Narratives of acceptance in men’s journeys of hair loss: Identity reconstruction,masculinities and competing pressures

Abstract

Hereditary hair loss can be a challenging experience for men, amid youthful masculine appearance ideals, pressures to invest in costly commercial treatments and popular trivialisation. Yet qualitative research on how men adjust to losing their hair is surprisingly rare, including in relation to the meaning and significance of hair loss acceptance. Based on qualitative interview and photo elicitation research with 34 men aged between 18 and 49 who identified as having experienced hereditary hair loss, this article explores the role of narratives of acceptance in their journeys of hair loss. The article draws on thematic analysis and a more holistic examination of individual stories to assess how understandings about accepting baldness connect to the navigation of competing pressures and masculinities. We adapt ideas about acceptance and identity reconstruction from the sociology of health and illness to show how, following periods of struggle, men often can come to experience baldness as more reconciled with their identity, something often accompanied by the easing of anxieties or insecurities. Yet we also show how ideals about the desirability of acceptance can act as normative scripts that channel traditional traits of masculinity, placing pressure on men to perform acceptance, even in periods of struggle. Our research shows how ideals about accepting difficult forms of bodily change can be intertwined with competing sets of masculine pressures, offering possibilities to experience a profound sense of emotional relief, and of reconciliation between self and body, while also connecting to expectations than can render acceptance as compulsory and struggle as problematic.

Introduction

Androgenetic alopecia, more commonly known as pattern baldness or hereditary hair loss, affects a sixth of males by the age of 30 and over half by 50 (Rhodes et al., 1998). While far from unusual, the loss of head-hair often presents as a challenging experience. Amid masculine appearance ideals centred on youthful forms of attractiveness and debates around medicalisation of baldness, a multi-million-dollar global industry implores men to invest time and money into retaining their hair (Jankowski and Frith, 2022). Meanwhile, male baldness is often trivialised or responded to with humour in public discourse and everyday interactions (Hodkinson and Hall, 2025). Against this context it is surprising, perhaps, that qualitative, sociological research on men’s subjective experiences and understandings of going bald remains sparse.

Informed by semi-structured interviews and photo elicitation with 34 men aged between 18 and 49, our research offers a rare examination of men’s subjective experiences of the process of going bald. Taking a biographical, life-course approach, the project explores hair loss as a journey and highlights the development of interpretations and responses over time, and in connection with other life events.

In this article, we highlight the importance of narratives of acceptance in many of men’s accounts of going bald, contributing to broader understandings of how individuals adjust to challenging forms of bodily change. Adapting discussions of adjustment and identity reconstruction in studies of chronic illness, we explore how coming to accept themselves as bald, or balding, could be experienced as positive and agentic components of men’s journeys. Through biographical work and the reconstruction of their identities, acceptance could enable men to feel at greater ease with existing outside of youthful masculine appearance ideals. Yet we also show how, particularly in the context of aesthetic changes and competing masculinities, narratives of acceptance can operate as normative pressures with the potential to render suffering and struggle as illegitimate. In the case of men and hair loss, we show how, during periods of struggle, pressures to accept and ‘move on’ could compound challenges, contribute to feelings of shame and generate imperatives to hide struggle and perform acceptance. While recognition of these contrasting sides of acceptance has broader application, it can also be connected to the specific expectations balding men can face, and their navigation of shifting and contrasting versions of masculinity.

Hair loss, distress and medicalisation

While sociological research on male pattern baldness is rare, studies in health sciences and psychology have often indicated that going bald can be a distressing experience for men. Such research has demonstrated connections between hereditary hair loss and anxiety, depression, declining self-esteem and struggles with body image (e.g. Budd et al., 2000; Cash, 1992; Luxon et al., 2009). Studies also indicate that bald men can be perceived by others as older and less attractive (Kranz, 2011; Muscarella and Cunningham, 1996). Qualitative studies are much more unusual but also have highlighted men’s negative feelings about going bald. Jankowski et al. (2021b) show how posters to a baldness forum tended to describe baldness as ugly, unmasculine and stigmatised, while men interviewed by Razum and Vukasović Hlupić (2022) described feeling unattractive and older, as well as feeling they were viewed differently by others.

Such findings are unsurprising, perhaps, amid the growth of new consumerist forms of masculinity centred on lean, youthful appearance ideals and pressures to groom or train to achieve them (Gill et al., 2005; Lefkowich et al., 2017). While fashion and body shape often are the most remarked on signifiers of these ideals, the presence of a full set of hair is ever-present (Jankowski et al., 2021a). Consistent with this, studies suggest bald and balding men are marginalised in media and, not least, outlets centred on fashion, beauty and fitness (Jankowski et al., 2014). Meanwhile, promotional imagery from the multi-billion-dollar hair loss industry typically presents bald men as unattractive, unloved social outcasts, imploring them to rediscover masculine desirability and success through treatments (Harvey, 2013; Jankowski et al., 2014).

