69: The Invisible Force That Impacts Men's Health

Episode Transcript

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Dr. Galli: Most of us take for granted the things that we see as normal and expected. So hopefully, we've at least parked the thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from?

Scot: All right. Welcome to the podcast "Who Cares About Men's Health." What we've got here are some guys who care about their health, and they're not afraid to talk about it either. We get this bad rap. Guys don't care or want to talk about their health. That's not true, proving it right now.

My name is Scot Singpiel. I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I'm glad that for the first time in the history of this podcast I actually sound better than Scot on this, and I care about men's health.

Dr. Galli: And I am Dr. Nick Galli. I'm an associate professor at The U in the Department of Health and Kinesiology, and I care about men's health.

Scot: So today, we're going to talk about a force. It's a force that controls us as men, and a lot of us don't even know it, but it's this invisible force that impacts how we think about our health, our body, and it could be responsible for a lot of bad health decisions. It's reinforced in magazines, TV shows, movies, social media, and communities. We cannot get away from it. As a matter of fact, the World Health Organization thinks it's the reason why men tend to live six to eight years less than women, this invisible force. What is it?

Troy: Dark matter.

Scot: Kind of. It's the notion of what makes a man a man, the forces called masculinity. Nick is an expert in this topic. I actually did for my master's program a research paper on masculinity and men's health, and what I found was fascinating. I don't know about you guys, but I hate the thought that anybody or any force is controlling what I'm doing.

Troy: Especially if it's shortening our life by six to eight years. I had no idea. Wow.

Scot: Yeah. Isn't that crazy?

Troy: That's crazy.

Scot: So, before we get going, Nick, maybe you can give us a definition of what masculinity is, because it's not a real thing. It's what's called socially constructed. It's just something that we as people made up.

Dr. Galli: Yeah. Let's say it's sort of the set of attitudes, beliefs, behaviors that dictate how men should behave, what they should think, what they should value. And as you said, Scot, it's pervasive. We're primarily talking about Western cultures and even more primarily the U.S. It cuts across everything that we do.

Scot: So an example of this and how it might impact our health is somebody offers you a steak or a salad and you take the salad, what happens? What happens if you've got your guy friends around?

Dr. Galli: Well, of course, it depends, but yeah, you're going to get . . . I mean, when I think back to when I was sort of in the prime of . . . Because it changes, right? So, for me, when I was in my late teens and in my 20s and spending a lot of time with my guy friends, now you're immersed in that. And so, for sure, you'd get some looks.

I mean, even on that specific topic, I remember going out to lunch and dinner with my guy friends and it was almost, "How much fatty food can you eat?" Like, it was a challenge. Everything is a challenge in the world of masculinity. Everything is a competition, including how much you can eat.

Troy: Nick, I wonder how much of this is learned, how much of this is just the fact that as a man you've got testosterone and testosterone tends to lead men often maybe to be more risk-taking or maybe more competitive. I don't know. I mean, are there certain elements there versus . . .

Dr. Galli: I think there's a biological component, but that becomes accentuated for sure by messages that begin very early on.

Troy: And by masculinity then, are we talking about . . . again, is it the way we're interacting with others? Is it the expectation I have for myself? Is it just this idea that I can't show emotion? What is it about this that's kind of the core element of it? And getting to that, what is it about it that's so detrimental that's really shortening our lifespan?

Dr. Galli: Well, I think too, before we go much further on it, true experts and scholars in gender studies and masculinity would probably argue that there are multiple forms of masculinity. And the kind that we're talking about here today and that tends to be especially problematic is sort of that dominant, what we call a very . . . this is a very scholarly term . . . hegemonic masculinity. Hegemonic is just a fancy way to say dominant.

I think one of the tasks and one of the goals is to try to diversify. There's nothing inherently wrong with masculinity, femininity, but building in some flexibility into those concepts that there's not just one way to be masculine or one way to be feminine.

What's problematic about this dominant form that, as Scot alluded, seems detrimental to our health is that, yeah, we box ourselves in as men into a certain way of being, and that's fueled by things that we see and expectations that we hold of ourselves and that others hold of us. And really, what needs to happen, and this is maybe skipping ahead to more practical, is there needs to be a much more flexible conception of what it means to be a man in society.

Scot: And that's difficult, right? Because I bet you we could all tell our stories . . . I don't know. I can only speak for myself I guess, but I grew up in a ranch environment in western South Dakota and there was a certain kind of way that guys were supposed to be there, which is all just created in our own brains. There's nothing inherent about a lot of it. And I didn't fit in, right? I was a little bit more sensitive. I was a little bit more delicate. I wasn't a big muscular guy, right? I didn't like to ride bucking broncs and bulls and I didn't like to fight. So that made me less than.

Dr. Galli: Absolutely.

Scot: And I spent a lot of my life, and I still think about it to some extent, but not as much, trying to come to terms with, "Oh, I'm not a man. I don't look for a chance to . . ." Like, if somebody gets in my face, I don't get right back in their face. That's not how I choose to handle it. Maybe I choose to talk it out. That's not manly, right? That doesn't fit that masculine definition. So, for a long time I've . . . and especially then comparing myself to my dad who was all those things.

Dr. Galli: Well, thanks for sharing that, and I think that speaks to one of the earlier manifestations of how this can become problematic, is when we see young boys in school who maybe prefer different types of activities that aren't perceived as masculine or act in ways that aren't perceived as masculine, and then they can become the subject of bullying. We know well the consequences of bullying on mental emotional health.

Scot: And also just my own emotional health not living up to this ideal.

