Researchers are focusing on a factor that makes aging harder for men: having to let go of their sense of masculinity.
That sense includes things like the need to be strong and stoic, or that it’s weak to ask for help. The trouble is, such ideas are a bad fit with the realities of old age, leaving many senior men poorly equipped to handle the challenges that come with growing frailer, retiring, losing a spouse or even needing to disclose their ailments.
“I hate to say it, but the way the traditional model of masculinity was written was for boys up to the age of adulthood,” says Edward Thompson, 71, professor emeritus of sociology at the College of the Holy Cross and a leading researcher on elderly men and masculinity. “Clear models of dignified masculinity are nonexistent for later life.”
Women, of course, carry the burden of their own cultural issues that can make aging hard, such as society’s emphasis on youthful beauty. But in contrast to men, many of the gender norms for women are sources of strength in later years, experts say, such as greater experience taking care of themselves and others, and the ability to form deep relationships and accept vulnerability as natural.
As doctors and therapists become more aware of the ways that aging challenges masculinity, many are using that knowledge to improve the health of senior men. For example, some will encourage older male patients to pay greater attention to health care as a way to retain or regain strength or be better providers for their families, says Jean Bonhomme, a physician in Atlanta who is on the board of advisers of the nonprofit Men’s Health Network, and founder of the National Black Men’s Health Network. Such strategies are presenting “health care as an ally to make men feel more like a man,” Dr. Bonhomme says.
What follows are a few traditional ideas about masculinity that can interfere with good health for older men, and how some men are redefining what it means to be manly in later life.
Having a fit, strong body is a central tenet of masculinity, experts say.
“A man’s body is expected to be a performative machine,” says Michael Addis, a professor of psychology at Clark University. “It’s not supposed to break down. And if you’re ashamed of what’s happening because it‘s against your notion of what it means to be a man, that adds to the stress of aging.”
Dr. Addis has written extensively on masculine norms and is only 52 years old. But he says that even he sometimes has to fight the mind-set that aging and masculinity are at odds.
“When I have knee-jerk reactions, like ‘I’m so lame, I can’t even lift a pencil anymore,’ I stop myself and say, ‘Wait a minute, it’s not that I’m not a man. It’s hard not to do the things you used to do, but geez, ease up.’ ”
Men don’t have to let go of feeling physically fit in old age, Dr. Addis says. They can still be incredibly fit into their 60s and 70s or later, he says. “It’s OK to challenge yourself. But adjust your expectations.”
One way that younger men demonstrate their strength and toughness is by taking risks. A 2000 review in the Journal of Men’s Studies found that men are more likely than women to engage in more than 30 behaviors that increase the risk of injury, illness and death, including smoking and heavy drinking, playing sports with high injury rates and driving without seat belts.
As people get older, however, the body lacks the same healing powers it once had. Thus, risk taking becomes downright reckless in older men.
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One way to break out of this cycle and still maintain pride in one’s masculinity is by substituting risk taking with another, less punishing, male ideal, says Julie Gast, a professor at Utah State University who studies men’s health behaviors.
As an example, Dr. Gast says that one of her retired male colleagues recently announced a bittersweet milestone: He had hired someone to do his snow blowing. “He said, ‘With my back at my age, I’m not going to put myself at risk. I won’t be good for anybody if I do this.’ ”
In other words, Dr. Gast says, he pivoted from displaying strength through risky behavior to focusing on his responsibility as family protector.
Experts agree that for men, leaving work is one of the most difficult parts of aging.
“Work is a very masculine experience,” says Dr. Thompson, adding that for many men, feelings of self-worth are strongly associated with a sense of achievement and of being recognized in the workplace. “For older men it was the one masculine space if you needed respect,” he says. “And for everyone, it’s competitive, even if only with yourself.”
Barry Walsh retired two years ago as chief executive of the Bridge, a large provider of social services for people with mental illness and developmental disabilities in Worcester, Mass. He now works part time at the organization providing therapy, training staff and consulting.
“Retirement feels as complicated as adolescence,” Dr. Walsh says. Among other things, there’s a big loss of status and influence. When he was CEO, he says, if he needed something in his office it arrived instantly. Recently, he says, it took three weeks to get a lightbulb replaced in his office. “I understand it, but I notice it,” Dr. Walsh says of the difference in his status.
Dr. Thompson emphasizes the importance of encore careers or volunteer work to keeping older men satisfied with life—and healthy. He points to retirees who teach part-time at vocational schools, or form consulting companies with friends, or take active roles in nonprofits. “It affirms their masculinity,” he says. “Even if they don’t need the income, they thrive on the environment, the achievement and the respect.”
We all know men who hate asking for directions. It turns out their aversion to asking for help extends to health professionals.
A 2011 paper in the Journal of Health and Social Behavior found that among 1,000 65-year-old men, those with strong masculinity beliefs were half as likely to receive preventive health care as those with more moderate masculinity beliefs. This was true even among men with high levels of education.
Experts say visiting a doctor is hard for men who value independence and self-reliance. It requires admitting vulnerability and then sacrificing control.
Some older men, however, take a different approach. They motivate themselves to make appointments with doctors by emphasizing the masculine norms of being proactive, of taking control, and not letting medical problems beat them.
“They say, ‘Yeah, you get help and take your medicines, that’s what men do because you’re responsible for your wife’s well-being, too,” says Dr. Thompson. Thus, seeking help preserves “masculine capital,” rather than threatens it, he says.
Many of today’s older men were taught to be like John Wayne, to be stoic and strong, and to not reveal their weaknesses, worries and emotions. But when they lose a spouse, or experience other losses, how do they grieve?
“If you spend your whole life stifling emotions and get to the point you’re alone, are you going to be able to share your despair with others? No, you don’t have the skill set,” says Dr. Walsh.
Researchers agree there’s reason for concern. A 2016 meta-analysis in the Journal of Counseling Psychology found that men who conform strongly to the masculine norm of self-reliance have higher rates of depression and other mental-health problems. Moreover, they are less inclined to seek treatment for them.
But many men are subtly adapting here, too. Dr. Thompson relates one colleague’s story about a widower who said he’d learned it’s really OK to cry and grieve: ‘I just have to figure out where to do it,’ ” the widower said.
His experience, says Dr. Thompson, shows that “masculinity still resonates, but it’s being applied in different ways.”
Ms. Linden is a writer in New York. Email her at reports@wsj.com.
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