issue? It certainly wouldn’t be unreasonable to try surgery after all this time, but given that you could need four operations at two sittings a few months apart, even the most aggressive surgeon might be reluctant to cut you open. If you avoid surgery, the key is to find out what load your tendon can just tolerate and do that amount of loading as much as possible, until your tolerance goes up. The good news is that tendons almost always have the ability to heal, even after years of failure to do so.
Here, the help-seeker uses technical terms to describe injuries and their locations (e.g. lateral and medial tendonitis), thus demonstrating his medical knowledge and evading speculation about the accuracy of the self-diagnosis. Texts employing medico-scientific jargon were generally direct in ways that aided the formulation and delivery of advice. In extract 2, the helpseeker has diagnosed himself and suggests two alternative medically based solutions: Extract 2: Sports Doc (Dr John Orchard), Men’s Health, December 2009 I’ve sustained an ankle/arch injury playing cricket. I’ve self-diagnosed this online as tibialis
1363 posterior syndrome and have been wearing orthotics. Should I go to a podiatrist to get these updated or just buy some new runners and get physiotherapy instead? Orthotics will generally unload certain parts of the leg/foot during running movements, so they can cure many injuries. What is less admitted (at least by podiatrists) is that orthotics can possibly transfer load to other places. Generally, they unload the muscles and tendons that hold up the arch, including the tibialis posterior. So if this is indeed your diagnosis (it’s worth having this checked), a full set of orthotics from the podiatrist will probably help.
This expert’s reply challenges the help-seeker’s informal diagnosis by suggesting professional intervention, thereby reinforcing the dominance of medical knowledge over lay opinion (or information from the Internet, which practitioners do not necessarily view as legitimate (Broom, 2005)). Extract 3 provides an example of the absence of medico-scientific jargon; here, personal experience is prioritised, although this is constructed as secondary by experts: Extract 3: Sports Doc (Dr John Orchard), Men’s Health, November 2009 I play Aussie rules football and experience sore legs a couple of days after the match. What is the best method of recovery to reduce this – ice bath, a low impact activity or massage? Delayed-onset muscle soreness (DOMS) is very common, and all of your suggestions are probably helpful. Anti-inflammatory tablets reduce DOMS as well. If it is very severe and always in a specific part of your legs, you should get a professional consultation to assess for specific diagnosis (e.g. compartment syndrome of the calves, backrelated hamstring pain).
Here, the help-seeker is vague about his problem (sore legs), although three specific suggestions are posited for recovery. Using a three-part list in this way is a common rhetorical device to convey completeness (i.e. the help-seeker has thought of everything) and normality (Jefferson,
1364 1990), thereby positioning the help-seeker as displaying some form of overarching knowledge. The expert reply begins immediately with a technical term that can be applied to the helpseeker’s experience and provides an acronym for this term, which functions to create a feeling of ‘professional’ knowledge in contrast to the vagueness of the help-seeker’s letter. The expert states that the help-seeker’s own ideas on what to do are ‘probably’ helpful but reinforces the role of medicine by suggesting medication and seeking ‘professional consultation’ for a ‘diagnosis’. Using medico-scientific jargon appeared to be an effective way for many men to communicate with experts. Letters written in general or vague terms, or where diagnosis via the Internet was evident, were met with reinterpretation, being rephrased in biomedical terms in the expert replies, reinforcing the imperative for helpseekers to engage with the medical world.
Demonstrating stoicism Overt enactments of hegemonic masculinities were identified across many letters, particularly in those concerning pain and injury. Here, issues were presented as resulting from participation in stereotypically masculine activities, such as weight lifting and intense physical workouts. While asking about treatment, men demonstrated stoicism by sharing how they continued to undertake activities that caused them (sometimes extreme) pain or discomfort, as shown in extract 4: Extract 4: Sports Doc (Dr John Orchard), Men’s Health, January 2010 I’ve been running for four weeks and have had intense shin pain every day. What can I do to help recover from it? If it’s typical ‘shin splint’ pain on the medial (inside) parts of the shin, the best treatment is arch supports in your shoes (orthotics, motioncontrol shoes or arch taping). If it’s on the front or outside of the shin, it’s more likely you might have chronic compartment syndrome. In the first
Journal of Health Psychology 19(11) instance, this would be treated with short-term rest, then breaks in-between runs so you are not running continuously.
