"Men's bodies, men's selves": men's health self-help books and the promotion of health care

International Journal of Men's Health, Jan, 2003 by Andrew Singleton

Men's health self-help books that deal with one topic, such as ED, impotence, or prostate cancer also rely on plain language and gendered assumptions in order to communicate their message. For example, in his book Prostate Cancer, Goldenberg (1992) employs a "mechanical" register to describe how a penile implant works:

   By simply squeezing the pump in the scrotum, fluid is transferred
   from the reservoir into the cylinders to create an erection. When a
   release valve on the pump is pressed the fluid returns to the
   reservoir and the penis becomes soft again. (p. 131)

Problem-specific texts are likely to be purchased and used as an adjunct to treatment for an existing, perhaps acute, medical condition. In contrast, general men's health self-help of the kind discussed in this paper places greater emphasis on prevention and lifestyle rather than in demystifying specific treatment programs.

While men's health self-help constructs and addresses men as a collective with their own unique problems, the genre of men's health self-help does not appear, upon examination, as explicitly political as some of the early publications that emerged from the post 1960s women's health movement, including the influential Boston Women's Health Book Collective's Our Bodies Ourselves (1971). Absent in the pages of men's health self-help are political statements or an explicit critique of medical power. This perhaps reflects the differences in the women's and men's health movements; the former is very much the product of a political movement (second-wave feminism), whereas the origins of the men's health movement are far more diffuse (variously the product of consumerism, media discourse, concern from the medical profession, and scholarly advocacy).

One further point about the target audience ought to be added at this point. Self-help is generally targeted at middle class audiences. Men's health self-help is no different. The books assume fairly high levels of literacy, lifestyle preferences, and income. In a chapter from How men can live as long as women titled, "Drafting Dr. Right," Goldberg (1993) tells his readers: "Options always exist. If the treatment you're getting isn't working, it's time to try another" (p. 43).

While this is an important statement, it is advice that works best for a man with adequate medical insurance, the ability to articulate his concerns to his doctor, and a certain level of mobility. It is not necessarily advice that can be acted upon by other groups of men, especially those in lower socio-economic groups. According to the U.S. Department of Health and Human Services [DHHS] (1998, p. 7), in "1994-95 poor men were six to seven times as likely to be uninsured as high-income men, depending on race and ethnicity."

As the foregoing discussion of the generic features of these books demonstrates, men's health self-help offers the male reader a comprehensive and accessible guide to reducing the risk of morbidity, improving one's day-to-day health and lifestyle, and understanding specific men's health problems. While not political in the manner of many women's health self-help books, this genre employs a style and tone to which the male middle class might readily relate. Importantly, the main objective of each men's health book is to take the reader on a journey that teaches him that he may develop health problems, helps him to understand in some way the reasons behind these problems, and encourages him to take personal, self-generated action in order to achieve a good outcome (cf. Rimke, 2000; Simonds, 1996). In emphasizing the primacy of the individual in health management, men's health self-help conflates with a neo-conservative ideological perspective about health care: good health is largely an individual's responsibility.