However, in a review of 37 studies, Jankowski and Frith (2022) suggest that, as well as directly exacerbating appearance pressures on balding men, the hair loss industry may be influencing academic research. Many of the studies included in the review (including work by Cash and Budd et al., above) had links to the hair loss industry, or were focused on samples of men engaging with baldness treatments and, hence, more likely to be struggling. For Jankowski and colleagues, the prevalence of serious well-being struggles among balding men – and the importance of hair loss treatments as a solution – may have been exaggerated. Recognising hereditary hair loss as natural bodily change that many men are able to adjust to, might be a more helpful starting point in assessing how best to support them, they suggest (Jankowski and Frith 2022; Jankowski et al., 2021a). Consistent with this, research on young balding men by Kranz (2011: 347) suggests a correlation between ‘acceptance’ of hair loss and lower levels of psychological distress, prompting the claim that acceptance ‘might allow young men to let go of their problem and to move on with their lives’. Notwithstanding questions about direction of causality here, the role of feelings of acceptance as part of hair loss journeys is one that warrants qualitative, and sociological, investigation.

Acceptance, identity reconstruction and ontological security

While detailed exploration of acceptance in men’s baldness experiences is minimal, insight can be drawn from understandings of chronic illness journeys. Here, key to conceptualisations of acceptance is the notion that bodily changes that result in challenging ongoing conditions can become reconciled with the identity of the sufferer over time. In social psychology, discussions of ‘illness identity’ have identified ‘acceptance’ and ‘enrichment’ as desirable patient orientations that demonstrate integration of long-term illness into identity and, in the case of the latter, an affirmative embrace of positive changes to life (Oris et al., 2016; Van Bulck et al., 2019).

Contributions from the sociology of health and illness offer nuanced explorations of the biographical journeys that those with chronic conditions can navigate, as they embark on complex pathways towards identity reconciliation and reconstruction following experiences of biographical disruption (Bury, 1982). Wilson and Stock highlight the importance of acceptance as part of journeys of adjustment to long-term conditions among young people. Following the severing of individuals’ sense of self in the past from present and future identity, complex biographical work can take place as part of redefining identity and coming to greater acceptance. Here, the illness becomes ‘an integrated part of the identity’ (Wilson and Stock, 2019: 1112). Similarly, Fang and colleagues highlight how, following an ‘existential’ loss of identity experienced by many long COVID sufferers, ongoing attempts to reconstruct identity and ‘fix their broken self-narratives’ formed part of participant endeavours to establish a coherent sense of being in the world that included their illness (Fang et al., 2024: 72). Similarly, Mahon et al. (2014) highlight how the process of adjusting to chronic illness can involve ‘confronting’ the self and an ability to ‘compose a new picture of themselves and their life worlds’. Of relevance here is Giddens’ (Giddens, 1991: 48) understanding of ongoing quests for ‘ontological security’ as ‘the struggle for being against non-being’. Here, ongoing reflexive identity construction forms part of individual quests for biographical continuity, as changes are accommodated into a coherent sense of one’s place in the world. Also significant are apparent acceptance narratives in the rather different context of body size, where some come to reject slimming discourses and embrace being higher in weight as a permanent part of their identity (Bombak and Monaghan, 2017; Joy and Numer, 2018). Importantly, while outlining the potential importance and value of acceptance, sociological research has often highlighted the complexity of identity reconstruction and the non-linear, unstable nature of journeys of acceptance (also see Wilde, 2003).

Hair loss, acceptance pressure and masculinities

Male hereditary hair loss does not involve the physical impairments typical of long-term health conditions or the potential health risks that sometimes can accompany higher body size. Yet going bald, as we shall show, may entail periods of struggle, as well as transitions towards greater feelings of acceptance. Adapting conceptual understandings about the reconstruction or reintegration of identity following periods of struggle, and of quests for greater ontological security following challenging bodily changes is of some value in making sense of such transitions, we suggest.

However, we also explore a more uncomfortable side to notions of acceptance, as we highlight how ideas about the desirability of coming to terms with bodily challenges can be associated with their own normative pressures. Jankowski’s research of men’s exchanges on a baldness forum offers hints at such pressures in highlighting a minority of forum users who downplayed the negatives of being bald, imploring others to keep their problems in perspective and make the best of their lives (Jankowski et al., 2021b). More anecdotally, several reader comments on a short online piece on baldness published by the current authors, played down the seriousness of hair loss and implored men to accept it: ‘It happens. Accept who you are and how you look and get on with life. There are so many bigger issues’, said one (Hodkinson and Hall, 2024).