This help-seeker states that his shin pain during running has been ‘intense’ and frequent (‘every day’), demonstrating his stoicism in that he has continued to run every day. The expert’s reply does not admonish or even comment on the continued exercise or level of pain but advises ‘short-term’ rest before continuing the running with arch supports. Where letters did not explicitly demonstrate stoicism, some replies encouraged the help-seeker to continue with activities that caused injury, as shown in the following extract 5: Extract 5: Sports Doc (Dr John Orchard), Men’s Health, January 2010 I’ve injured my sternum after a chest workout. My GP thinks it’s where the rib meets the sternum and that the cartilage is inflamed/damaged. Is there anything you recommend? We see this injury occasionally in sports medicine and it is tough to treat. It’s probably a type of stress fracture between the rib cartilage and sternum, which is bone. It’s more common in younger athletes when there are extra growth plates around the sternum. Longer term rest may fix it and active stimulatory treatments (ultrasounds and similar machines at the physio) may heal it. The best news is that it shouldn’t get worse. If the pain is bearable, you can just train through it.
Here, the expert notes that ‘longer term rest may fix’ the injury but goes on to advise training through it ‘if the pain is bearable’. This implicitly constructs the bearing of pain (a demonstration of stoicism and masculinity) as having priority over healing injury. Ceasing activity due to injury and discomfort was sometimes actively admonished by some experts, as shown in the following extract 6: Extract 6: Bionic health, FHM, January, 2010 When I run long distances, my calves always get cramped, which means I can’t run for a week after
Anstiss and Lyons that. Why does this happen; am I doing something wrong? Should I just stop running altogether? Personal trainer Nick Mitchell is not a happy man. ‘Don’t be silly’, he says. ‘Unless you have a pre-existing injury causing you to run incorrectly, there’s absolutely no reason for you to not run because of muscle cramps’. A cramp occurs when a contracted muscle fails to relax due to what is called hyperexcitability of the nerves of the muscle – basically when you subject the muscle to an undue level of stress of stimulation. ‘This is the most likely cause in ****’s [name withheld] case, although you also need to ensure adequate hydration and intake of potassium and magnesium salts. A good sports electrolyte drink can take care of this as a potentially limiting factor’, he says.
Here, the help-seeker does not mention pain explicitly but implied it through the use of the word ‘cramped’, suggesting perhaps an unwillingness to openly label discomfort as pain. The reply describes the expert as ‘not a happy man’ due to the help-seeker’s intolerance to discomfort. It appears that discomfort resulting from muscle cramps does not provide sufficient reason to prevent a man from running (even if he feels he cannot run for a week afterwards). The expert’s quoted speech draws on a traditionally feminine referent (silly, see Bem, 1974) to criticise the help-seeker. Stopping running due to discomfort is aligned with failure to adhere to the stoic tenets of hegemonic masculinity. This analysis suggests that men were frequently positioned as needing to be stoic, ignoring pain and discomfort and resisting displays of vulnerability. Some of the expert replies demonstrated insensitivity to issues and reprimands for suggesting the discontinuation of activities due to discomfort, reinforcing findings that many men struggle to get appropriate recognition of issues from experts (O’Brien et al., 2005).
Distancing the feminine In some cases, letters and replies constructed a clear avoidance or distancing from femininity
1365 by demonstrating a disdain for ‘feminine’ concerns such as nail grooming or diet. For example, in extract 7, the help-seeker explicitly constructs nail parlours as ‘girly’, and the expert reply reinforces this by suggesting that ‘manhood’ disappears when a male enters such a feminised space: Extract 7: Bionic Health, FHM, November 2009 The skin on the back of my hands is dry and painful. Do I need to take a trip to a girly nail parlour or are there some home remedies? Either way, prepare to leave your manhood at the door. ‘A good quality manicure will deal with cuticle dryness, as a nail technician will apply a hand moisturiser at the end’, says Maria Epiphaniuo, therapist at a trendy bloke’s grooming salon. But if you can’t bear to leave the house on such a mission, have a go yourself, as Maria explains. ‘Use a homemade mask by slightly warming up some olive oil and soaking your hands in it. Follow this by wrapping the hands with cling film, and then wrap them in a damp, hot towel for 10 minutes’. When you’re done, why not chop your own gonads off?
