Rheumatoid arthritis (RA) affects more women than it does men, and RA is also believed to take different courses in men and women. While it is likely that gender identity could have an impact on a patient’s personal experience of managing the disease, most qualitative studies of the patient experience with RA have primarily been conducted with female participants (the number of women participating in these studies ranged from 78% to 100%).
A new paper
by Caroline Flurey, PhD, and colleagues, published in Sociology of Health and Illness,
seeks to better explore the experiences of men with RA in the context of their lives, their masculine identity, and their ability to cope with the disease.
The paper focuses on 5 men with RA, all of whom were under the care of rheumatologists in England’s National Health Service (NHS) trusts. Each subject took part in a 1-hour individual interview. On the basis of the interviews, the researchers identified 3 typologies that demonstrated the impact of RA on masculine identity:
Typology 1: retaining hegemonic ideals of masculinity
Two of the men in the study valued continued participation in activities (including sports and paid work) that they associated with masculinity, though they candidly admitted that their abilities to perform these roles have declined with disease progression. The 2 patients indicated that they were reluctant to disclose their illness to employers or friends because of the invisible nature of the disease, the potential to be ridiculed, and the potential to be viewed as different from other men.
Typology 2: trying to negotiate masculinity
Two men were interviewed to assess this typology. Both were forced to take early retirement due to RA, and found the loss of paying work difficult. One of the men reported being diagnosed with depression after having retired. These men sought new activities—such as gardening or spending time with grandchildren—and tasks that would allow them to renegotiate their self-perception of masculinity.
Typology 3: rejection of hegemonic masculinity
One man interviewed demonstrated comfort with his identity that allowed him to engage in activities—such as playing, music, and dancing—that might not be considered traditionally masculine according to hegemonic ideals. The researchers suggested that this subject was able to reject the need to behave in normatively masculine ways, and that doing so allowed him to cope with RA by participating in activities that he finds pleasurable.
The authors state that their data provide important information about the coping styles of men with RA, and could be a basis on which to inform the design of supportive intervention for men with RA. Further research will be necessary to determine whether there exists a clinical need to provide services that are tailored to the potentially different needs of men with RA.
“These novel data about the impact of a long-term condition (RA) on masculine identity indicate that to incorporate RA into masculine identity it is necessary for masculinity scripts to be re-written, which some men find challenging,” the authors write. “These  distinct case studies highlight the different coping strategies and support needs that should be considered when designing support and self-management services for men with long-term conditions.”