There may be a tension, then, between the distress caused by going bald in the context of pervasive youthful masculine appearance ideals, and different sets of scripts that highlight the need to embrace hair loss and move on. Moreover, acceptance may involve both a positive set of feelings or aspirations in journeys of identity reconstruction and adjustment and a set of normative pressures with the potential to exacerbate challenges of self and identity. There are signs of such tensions in studies of sufferers of less common forms of hair loss. In a study of female and male sufferers of alopecia areata, Davey et al. (2019) highlight how participants felt caught between feelings of loss and despair about hair loss, and narratives from doctors and others that played down its importance. Participants also experienced internal tensions between hiding their hair loss and feelings of shame from doing so: wishing they could go ‘bald and proud’. In a recent study comparing men and women’s experiences of hair loss through cancer-treatment, Trusson and Quincey (2021) identified a tendency for the former to play down the seriousness of hair loss through humour or highlighting the greater suffering of others.

In the case of men, such tensions connect to the navigation of shifting, competing versions of masculinity. Often regarded as part of hegemonic masculinity (Connell and Messerschmidt, 2005), stoicism, courage, rationality and playing down of struggle are associated with long-standing tendencies for men to find it challenging to acknowledge or seek support for emotional difficulties (Milner et al., 2018). In recent years, theorists have identified shifts towards more inclusive (Anderson and McCormack, 2018) or caring (Elliott, 2016) masculinities, characterised by greater emotional openness and intimacy. Yet studies continue to indicate the complex, contradictory nature of masculinities as men negotiate tensions between developing and differing expectations (Crawshaw, 2007; McQueen, 2017; Ralph, 2024). In some contexts, more traditional pressures to supress struggle, eschew support and ‘move on’ can be difficult to overcome (Bennett and Gough, 2013; Hodkinson and Das, 2021). In journeys of hereditary hair loss, such negotiations also take place in the shadow of pressures that can compel men to pursue the achievement of youthful, masculine appearance ideals, while simultaneously avoiding the traditionally feminine trait of vanity (Gill et al., 2005; Lefkowich et al., 2017). In this context, then, notions of acceptance, and quests for ontological security, may become entwined with these masculine pressures, even while holding the potential of providing relief from others.

In the discussion that follows, we highlight how men’s talk about acceptance often demonstrated journeys of identity reconstruction that could feel liberating, but also showed how ideas about acceptance could become normative expectations that exacerbated challenges as they sought to negotiate competing pressures and masculinities.

The journeys of hair loss project: method

Our research examined men’s experiences of pattern baldness through qualitative interviews and photo elicitation with 34 men aged between 18 and 49 and based in the United Kingdom. Participants were recruited through advertising on a range of social media communities, including those oriented to a diversity of local areas and neighbourhoods close to the project base in the South East of England, groups oriented to fathers, LGBTQ+ forums and the social media profiles of the researchers. To encourage participation and maximise diversity, a £30 Amazon voucher was offered. The sample included men in their 20s, 30s and 40s, most of whom had begun to notice hair loss before they were 30. The sample was predominantly white, professional and straight, but with a notable minority of South Asian or Middle Eastern origin (n = 6) and a minority identified as gay, bisexual or asexual (n = 6) while one preferred not to disclose his sexuality. Most cited professional occupations and this, alongside an absence of men of Black/African or South-East Asian origin, represents a limitation. Approximately two-thirds were based in Surrey or Greater London, with the remainder from a variety of other locations in the United Kingdom.

Interviews lasted roughly 90 min and were carried out online via Microsoft Teams. This enabled flexibility with respect to timing and allowed participation from a convenient location. Participants were asked to have their cameras on and this, we believe, enhanced rapport while enabling them to demonstrate how their hair looked and had changed. The conversations were enhanced by the use of photo elicitation (Harper, 2002; Padgett et al., 2013). Men were asked to identify 3–5 photos of themselves that they felt illustrated the development of their hair loss and were invited to talk through them in detail in the first section of the interviews. The photos did not form part of the analysis but were used as a means to allow the men to reflect on their experiences in advance, and as a visual stimulus that enhanced the biographical orientation to the interviews by helping participants explore their shifting pathways. Men typically selected photos of themselves, alone or with others, taken as part of everyday life or events with friends or family, enabling discussion of how hair-loss developments connected to other aspects of life. We also used a more standard topic guide, with themes covering emotional responses, appearance adaptions, interactions, hair loss treatments, well-being and connections to other aspects of life.

Analysis entailed a mixture of interview-specific fieldnotes shared between researchers after interview completion, and more systematic thematic coding using NVivo. Our coding approach was flexible and iterative and, though influenced by Braun and Clarke’s (2006) valuable explanations, did not rigidly adhere to any particular schema. Our approach primarily centred on development of emergent themes but also was informed by existing interests, questions and preconceptions. Moreover, even while dividing data up, we sought to remain attentive to personal pathways and contexts through attention to individual transcripts and fieldnotes. The discussion below brings together a variety of themes and sub-themes relating to contrasting narratives about acceptance, as well as to shifting individual narratives. In the first section, we explore themes relating to accounts of coming to feel more reconciled with going bald, including how this could connect to identity reconstruction and feelings of liberation. In the second, we show how ideas about the desirability of acceptance could act as a set of pressures on men to convey a sense of comfort and security, examining this through two sub-sections; on the shame that could accompany hiding or treating hair loss, and on constraints on men’s approaches to talk. The research received a favourable opinion from the University of Surrey Ethics Committee. All volunteers were provided with an information sheet and asked to complete a consent form. The process of losing hair can be emotionally challenging and so participants were advised, via the information sheet and during the interviews, that they were free to not answer questions and/or to terminate the interview or withdraw from the project. Participant names have been changed and identifying information removed.