In this reply, the help-seeker is chastised for raising an issue that is viewed as stereotypically feminine, which involves (female) vanity about a feminised part of the body: the hands (Motchenbacher, 2009). The reply implicitly denigrates the men who attend salons, who leave their ‘manhood at the door’, while the humorous reference to castration positions them as less than masculine. Texts regarding healthy eating also distanced help-seekers from femininity, though in more subtle ways. Specifically, texts explicitly positioned readers, who were concerned about nutrition, within a space of athletic performance. In doing so, help-seekers were distanced from being concerned about nutrition associated with good health or dieting. In this (hegemonic) context, such positioning is not surprising given links between femininity and healthy eating (Lyons, 2009). Requests for nutrition advice may suggest a shift in men being able to express
1366 concern about food and calorie intake in legitimate ways (Grogan and Richards, 2002), such as through the lens of high-performance sports, as shown in extract 8: Extract 8: Belly Burner (Matt O’Neil), Men’s Health, November 2009 I have a 24-hour mountain-bike race coming up. I sweat a lot. What is the best way to replace my energy, powder/gels, sports drinks or proteincarb bars? These are all good energy options for endurance sports. It would be good to consume them all over the 24-hour period for variety. Sports drinks are a must, especially if you sweat a lot, because they help replace fluid faster than water alone. Your targets are about 50 grams of carbs per hour, which is 600 millilitres of sports drink or less if you have solid food and water. Choose what suits you individually. Lastly, monitor your sweat loss in training by weighing yourself before and after a workout, so you know how much fluid to replace.
Here, the text positions the help-seeker as an endurance athlete (demonstrating a form of hegemonic masculinity), placing his dietary needs as a performance issue (rather than healthy eating). The expert’s reply legitimises these constructions, leaving them unquestioned. The helpseeker’s suggestions are commended as ‘good energy options’ and he is advised to monitor his own body through training, placing him in the ‘expert’ position. The prioritisation of performance-oriented eating at the expense of healthy eating may be a way of distancing food intake from femininity (Sloan et al., 2010) and therefore a way of enacting hegemonic masculinities. However, in extract 9, the help-seeker is requesting advice about the nutritious value of vegetables and his concern over kilojoule content: Extract 9: Belly Burner (Matt O’Neil), Men’s Health, November 2009 How nutritious are vegetables like capsicum and onion? I much prefer them to greens, but worry that they have a higher kilojoule content?
Journal of Health Psychology 19(11) All vegetables are good. Each type or colour tends to have specific antioxidants and protective chemicals. Red capsicum has lycopene, which reduces your risk of prostate cancer. Onions have quercetin, which reduces inflammation. Green leafy veggies are packed with vitamin C. That’s why we nutritionists push the variety angle, so you can get a variety of nutrients. Potatoes and corn are the starchy veggies; almost all others are low in kilojoules.
Here, the first sentence of the help-seeker’s text explicitly positions the help-seeker as adverse to eating vegetables, particularly green vegetables. This is consistent with research linking ‘real’ men (as portrayed in popular news media) with diets that are high in meat, particularly red meat, and low in fruit and vegetables (Gough, 2007). Interestingly, the primary concern of the text then shifts to reducing the kilojoule content of food, potentially associating the help-seeker with the feminised realm of dieting (Gough, 2007). The concern over kilojoule content is legitimated by the expert, who suggests some vegetables to avoid (‘potatoes and corn are the starchy veggies; almost all others are low in kilojoules’) but who also encourages the consumption of a variety of vegetables for healthy eating. This, again, suggests a shift in men being able to express concern about their weight and food intake in legitimate ways (Grogan and Richards, 2002). Perhaps there is a softening of traditional masculinities in which concern for health and diet is increasingly valued, similar to recent research that has found some softening around masculinity in American football when it concerns head injury (Anderson and Kian, 2012). Anderson and Kian (2012) suggest that expressions of pain may be increasingly acceptable in young athletes and also that traditional masculinity may no longer necessarily require the sacrifice of men’s health for the sake of sport. Perhaps there is a softening more generally, such that (particularly young) men can negotiate acceptable masculinities around more feminine foods and weight concerns in trying to achieve health. However, this extract could also be seen as demonstrating the health-seeker taking active control of their diet and thereby
Anstiss and Lyons reinforcing traditional masculine attributes such as agency, control, responsibility, independence and autonomy.
