Fragile masculinity has been haunting society since its very beginning, shaping habits, ideologies, and prejudices, such as homophobia and sexism. The term is used to describe men who experience anxiety when they feel like they aren’t meeting traditional cultural standards of manhood.
A study from the University of South Florida, published in the Journal of Personality and Social Psychology as “Precarious Manhood“, explains that many men feel masculinity is something fragile, something they can lose if they don’t constantly prove it.
Of course, it’s a sociological phenomenon that affects multiple spheres of society. But we need to talk about what happens when fragile masculinity goes beyond social boundaries and begins to affect men’s health as well.
What is masculinity and why is it treated as something to defend?
Masculinity isn’t something we’re born knowing. It doesn’t come written in our DNA or tied to any specific biological trait. What we call “masculinity” is something we learn while growing up, through family, school, friendships, movies, and the countless messages the world sends about how a man is “supposed” to act.
A man should be strong, unshakeable, and always in control. A man must provide, protect, and never show softness. Crying or being vulnerable? Off-limits. Society builds this narrative. The problem lies exactly in these kinds of statements.
A real-life example of this is the new Superman movie, directed by James Gunn. The film received a wave of criticism (mostly from men) for portraying the world’s strongest superhero in a more sensitive and emotionally aware way. And that reaction itself says a lot. When even a fictional alien who can lift planets is “not allowed” to show vulnerability, what does that say about the expectations placed on real men?
And when it comes to health, this pressure becomes even bigger: many men avoid routine exams simply because the idea of another man touching their body feels like a threat to their masculinity. And of course, this fear isn’t only about fragile masculinity. It also shows how society still perceives homosexual men as somehow “less masculine.”
What the stats say about men’s health
According to research published in the World Journal of Surgical Oncology, prostate cancer (PCa) is the second most common cancer among men worldwide. In 2022 alone, there were roughly 1.5 million new cases and about 397,000 deaths caused by the disease. Projections also indicate that global prostate cancer cases may double by 2040, rising from an estimated 1.4 million in 2020 to nearly 2.9 million cases per year.
And the risks aren’t only physical; they exist on an emotional level as well. A recent 2024 study from the University of Zurich identified subgroups of men who, by strongly adhering to traditional male role models, show a significantly higher risk of suicide.
What a urologist wants you to know
In an interview with Dr. Flávio Pestilla, we were able to deepen our understanding of the topic. There couldn’t be anyone better to talk about this: he grew up with a urologist father and has been interested in the field from the beginning of his medical residency, eventually specializing in it.
Pestilla says that there is still a huge taboo surrounding the digital rectal exam when it comes to prostate cancer. “A lot of men feel shame and prejudice when reaching out to a doctor for this kind of exam.” He also points out that PCa has a 98% chance of cure when diagnosed early. “That’s why we have Blue November, which began in 2003 in Australia, intending to raise awareness about men’s health. We try to break this taboo because the digital rectal exam is just a simple physical examination”, he clarifies.
According to Dr. Flávio, women tend to discuss these issues more comfortably because they grow up attending gynecological appointments from their first menstruation onward. Men, however, typically seek medical attention only when symptoms arise, often in their 40s, when prostate health becomes a concern. He also explains that although Blue November focuses primarily on prostate cancer, urologists should address men’s health as a whole (including sexual health) rather than limiting the conversation to a single condition.
The recommended age to undergo this exam ranges from 40 to 45 years old. Men who have first-degree relatives with the disease, as well as Black men, who have one and a half to two times higher chances of developing prostate cancer, should start even earlier. Those without risk factors can seek medical guidance between 45 and 50 years old.
As a professional deeply immersed in urological care, he notes that many men’s reactions are rooted in fear: the discomfort of being touched and the belief that such an exam could somehow undermine their masculinity.
In Dr. Flávio’s practice, it’s common for older patients to seek a professional only because their families insist. Yet, the digital rectal exam remains a sensitive topic to address with many of them. Some of these patients have never seen a doctor before. They come in complaining about back pain and blood in their urine. Unfortunately, after proper testing, many receive a diagnosis of advanced prostate cancer. And when it reaches this stage, there is no cure anymore; treatment is the only option left.
But things are beginning to change. He notes that, from time to time, a young man in his twenties comes in saying he has no symptoms but wants to undergo routine urological exams. “It still catches the team off guard (in a good way) because such proactive behavior was rare in the past.” He explains that media coverage, the impact of Blue November campaigns, family support, and easier access to reliable information have been the main forces behind this change.
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The article above was edited by Clarissa Palácio.
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