Acceptance and identity reconstruction

The journeys men described to us varied but many described comparable moments and stages in their experiences of hair loss. Most described a period of discovery where it first became evident their hair was changing and, sometimes, one of ‘denial’ where life continued largely as before but with hair loss a growing worry in the background. As hair loss became more noticeable, a longer period of uncertainty or struggle often ensued. During this liminal period, in which significant hair remained, men often suffered from different degrees of anxiety about the present or future, or a developing sense of loss, as they struggled to adjust to their changing appearance. Many turned to different approaches to hide, manage or arrest their hair loss – measures that could be accompanied by emotional cycles of hope and despair. Struggles could be especially challenging for those experiencing hair loss in their teens or early twenties, as well as those who were single or involved in cultures that placed significant value on appearance and grooming, including (though not limited to) some gay participants.

However, many described how they had, over time, developed a greater acceptance of becoming bald. Some explained how their hair loss began to reach what felt like a ‘point of no return’, where attempts to hide or intervene were futile. Meanwhile, becoming and feeling older, settling down with a partner, having children, or career developments could affect changes of priority and transitions towards different forms of identity and masculinity, reducing how important hair loss felt. Shifts in social life and, particularly, a reduction in the importance of nightlife – with its extensive emphasis on appearance and courtship – could also play a role. Identity reconstruction (Wilson and Stock, 2019; Fang et al., 2024) was of importance here, as men described how priorities and orientations shifted, and how baldness had become incorporated into a renewed sense of self. For Gareth, becoming bald had gradually come to feel more in keeping with his identity as he had begun to embrace the notion of being a thirty-something, amid changes in career-orientation, lifestyle and body:

you’re kind of concentrating more on a career [when older], maybe perhaps feeling a bit more comfortable in sort of wider direction of travel . . . physically as well you can’t quite do what you used to do . . . So maybe it is a case of, you kind of feel more like you’re mature. And so . . . the hair kind of fits that look maybe – or you feel more comfortable? It kind of fits in with that stage of life. (Gareth, 34)

Accounts of acceptance also highlighted the role of proactive biographical work as part of the development of a changed overall appearance and identity inclusive of baldness. Often this entailed experimentation with new aspects of appearance, such as beards, glasses, fashion or an embrace of fitness and lifestyle changes. While appearance adaptions could sometimes play a compensatory role (see Cash, 1992), they often seemed to entail more positive and reflexive forms of aesthetic identity work (Giddens, 1991); quests to adapt to and accommodate hair loss, and to negotiate different sets of masculine expectations. Rather than being straightforward, this process could entail elements of experimenting back and forth. Calum had experimented with new approaches to clothing, stubble and even glasses as he sought to hone a more ‘grown-up’ look that enabled him to cultivate and express a new, balder, self:

I feel like for the lack of hair that I had and the lack of choices that I have with my hair, that sometimes wearing my glasses with my thinning hair actually . . . looks smart. I don’t think . . . I quite like having the glasses with trying to make my hair look better and wearing a shirt . . . I think with my hair kind of thinning, that I’ve been trying to look for something that’s smarter and maybe more grown-up. (Calum, 42)

Rather than being isolated, elements of such reflexive identity work would tie in with other developments in life as part of journeys of acceptance. Daniel’s journey towards acceptance had involved a coming together of various factors. These included his hair loss reaching a point where it became unrealistic to cover up bald patches, a determination to move on positively from a challenging COVID lockdown period, an embrace of shorter haircuts that felt in keeping with a balder look, and an increasingly positive interest in wearing hats – as an affirmative expression of identity rather than a means to ‘hide’ baldness:

It’s only in the last few years that it’s actually disappeared and thinned quite badly on the top . . . So I thought, you know, if it’s thinning and disappearing . . . not much you can do about it at some point and, on the whole, nobody really cares . . . I was like, right, get it back nice and short . . . I do occasionally wear my hat, but I’m confident in saying that’s because I actually find them interesting and sometimes it’s just nice to, you know, going out for the day, put something funky on . . . it’s not to hide, it’s, I’ve got this catalogue of cool hats and they’re not just a safety net anymore. (Daniel, 30)

Many of those who described journeys towards greater acceptance used the language of liberation or release in describing how this felt. Acceptance seemed to restore a sense of agency and to entail a greater feeling of ontological security (Giddens, 1991), following earlier periods that sometimes had centred on struggle, uncertainty or shame.

