The manosphere, a diffuse commercial ecosystem and loose collection of online communities united by shared beliefs about masculinity, misogyny, and male victimisation, is an under-recognised determinant of health harms. This network has been implicated in considerable health harms: widespread mental health impacts, especially in young people; violence against women, girls, and gender minorities; and delegitimising help-seeking in boys and men. In this Viewpoint, we argue that the manosphere is best understood and addressed as a public health problem.
Despite long-standing evidence of poor health and life expectancy outcomes among men, particularly among men who are socially or structurally marginalised, men's health has generally received little and uneven attention in health policy and practice. Its gendered and intersectional aspects have been especially overlooked. This third paper in the Lancet Men's Health Series examines why men's health has received so little policy attention and proposes strategies to raise men's health on national and global agendas. We applied a gender lens to the 3-i theory-based framework and analysed how ideas, interests, and institutions shape the prioritisation of men's health within national and global policy agendas. We review the modest development of men's health policies and assess how power and politics, including the roles of a range of stakeholders from global and national health spaces, commercial actors, and civil society organisations, have shaped the construction of the problem as well as policy attention and framing, resource allocation, and interventions. The scarcity of attention paid to men's health on global and national agendas reflects how power operates through ideas and institutions which contribute to the conflation of gender with women, institutional inertia, and contested constructions of individual versus structural drivers of ill health. We highlight how this has created a space in which commercial actors, including the manosphere, can shape narratives and influence men's health in ways that align with commercial or ideological interests. We conclude by proposing politically informed strategies that recognise how power, institutional arrangements, and competing interests shape men's health policy within prevailing gender and structural orders. We identify entry points for advancing men's health equity and wellbeing that draw on empirical evidence and technical guidance, are grounded in political realities, and are consistent with a commitment to gender justice for all people.
Males have lower life expectancies and greater disability-adjusted life-years (DALYs) than females, and particularly poor outcomes are seen among males in marginalised contexts. In this paper, we provide an epidemiological overview and highlight the intersectional nature of men's health. We analyse mortality and DALYs data from the 1990-2023 Global Burden of Diseases, Injuries, and Risk Factors Studies to illustrate our intersectional framework and draw attention to how health varies in men and to show key themes. Conditions that contribute most to the poor health of males include non-communicable diseases (eg, cardiovascular diseases and cancers), substance use, suicide, injuries (eg, road traffic incidents and interpersonal violence), and respiratory infections (eg, tuberculosis and COVID-19). Although cardiovascular disease and cancer make the largest contributions to men's higher mortality rates, determinants of health such as violence and war, migration, economic stagnation, and labour market changes due to automation and new technologies will disproportionally affect their health in the future. Injuries, violence, and other external morbidity causes often occur at a young age and in unequal distributions across the sexes, making a large contribution to DALYs. Although biology plays a role, the pattern of many diseases contributing to health differences reflects the intersection of health behaviours, shaped by patriarchy, ideas of masculinity, and structural drivers (including commercial determinants of health); many of these are preventable. Although improvements in some health behaviours are seen, exceptions occur in marginalising social conditions (eg, incarcerated men, men experiencing homelessness, men with mental illnesses, men with substance use disorders, men with low income, men who have sex with men, and those who are gender non-conforming). Multiple data sources detail men's shorter life expectancies and the drivers compared with women, but going beyond sex disaggregation remains challenging and is an urgent priority for research and health monitoring.
Men occupy a privileged position within gender power relations: the male body has been the default reference point for biomedical research and therapeutic development (with the historical exclusion of women from medical trials), and men dominate health services leadership and exercise well documented medical misogyny. Yet despite their privileged position, many aspects of men's health outcomes are neglected and undertheorised because they are not examined through an intersectional gender lens. Although consideration of gender and masculinity is important for understanding men's health, research thus far has focused predominantly on men's harmful health behaviours, overemphasising individual determinants of health, and a deficit-based approach. Little attention has been paid to the influence of structural determinants of men's health risks and vulnerabilities, or the gender-specific health outcomes of worsening social and economic inequalities. In this first paper of a Lancet Series on men's health, we present a conceptual framework for understanding men's health from an intersectional perspective, highlighting how structural, social, and commercial determinants of health, intersectionality, and syndemic theory can be combined to analyse men's health at different socioecological levels. We illustrate the framework using four selected case studies that show how the health outcomes of marginalised men are influenced by complex interactions. We provide a working definition of men's health that reflects existing literature and builds on the conceptual framework and case studies. Promotion of gender justice and health equity requires moving beyond one-dimensional approaches that construct men as problematic individuals, and towards better understanding and action on the broader set of power systems and structural determinants underpinning men's health.