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The tougher men think they are, the less likely they are to be honest with doctors

Men, who die on average five years earlier than women, prefer male doctors, but are more honest with female doctors

Rutgers University

Men are less likely than women to go to the doctor, more likely to choose a male doctor when they do go, but less likely to be honest with that doctor about their symptoms, Rutgers psychologists have found. The researchers believe this may contribute to men's dying earlier than women.

"The question that we wanted to answer was, why do men die earlier than women?" said Diana Sanchez, associate professor of psychology in the School of Arts and Sciences. "Men can expect to die five years earlier than women, and physiological differences don't explain that difference."

Sanchez and Mary Himmelstein, a doctoral student, have published studies in Preventive Medicine and The Journal of Health Psychology describing their research.

Himmelstein and Sanchez found that men who held traditional beliefs about masculinity - that men should be tough, brave, self-reliant and restrained in their expression of emotion - were more likely to ignore medical problems, or at least put off dealing with them, than women or than men with less traditional beliefs. They were more likely to choose a male doctor, based on the belief that male doctors were more competent than female doctors. Paradoxically, however, the researchers discovered that men, having chosen a male doctor, were less likely to be open with that doctor about their symptoms.

"That's because they don't want to show weakness or dependence to another man, including a male doctor," Sanchez says.

Ironically, the researchers found, men tend to be more honest about their medical symptoms with female doctors, because, Sanchez theorizes, to be honest about vulnerabilities causes them no loss of status with women.

For their study, reported in Preventive Medicine, Himmelstein and Sanchez asked participants - about 250 men -- to fill out an online questionnaire designed to elicit their opinions about manhood and relative attributes of men and women. The participants also answered questions about doctor preference. The higher they scored on the masculinity scale, the more likely participants were to prefer a male to a female doctor. The researchers then recruited 250 male undergraduates at a large public university and had them fill out similar questionnaires. Each subject was interviewed by male and female pre-medical and nursing students about their medical conditions. The interviews took place in clinical examining rooms, and the interviewers wore white coats. The higher the subjects scored on the masculinity scale, the less likely they were to discuss their symptoms frankly with the male interviewers.

In the research published in The Journal of Health Psychology, Himmelstein and Sanchez interviewed 193 students (88 men and 105 women) at a large, public university in the northeastern United States, and a separate sample of 298 people, half men and half women, from the general population. They found, as they expected, that men who held strongly traditional opinions about masculinity were less likely to seek medical help, more likely to minimize their symptoms and suffered worse health outcomes than women and men who didn't share those opinions. However, they also discovered that women who thought they should be brave and self-reliant - according to their responses on questionnaires -- were less likely to seek treatment, more likely to put off seeking medical help and less likely to be forthcoming with their doctors than women who did not hold bravery, toughness and self-reliance as core values.

Self-reliance, therefore, seems to be dangerous to one's health, regardless of gender.

"It's worse for men, however," Himmelstein says. "Men have a cultural script that tells them they should be brave, self-reliant and tough. Women don't have that script, so there isn't any cultural message telling them that, to be real women, they should not make too much of illnesses and symptoms."

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