Liberation often was felt particularly strongly when acceptance took place suddenly, as part of pivotal moments of agency and identity work. Taking the form of what Gidden’s (1991) terms ‘fateful moments’, these often involved bringing an end to periods of intense uncertainty and struggle by clippering or shaving the head. Often long anticipated, such moments could affect a dramatic aesthetic change and a symbolic embrace and display of baldness. Several men explained that the moment of shaving their head had felt like a release from years of fighting to hide or prevent hair loss in the shadow of prevailing youthful appearance ideals. For David, a particularly difficult year travelling, followed by changes to location, work and social networks, enabled an opportunity to take the ‘fateful decision’ (Giddens, 1991) of having his head shaved – a moment he experienced as one of profound relief:

Psychologically it almost felt like a weight was like weighing me down . . . And I was like, I’m sick of this now. You know what? I have a fresh start. I’m going back home. I’m going back into a new job . . . It’s time to leave that life behind and just walk the street with the wind and not care . . . I went to the hairdresser on Saturday morning . . . and I just said shave it to the lowest level that you’ve got – just do it! And I remember seeing the results and I was like . . . why did I not do this five years ago? It was just relief . . . That’s when the acceptance happened. (David, 36)

Importantly, although the extent of feelings of release from earlier years of struggle often was striking, acceptance rarely seemed absolute. Most of the men still regarded their hair loss as negative overall and, although many had developed significant critical awareness of the activities of the hair loss industry and the limitations and risks of what it offers, several noted how, were a ‘magic’ (cost- and hassle-free) baldness cure to emerge, they might still consider it. Moreover, many continued to invest in youthful masculine bodily ideals in other respects, through an embrace of fitness, for example. Even shaving the head – typically described as a release from dominant appearance pressures – could entail elements of ongoing appearance-anxiety, where the unevenness created by a few days of growth could prompt self-consciousness. Here, rather than being removed altogether, youthful appearance pressures centred on a full head of hair seemed to have been replaced, at least in part, by pressures to live up to a different masculine aesthetic.

Acceptance could also be inflected with established masculine behavioural traits, such as a fatalistic form of stoicism, a sense of learning to get on with life with a sense of resignation or regret, as in Ishaan’s account, below:

Yeah, so I’m happy. It’s just something I have to learn to live with when it comes to this area here [balding patch], but . . . it’s not something that affects me now, the way it affected me back then. I think maybe it’s a little bit to do with the fact that I’ve learned to accept it. That’s come with time as I’ve got older, a bit more wiser. I’ve learnt that might . . . if I’m losing my hair, I’m going grey at the same time. . . my beard started turning grey, so it’s . . . just something I’ve accepted goes hand in hand. (Ishaan, 42)

The ambiguity in some accounts show how it is important to recognise that, as in studies of chronic health conditions (Wilson and Stock, 2019; Fang et al., 2024), narratives of acceptance can be partial, non-linear and incomplete. In some cases, statements about acceptance can entail an emphasis on stoicism, as well as hints towards ongoing struggles or uncertainty. While straight men’s accounts, including that of Daniel and Calum (above), sometimes entailed such ambiguity, we noted that gay participants, including Ishaan, seemed particularly likely to maintain substantial uncertainties, including by leaving open the possibility of using hair loss treatments, for example. Our research offered tentative support, then, for previous work highlighting the strength of pressures relating to body image and grooming among some gay men (Joy and Numer, 2018).

Notwithstanding such complexities and diversities, the accounts of many of the men, across different sexual orientations and social positionings, highlighted how they had, to a degree, managed to come to terms with going bald, and how a greater sense of the integration of baldness into their sense of self could feel liberating. Such narratives indicated a renewed sense of being in the world and a sense of reconnection between self and body. They also inferred profound feelings of relief from youthful male appearance ideals centred on a full head of hair. As we have inferred, however, such ideals continued to inflect some aspects of their journeys in practice, while notions of acceptance could be associated with their own, different, sets of masculine expectations.

Acceptance as pressure and performance

As well as forming part of men’s stories of coming to terms with baldness and feeling released from dominant expectations, acceptance narratives could take the form of ideals about how men should respond to hair loss – ideals that were intertwined with their own sets of masculine expectations and that had the potential to become challenging pressures. Important here was an association between acceptance and authenticity – ideas about the desirability of accepting who you are and responding to natural bodily changes in a way that shows comfort with new realities. This is visible in Robert’s positive reflections on shaving his head as a moment he embraced his authentic self:

I would say that’s by far the greatest thing you could ever achieve from the whole process – is having that confidence . . . that you are appreciating and accepting your body for, for what it is. Accepting that for who you are and everything and having that confidence . . . you build on that sort of that platform of, ‘right this is a new me’ . . . (Robert, 33)

