By Valeria Quaglia, author of Wounded Masculinities: Men, Health, and Chronic illness

Imagine waking up every morning knowing that your survival depends on a small device attached to your abdomen, on calculating every gram of carbohydrates you eat in each meal, and on your ability to interpret your body’s signals in time, before a sudden drop or spike in blood sugar puts your life at risk. Living with type 1 diabetes —an autoimmune disease that has no cure and that has a profound impact on everyday life - means becoming something of a mathematician and a bit of an acrobat: balancing control with risk, independence with vulnerability, the everyday routine with the unpredictability of the diabetic body. 

Now, imagine having to deal with all these burdens in the “backstage” - in a Goffmanian sense - of your everyday life: the constant fluctuations in blood glucose levels and their consequences (e.g. weakness, dizziness, the risk of suddenly losing consciousness), the relentless self-monitoring practices (measuring glycaemia, counting carbohydrates, administering insulin several times during the day), and then the adjustments, the invisible labour of anticipating and containing bodily instability. While, on the “frontstage” of your social life, you have to deal with a society that expects from you to be tough, physically strong and always in control, and to never show any sign of fear or weakness. In other words, you have to demonstrate to others that you are “a real man,” just the way society expects you to be, regardless of the needs of your body. 

Experiencing chronic illness represents a significant challenge for men, as it can interfere with the ability to meet the cultural expectations associated with what Connell defines as “hegemonic masculinity”—that is, the most socially valued and legitimised way of being a man within a given time and social context. While much of the earlier literature has portrayed masculinity in overly simplistic and homogenising terms—often treating men as a monolithic group defined by risk-taking, emotional detachment, and disengagement from care—more recent critical studies on men’s health (Gough, Robertson 2009) have challenged this view, arguing that it pathologizes male behaviour and overlooks the diverse, situated ways in which men actually relate to their bodies and engage in practices of care. 

Drawing on this literature, in Wounded Masculinities, I explore how men renegotiate their identities after the onset of type 1 diabetes, using diabetes as an empirical case to reflect more broadly on the relationship between masculinity and health. Based on qualitative and digital methodologies, in my studies I found that there is no single way of being a man, and that men do not necessarily neglect their health to prove their manhood. Diabetes self-management practices—like health practices more broadly—are deeply symbolic, as they are shaped by cultural meanings and embedded within social relations. The way these practices are performed, made visible, or kept hidden plays a central role in how men position themselves within the gender order. Whether by displaying (glycaemic) control and technological competence, highlighting their physical endurance despite the illness —for example, through sport—or, conversely, by deliberately minimising their self-management efforts to assert autonomy over their body, diabetic men assemble their identities and accumulate masculine capital in order to be recognised and legitimized from others.

The way men engage with self-care is not obvious, rational, neutral. It is inevitably shaped by cultural scripts, symbolic meanings, and embodied expectations. A pink pouch carrying glucose meters and insulin pens, for instance, may be perceived as a feminising object and may become a barrier to diabetes treatment adherence, as was the case for one of my interviewees. In contrast, engaging in endurance sports to manage blood sugar levels supports glycaemic control while simultaneously affirming traits traditionally associated with masculinity, such as strength, control, and physical resilience. In my studies, I found that many men with diabetes engage in sports such as marathon running, competitive cycling, boxing, or bodybuilding. In this way, certain health practices become real “manhood acts” that symbolically compensate for the perceived threat to masculinity posed by practices of self-care. Through a bricolage of health practices men sustain, adapt, or reconfigure their sense of self in relation to dominant masculine ideals.  

The findings of my studies, in line with broader critical research on men’s health, highlight the urgent need to bring a gender-aware perspective into clinical practice. Social science has much to offer in this regard, because health is not only biological—it is also psychological, cultural, and social. Adopting a gender-sensitive approach to health means, on the one hand, recognising that there is no single way of being a man: masculinities are multiple, situated, and shaped by intersecting factors such as social class, age, ethnicity, sexuality, and life experience. These differences influence not only how men construct their identities, but also how they relate to their bodies, interpret symptoms, seek care, and manage illness. Only by acknowledging this diversity we can address the health inequalities that disproportionately affect many men.  

On the other hand, it also means questioning the implicit assumptions about who is expected to take responsibility for care-related practices. Just as other chronic conditions, diabetes management is a constant, demanding part of everyday life. Yet who is actually responsible for carrying it out? From my studies it has emerged that, often, it is women—mothers, wives, partners— who carry the burden of caring for their diabetic child, partner, or husband. Therefore, by taking this into account, we have the opportunity not only to foster health and wellbeing for all, but also to challenge the gendered structures that, still today, naturalise inequality, and to contribute to the promotion of a more just and equitable society.

Valeria Quaglia is a tenure-track researcher in Sociology at the Department of Education Sciences “G. M. Bertin” at the University of Bologna, Italy. Her research focuses on the sociology of health and medicine, with particular attention to illness narratives, aging, digital health, health professions, and gender perspectives on health and illness. She is the author of Wounded Masculinities: Men, Health, and Chronic Illness, a monograph published by Palgrave Macmillan, and of several peer-reviewed articles and book chapters. She teaches Sociology of Education and Sociology of Welfare and Social Policies in the Master’s and Integrated Master’s Degree programs at the University of Bologna, Italy.

References

Connell, R. W. (1995). Masculinities. California University Press. 

De Visser, R. O., Smith, J. A., & McDonnell, E. J. (2009). ‘That’s not masculine’ Masculine Capital and Health-related Behaviour. Journal of health psychology, 14(7), 1047-1058.

Gough, B., & Robertson, S. (Eds.). (2009). Men, masculinities and health: Critical perspectives. Basingstoke, UK: Palgrave Macmillan.

Schrock, D., & Schwalbe, M. (2009). Men, masculinity, and manhood acts. Annual review of sociology, 35(1), 277-295.