Discussion Published help-seeking letters and replies drew on a number of explicit discursive practices, which reinforced hegemonic ideals. Male helpseekers who positioned themselves as selfreliant, independently knowledgeable, stoic and as avoiding associations with aspects of femininity were positively reinforced through expert replies. Conversely, letters that did not adhere to these tenets were shown to be in breach by expert replies, which were condescending or ridiculing. Thus, the letters and their replies can be seen as a site where the boundaries of acceptable masculinities in a help-seeking context are being policed. This is consistent with Campbell’s (2000) notion that masculinities are ongoing performances requiring (re)enactment and ongoing defence. In seeking help, many of the letters drew on ‘medico-scientific’ terms and jargon, allowing help-seekers to position themselves as independently knowledgeable. Replies were responded in similar terms but prioritised consulting a health professional over any other form of helpseeking or personal assessments. Asserting medical and health practitioner authority over readers’ bodies is an example of the ‘lens of medicalization’ in practice (McCabe, 2005). Nevertheless, informed and knowledgeable help-seekers (as opposed to vague help-seekers) seemed to gain some power in this context. This is resonant with previous research with men with prostate cancer, in which self-directed investigation of prostate cancer and the learning of relevant medical terms facilitated men’s communication with medical professionals. In turn, this afforded male patients both independence and active involvement in treatment decisions (Ollife and Thorne, 2007). Demonstrating forms of stoicism was also a key feature across many of the letters and replies in the magazines. Stoic ideals are a central
1367 feature in many Western masculinities (O’Brien et al., 2005; O’Neil, 2008). Both letters and expert replies constructed men as needing to be stoic, to ignore pain and to resist displays of vulnerability. Some of the expert replies even demonstrated insensitivity to issues and reprimands for suggesting the discontinuation of activities due to pain, suggesting that men may struggle to get appropriate recognition of issues from experts (O’Brien et al., 2005). Consistent with previous research, these findings also demonstrate that distancing oneself from women, and from femininity, was one way in which both help-seekers and experts enacted masculinities (Campbell, 2000; Courtenay, 2000). Feminisation was used as a means for men to undermine other men’s enactments of masculinities (Campbell, 2000). Some medical practitioners hold unfavourable views of male patients (Seymour-Smith et al., 2002), draw on health stereotypes of men to justify asserting control within consultations, use strategies to maintain expert status in face-to-face interactions and feminise men who perform masculinities differently (Broom, 2005). Several themes were notably absent from the advice columns, namely, letters regarding sexual and emotional health. Farrimond (2012) has suggested that certain types of issues may be more easily disclosed by men than others and that a taboo may exist around seeking help for issues that may threaten masculine identity, such as testicular and prostate issues. These issues may also be considered taboo by readers of men’s magazines, discouraging them from asking for help in such a context or discouraging editors to publish such letters. Some men may construct themselves through formulations of hegemonic masculinity to defend themselves while performing stereotypically feminised behaviours (Gough, 2007). However, Farrimond (2012) suggests that too much emphasis is placed on specific values and practices attached to hegemonic masculinity. Thus, men may negotiate identities of health and masculinity according to the context they are in (Farrimond, 2012). It may not matter
1368 what men do (i.e. asking for help), as long as they are able to be positioned as powerful in doing so (i.e. by competing for power with experts). A teasing apart of hegemonic practices and values from hegemonic identities may shed light on the malleability of hegemonic masculinities, particularly in regard to carrying out health behaviours. The current results have implications for how men are viewed in the literature and in practice. While men are often framed as reluctant to use health-care services due to enactments of masculinity, men’s expectations of criticisms in reaction to disclosure may play a part in whether men choose to disclose issues to practitioners, how they disclose (i.e. choosing disembodied forms over face-to-face consultation) and how long they take in doing so. Expectations of criticism may also play a pivotal role in whether or not men seek help for issues that are considered socially taboo, such as sexual and emotional health or those linked with feminine worlds. Future research across other domains would help provide insight into potential challenges faced by men and the complex negotiations and performances they may have to engage in when seeking help. The men who typically buy FHM and Men’s Health are a relatively privileged group (employed, middle class). The emphasis of these magazines (men’s lifestyle and the male body) creates a particular environment in which certain discursive practices are more likely to emerge than others. It is likely that editors select and reinforce particular discourses and discursive practices that suit their magazines and their readers, which may explain why we found such hegemonic-oriented discursive practices. How readers interpret these texts, whether they accept (or reject) the constructions and positions evident in the letters and replies or how they engage with the help-seeking pages in men’s magazines requires further research. Seeking help in relatively anonymous ways, such as emailing men’s magazines, may be ‘safer’ for men. Help-seeking via the internet, given its relatively anonymous nature and
Journal of Health Psychology 19(11) increased accessibility for many, may also be a useful tool for initial help-seeking steps. Funding This research received no specific grant from any funding agency in the public, commercial or notfor-profit sectors.
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