Robert’s account demonstrates his sense of confidence and release at having reconciled baldness with his developing identity. Yet such discourses sometimes included an implicit critique of responses to hair loss deemed less authentic. Such a critique became explicit in some accounts where participants characterised attempts to hide or counter hair loss as unrealistic, or even ‘embarrassing’ attempts to defy reality. Emmanuel described a tendency among ‘older generations’ to try to obscure baldness by brushing hair across thinning patches, suggesting this conveyed a lack of self-acceptance:

I don’t mean to disrespect anyone by saying it, but it looks a bit lame, the fact that you’re trying to . . . older generations trying to do what we call . . . ‘the curtain’. So when they . . . try to cover it, it’s just not looking good . . . I value character a lot, and being proud of who you are . . . we need to feel comfortable with who we are. (Emmanuel, 32)

In a similar way, some men distanced themselves from significant or costly hair loss treatments. While this could demonstrate agency and critical awareness with respect to the hair loss industry and the efficacy of its products, it also entailed a focus on how such interventions could be regarded as desperate or inauthentic. Such discourses tended to be strongest in the accounts of some straight participants, but not exclusively so. For Joshua, who identified as gay, and who still wondered about the possibility of using hair loss treatments himself, the sudden appearance of thick hair following a transplant might display a failure to accept ‘the inevitable’:

like the people in the ads who are saying I used to look like this and now I’ve got this hair. There is . . . there’s something . . . there’s something in there that’s like, mm, you’re pretending . . . you’re fighting against the inevitable here . . . a similar kind of feel to it as a combover I guess. (Joshua, 34)

Men’s internalisation of such discourses could create pressures to perform acceptance of hair loss to others, whether or not this matched up to their feelings. For some, this seemed to create a significant disjuncture between social performance and self-identity (Giddens, 1991). Alluding to his awareness of such pressures, Joshua put it the following way: ‘you have to actively accept it, you have to avoid trying to do something with your hair that is making it look like you’re denying that it is happening’. In practice, this could affect men’s feelings and approaches relating to managing their remaining hair, as well as their interactions with others about baldness.

Hiding, treatment and shame

While clippering or shaving their head was often experienced as a genuine moment of affirmation and liberation, it sometimes could tie in with masculine pressures associated with expectations to accept bodily changes and challenges. Sometimes, expectations for them to shave their head could create anxiety for men at earlier points in their journeys. Robert eventually did experience a sense of relief when he shaved his head, but had found it difficult when people were encouraging him to do so before he felt ready:

Yeah, they always say to shave even more off now and I’m like ‘ohh, I’m not at that stage’ . . . It felt like a big decision to make . . . you try and sort of process what the pros and cons are and if I’m gonna shave my head, what are people gonna think like I’ve had nice set of hair and it was gone the next day. (Robert, 33)

Conversely, those considering or engaging with attempts to hide or reverse hair loss were often aware how negatively such interventions could be seen by others, exacerbating anxieties. Competing pressures created complex tensions here. On the one hand, pressures to exhibit the full head of hair so integral to prevailing youthful masculine aesthetic ideals could make such interventions seem essential. On the other, ongoing acts of hiding or treating hair loss could feel shameful due to their divergence from pressures to accept and to present themselves authentically. Concerns that attempts to hide baldness might be revealed, for example by the wind or rain, or that the impact of treatment would be too obvious, were highlighted. This could sometimes even prompt a change of approach. Lewis’ worries that sections of hair he brushed across bald patches had become too obvious prompted pressure to cut his hair shorter to avoid ‘trying too hard’:

the most recent haircut, I think I’d say I’ve left this [section of hair brushed across] bit too, it’s quite long or thick . . . So I think the next haircut that probably needs a bit taken off because it’s trying too hard and just need to accept it more, yeah. Yeah, it’s like you can see it there . . . And it just doesn’t look so natural . . . (Lewis, 35)

For some, over-obvious attempts to hide or reverse hair loss had the potential to be more socially embarrassing or negative than going bald itself. Marcus used the language of not wanting to appear ‘vain’, evoking a specific disavowal of concern about appearance often associated with traditional forms of masculinity but also prevalent as an ongoing tension even among many who embrace newer forms of masculine grooming (Gill et al., 2005). In Marcus’s account, vanity is associated with appearing ‘concerned’ about baldness, connecting together the tendency in established masculine scripts to venerate stoicism and reject excessive focus on appearance:

I didn’t look at any solutions. No, I didn’t. I wouldn’t. I wouldn’t want to appear vain . . . That would be far worse than to be bald. The idea that I was vain enough to care or vain enough to do something about it for me would be worse than just being bald . . . The guys who do, I can totally understand . . . but certainly for me, I always just thought, don’t appear to be concerned about it . . . (Marcus, 41)

Constrained interactions

As well as contributing to feelings of shame in relation to engagement with baldness treatments or other aesthetic solutions, the need to perform acceptance could affect men’s interactions with others about their hair loss. Many indicated the prevalence of humorous comments from friends, relatives and others, and some initiated baldness jokes themselves to bring their baldness into the open. Others, though, strongly disliked baldness jokes but felt under pressure to participate in order to convey a sense of acceptance and comfort. Eric had struggled for many years with such interactions, explaining how, for a long time, he had ‘brushed over them’ or ‘even just feigned a sort of chuckle along’ (aged 41). Richard indicated greater comfort with baldness humour but speculated that his tendency to make jokes about his own hair was a way of ‘letting people know that, like, I’m OK with it’ (aged 35).

