Abstract
Commentary on: A narrative inquiry of men’s perceptions of support and masculinity: semi-structured interviews of men living with non-cancer-related lymphoedema in the United Kingdom (Cooper et al., 2025).
This paper (Cooper et al., 2025) employs a qualitative narrative inquiry to explore how men diagnosed with lymphoedema (non-cancer related) perceived and experienced their masculinity, access to healthcare, and support. The study findings are based on interviews with 12 participants living in the United Kingdom, identifying as men, and diagnosed with primary or secondary non-cancer-related lymphoedema. A linguistic and reflexive analysis approach was taken to analyse the data, and three overarching phases (sequential themes) on men’s experiences were identified: disruption, accommodation, and long-term adaptation. The participants’ narratives show that lymphoedema affected and changed men’s daily lives. Men commented on struggles they encountered due to abrupt limitations of their social lives and physical capabilities. The visible tissue swelling on men’s limbs (legs) resulted in insecurities associated with body image and negatively impacted their sense of masculinity.
Men reported difficulties accessing lymphoedema-related healthcare and a lack of recognition and tailoring of knowledge sharing and healthcare services to men’s needs. This study comes at a critical time when global researchers have criticised the ‘gender insensitive’ approaches and the sidelining of men’s issues in both research and healthcare services (Cornell et al., 2021), which worsens ‘the crises of masculinity’ as put by the researcher. The UK parliament and global bodies have called for a shift in addressing the ‘negative’ impact of masculinities on men’s access to healthcare (UNAIDS, 2020; UK Parliament, 2024). Although formal support for men to adjust to lymphedema is poorly aligned with their needs and requires urgent attention, they reported strong informal support, particularly from their life partners, which played a crucial role in adapting and living with lymphoedema.
Importantly, the study employs two theories, the hegemonic masculinity framework and the Health, Illness, Men and Masculinities (HIMM) framework, to understand how chronic illness such as lymphoedema disrupts men’s masculine identity (Connell & Messerschmidt, 2005; Evans et al., 2011). Hegemonic masculine ideals that value stoicism, self-reliance, social dominance and financial independence are shown to be impacted by the chronic condition. This study provides a gender-sensitive reflection on men’s efforts and coping mechanisms to preserve their autonomy and masculinity while dealing with vulnerabilities imposed by lymphoedema. It calls for more research to inform masculinity-focused healthcare services.
This study makes a significant contribution towards a growing body of literature exploring the role of masculinities on men’s access and engagement with healthcare services. The central findings of this study – that men living with lymphoedema often perceived healthcare seeking and support as misaligned with dominant masculinities – resonate with current literature on masculinity and gender norms as constraints to accessing healthcare for men (Gibbs et al., 2015). As a researcher focusing on men, healthcare-seeking behaviours, and negotiating masculinities in the marginalised prison setting, I find the use of the HIMM framework particularly important and instructive. It helps to illuminate how men draw on masculinities, particularly ‘masculine capital’ (de Visser et al., 2009), to ascertain their agency and manage threats to their masculinity and autonomy imposed by the illness.
The study employed a narrative inquiry approach, which strengthens the study’s methodological approach by foregrounding men’s lived experiences. This study, like qualitative studies I have conducted, places an emphasis on how men communicate about their bodies, pain, and adaptations, which reveals the background work men undertake to maintain their masculine identities under the threat of sickness. These findings align with my research in both the prison context (Ngcobo et al., 2023) and HIV-related healthcare (Ngcobo and Shumba, 2023; Ngcobo et al., 2025) – where men often downplay their symptoms, delay help-seeking, and resist support an attempt to appear as strong and safe-keep their masculinity.
This study contributes to a timely research agenda that not only focuses on and critiques masculinities and their influence on men’s behaviours, but also explores how healthcare systems can become places where gender norms manifest and, thus, an important site for gender transformative research and practices. Importantly, these findings raise important questions: (1) How do intersections of identities like race, gender, sexuality, and class shape men’s experiences? and (2) How can researchers and healthcare practitioners help develop systems that accommodate alternative masculinities rather than understand men as outcomes of homogenous masculinity?
This study’s findings offer practical, evidence-based guidance for clinical practitioners, clinical trainers, and policymakers. For clinicians, this study highlights the need to holistically assess and understand patient health issues beyond symptoms. By this, I mean the assessment should aim to take into account gendered dimensions. One striking example where the gender dimension considerations are lacking is the limited availability of lymphoedema support groups that are designed to cater to men, with existing support structures mainly focusing on breast cancer survivors, who are, in the main, women. This resulted in men in this study reporting attending support groups where they felt excluded and invisible.
This study could enrich the training curricula of healthcare practitioners by introducing the concept of health-related masculinities. For example, the same narrative-based approaches could be used by healthcare providers to assess how patients perceive and understand their illnesses in light of their gender identities. This could also include training healthcare providers to understand men’s silence when they downplay their symptoms to improve clinical understanding and communication. This study provides empirical evidence and support for health strategies and policies that seek to improve men’s access to healthcare. In the United Kingdom, initiatives such as the National Men’s Health Ambassador (UK Parliament, 2024) are well supported by this study to ensure the promotion and inclusion of men in healthcare access. There is a need for public policy internationally to acknowledge and create policies that will improve understanding and cater to gender diversity and nuances of masculinities and their intersections with other identities such as race, gender, class, etc.
Finally, this study’s findings invite researchers on gender and health to consider how masculinities intersect with health, particularly in chronic diseases. The authors argue that non-cancer-related lymphoedema has received little attention in research and healthcare practices. Yet it is in these clinical ‘marginal’ spaces that theories could be tested. For example, consideration of hegemonic masculinities add insight. However, considering that the study participants are predominantly White, the theoretical framework would then not be able to explain how men of colour and queer might experience lymphoedema. Further studies such as this within healthcare facilities could capture the experiences of men otherwise not included in this study.
This study is a timely contribution to masculinities and health research. The study findings build on an established sociological framework and add depth to healthcare provision for men. The findings of this study will be particularly useful for healthcare providers, allied professionals and policy makers. Importantly, this study is a reminder that healthcare services are gendered, and failing to account for gender dimensions may result in inequalities in accessing healthcare.