While engagement with humorous exchanges could enable men to perform a sense of comfort and acceptance, serious forms of talk about hair loss struggles was more unusual. In particular, few had talked in detail with others about the emotional challenges that could accompany the loss of their hair and many described keeping their anxieties to themselves amid a strong sense of discomfort with talking about them (Hodkinson and Hall, 2025). ‘It’s not something that you like to talk about really’, Patrick (aged 42) explained, adding that ‘it is kind of slightly icky to talk about it with people’. He went on to indicate that he felt uncomfortable drawing attention to his struggles to accept losing his hair and to the extent of his worries about his appearance. Consistent with this, while reasons for men’s struggles to talk about their emotional struggles with baldness were complex and context-dependent, they often connected to the same pressures to perform acceptance that prompted many to participate in jokes and to avoid visible signs of trying to hide or reverse hair loss. Unlike other challenges men might face, suggested Marcus, hair loss is not taken seriously enough to warrant serious or emotional forms of talk:

it’s not a thing that I think is something we are open about . . . if somebody was to talk about depressive thoughts, anxiety, self- harm, these are all things that are accepted . . . But I’d never lump baldness into that . . . if you suddenly started to try and put that in that mix, I think that maybe, it would be a bit jokey. I think people consider it something that you can joke about. I clearly think it’s something I can joke about ’cause I do it to myself. (Marcus, 41)

Importantly, rather than suggesting it unacceptable for men to exhibit struggles in a general sense, Marcus’ point is that hair loss is regarded as too trivial or humorous to warrant this. As with showing too much ‘vanity’ through attempts to conceal or reverse baldness, conveying hair loss struggles would feel problematic, and in breach of masculine pressures to exude comfort, control and an absence of concern for appearance. Such pressures may, we suggest, be particularly strong for men in the context of aesthetic changes to the body such as hair loss, creating a potentially difficult disjuncture for some between their emotional struggles and social performances.

Discussion: acceptance narratives, competing pressures and masculinities

In this article, we have explored the role experiences and expectations of acceptance can play in men’s journeys of hereditary hair loss. Against the background of emotional struggles and an unwanted divergence from prevailing masculine aesthetic ideals centred on a full head of hair, we have outlined how men often spoke of their eventual achievement of a measure of acceptance of their hair loss. Drawing on understandings from the sociology of chronic health conditions (Wilson and Stock, 2019; Fang et al., 2024) and body-weight journeys (Bombak and Monaghan, 2017; Joy and Numer, 2018), we have shown how such pathways towards feelings of acceptance entailed processes of reflexive identity reconstruction as men described reaching a more comfortable sense of being in the world (Giddens, 1991). Amid shifting orientations and developments in other dimensions of life, they had come closer to a point where self and body felt more aligned with one another. As in studies of adjustment to other forms of bodily change, such journeys were often uneven, with feelings of acceptance sometimes remaining tentative, uneven or even tinged with regret. Moreover, although often experienced as a visceral release from the pain associated with youthful appearance pressures, they likely retained aspects of such ideals in some respects, while also entailing a shift towards masculine social expectations associated with different social roles and stages in life. Yet our findings still highlight a clear possibility for men, in the right circumstances, to reconcile themselves with hair loss and become more comfortable with a bald appearance over time. Such findings offer significant encouragement for pursuit of non-medicalised approaches to the support of men experiencing hereditary hair loss, and the exercise of caution with respect to the growth of commercialised hair loss treatments (Jankowski and Frith, 2022; Kranz, 2011).

We also have shown how acceptance narratives integrate with masculine pressures of their own and that these have the potential in some contexts to exacerbate struggle and compel performances of comfort that are at odds with what men are feeling, particularly during more challenging periods. Attempts to obscure, arrest or reverse hair loss could be accompanied by a sense of shame. The need to avoid an appearance of struggle, meanwhile, could make participation in baldness jokes feel compulsory, while creating barriers to serious forms of emotional talk or support-seeking (see Hodkinson and Hall, 2025). As well as making the pursuit of aesthetic or medicalised responses to hair loss more fraught, narratives about the need to accept baldness sometimes could, ironically, make it more difficult for men to seek the kinds of support that might help them to adjust.

In a broader sense, our discussion highlights the complex, competing pressures men experiencing aesthetic bodily changes can find themselves negotiating, and the contrasting sets of masculine expectations to which these connect. The emotional struggles many experienced were heavily inflected by appearance-centred, consumerist versions of masculinity where youthful, lean and effectively groomed bodies (with a full set of hair) become synonymous with male success, desirability and status (Gill et al., 2005; Jankowski et al., 2014; Lefkowich et al., 2017; Rosenmann et al., 2018). As we have seen, this is relentlessly highlighted in hair-loss industry advertising that presents hereditary hair loss as a severe detriment to masculinity (Jankowski and Frith, 2022). Whether suddenly or gradually, reaching a point of greater hair loss acceptance often was experienced as a liberation from struggles to live up to such ideals, even in those cases where regrets and anxieties persisted. Notwithstanding the likely significance of different modes of masculinity as part of such feelings of ‘release’, there remains a case for understanding men’s journeys of acceptance and the reconstructions of identity they involved as a partial contestation of youthful aesthetic masculine ideals and, in particular, of commercial baldness medicalisation (Jankowski et al., 2021a).

Yet, second, balding men across different social categories and sexual orientations often were negotiating contrasting and also pervasive pressures – this time emanating from discourse about the desirability of acceptance itself. Acceptance pressures may not be exclusive to men’s journeys (Davey et al., 2019) but, in the context of such journeys, they can channel familiar traits associated with hegemonic masculinity. These include stoicism, courage, resilience, and avoiding an appearance of struggle or the need for support (Buchbinder, 2010; Connell and Messerschmidt, 2005; Lohan, 2010). Moreover, for many, the pressure to navigate male appearance ideals while avoiding impressions of vanity (Gill et al., 2005) is also of importance, making acceptance pressures particularly acute in the context of the navigation of aesthetic bodily changes. As Gill et al. (2005) have suggested, men can be compelled to present an ‘unselfconscious self’, forging ‘a delicate path between an appropriate level of care and attention to one’s body, and the twin pitfalls of vanity or obsession’ (p. 19). Notwithstanding substantial shifts in the range of possibilities for male emotional expression in recent years (Elliott, 2016), our research adds weight to existing studies showing how men can still struggle to navigate emotional challenges in contexts where traditional masculine expectations remain influential and where struggle or the need for help can be scripted as illegitimate (Hodkinson and Das, 2021; Ralph, 2024). The context of hereditary hair loss may be one in which such challenges are particularly acute. Centred on appearance rather than physical impairments, baldness is also commonly subject to specific forms of trivialisation and humour. As such, it provides an example of how, even amid the development in some contexts of more intimate, caring masculine scripts, male emotional expression and interaction may still only be appropriate in the context of life challenges regarded as sufficiently serious (Hodkinson and Hall, 2025; Ralph, 2024).

Importantly, the negotiation of different forms of struggle and acceptance, amid these competing pressures, is liable to fluctuate across individual journeys and to vary somewhat between men in different contexts, where the availability of different masculine scripts may differ. Here, the United Kingdom and, hence, global north, context of our research should be noted, while the navigation of masculinities we have described pertains to a range of primarily middle-class men. The continuing importance of traditional dimensions of masculinity in the context of baldness journeys to a demographic sometimes associated with greater divergence from such orientations is noteworthy, perhaps. While almost a fifth of our sample were non-white, overall numbers were small, and consistent differences of ethnicity (and indeed class) were difficult to discern in respect of the themes discussed in this article, with similarities more notable. Not surprisingly, perhaps, the role of sexuality was a little more visible, alongside other factors such as age and relationship status, though here too, differences were inconsistent and overlaps considerable. As we have noted, younger men, single men and those connected to scenes or cultures centred on grooming (including but not limited to some gay participants), seemed more likely to persist with efforts to obscure or treat their hair loss, in the face of competing pressures. Equally, such men often described feelings or expectations related to acceptance. Further exploration of the interplay of acceptance narratives and competing masculine pressures in the context of structural and contextual differences would be of value in future research.

In relation to the present study, however, we would suggest that, as a result of competing pressures and contextual specificities, it would be an oversimplification either to regard acceptance as a straightforward form of liberation from hair loss struggles, or as a harmful enactment of more traditional components of hegemonic masculinity in the face of disruption and emotional difficulties. Rather, acceptance can form an essential part of the easing of hair loss struggles and the reconstruction of identity, while also having the potential to create pressures associated with traditional masculine scripts. Men’s journeys of hair loss, then, should be understood as punctuated by negotiation of competing pressures, amid contrasting sets of widely circulated masculine expectations – expectations that may not always be straightforwardly placed as progressive or regressive, dominant or subordinate. Depending on context, identity and location, and at different stages in their journeys, balding men may find themselves feeling torn in different directions, or coming to navigate somewhat more comfortable paths forward, in relation to competing yet pervasive narratives about how men should be and how they should respond to changes and challenges.