Dr. Galli: That you're not good enough. That you don't . . .

Scot: Exactly.

Dr. Galli: . . . meet that standard. I relate. I mean, where I grew up in a mid-sized city in central California, at my high school, for the boys, there were sort of two ways to be popular: one if you were a tough guy and/or two, if you were good at sports, and physical sports particularly, so football or the mainstream sports. If you couldn't check either of those boxes, you were sort of on the fringes of popularity or of acceptance.

Troy: Scot, it's interesting to hear you talk about that because I think I too . . . I mean, I didn't grow up in a ranching community. I grew up in a coal mining community, a small town. And as a skinny nerdy kid, middle school was miserable. I got beaten up. Not just bullied, but physically beaten up by kids in school and it was awful.

Scot: Wow.

Troy: And that kind of stuff sticks with you. I think probably over my entire life that element or that definition of masculinity, that's probably affected me.

And it's funny. I think back to two years ago, Scot, when you approached me and said, "I want to do a men's health podcast. Will you co-host with me?" It was like this sense of this imposter syndrome, like, "Who am I to talk about men's health? I am not a manly man."

And obviously, as we do this podcast, you realize that masculinity or that sense of the manly man, that's not who most men are. I don't think that's really who most men are. I think, like you said, Nick, that's the image that's out there and that's what we feel we should be. But you look at the men you know in your life and the men work with, most men are not that way.

Dr. Galli: If we were to all Google "men's health" right now, what would come up is probably very different than the things that we're discussing today. I mean, there's even a magazine called "Men's Health," and what do you get in that magazine? You get chiseled muscular bodies, very much an aesthetic and physical version of what health is.

Scot: Yeah. And not only that, but you get these attitudes of a man in "Men's Health" is great in the bed and takes care of his woman, and just all of these images and these thoughts that . . .

Troy: Well, not just takes care of his woman, takes care of multiple women. If you read "Men's Health" magazine, it's like . . . yeah, that's been my image of men's health is "Men's Health magazine. How often do you see a thin guy on the cover of "Men's Health" magazine? It's usually dudes who are just totally ripped and built and just these massive dudes.

And all the articles there, it's about that. It's about living a lifestyle. Not all of them, but a lot of them have to do with maximizing that lifestyle, live hard/play hard, work hard/play hard lifestyle, and a certain element of sexual prowess or whatever else some of these articles . . . and so it's a . . .

Dr. Galli: This makes the battle even harder, right? Because now we have sort of the big media hijacking the concept of men's health. Not just masculinity, but men's health, and selling it to the masses.

Scot: Yeah, it's that either/or, right? So it doesn't leave you any in between. It's either you're working out and you're doing high intensity exercise and you're eating just perfectly, or if you can't live up to that ideal, which sometimes I think I can't do that. So then it's just like, "Well, why even bother if that's not what I'm going to get?" So I think it's a little dangerous that way as well.

Troy: For sure.

Scot: Hey, Nick, I want to share another little aspect and then I want to kind of steer the transition of the conversation into how maybe each one of us can claim our own form of masculinity, because I think ultimately that's what we should be able to do.

So I can't speak for Troy, but I wasn't very confident and I lacked confidence for a long time in my life because I didn't fulfill this ideal of masculinity. And that can lead to mental health issues. That can lead to feelings of inadequacy. But I have noticed, too, that there are some men that are very confident in themselves and they might not fulfill that norm of hegemonic masculinity, but yet they create their own, right? To some extent, showing control and restraint in not doing all those dangerous behaviors can be a form of masculinity.

How exactly does that work and what are your thoughts on developing your own version of it? And then how are you confident in that version as you interact with the rest of the world?

Dr. Galli: That's a big question.

Scot: Hey, listen, I gave you a little bit of warm-up to get to this point. So I figure you should have all the answers by now.

Dr. Galli: Okay. There's not going to be a simple answer to this, but there are forces at play. I think two of them come to mind, as I think about folks who are sort of able to transcend what we've been talking about here.

One is just time and maturity. The young adult males are the ones who are kind of most at risk I would say for really trying to live this ideal that can be dangerous. As we get older, we care less about what other people think, we have different priorities, and so it becomes easier as we get into more middle adulthood to just sort of be our own person and not give a crap about what people say I should be. Now, that said, there are definitely some people who struggle with that. So I think time and normal development is an asset.

And then I think another asset that some folks have are support of influence and people in their family who are just unconditionally okay with a boy being how they want to be, and for that matter, a girl being how they want to be. Of course, there are forces outside the family, but that primary family tends to be the most powerful force for a lot of kids. And I think that goes a long way.

And as a young boy, if you want to play with Barbie dolls, that's fine. If you want to watch "My Little Pony," that's fine, or whatever. That's what it was when I was a kid growing up.

I think it seems very subtle, but when you are surrounded by folks who are just okay with you being you and not making snide comments or forcing you to be something that you don't want to be, then I think that allows for the possibility of just, as you said Scot, being comfortable in your own skin, even if that doesn't align with what you're seeing of other boys and men.

Troy: And I guess though, Nick, as we talk about this . . . I mean, certainly there are some elements of masculinity that are valuable, but at what point do you feel like that truly becomes toxic? We talk about masculinity or toxic masculinity. When does that sort of thing become toxic? And are we talking toxic to others, toxic to ourselves? How does that play into it?

Dr. Galli: Yeah, I think both. I mean, any time that somebody has fully internalized . . . I think of heavy drinking, womanizing, or having multiple partners and not exhibiting safe and thoughtful sex behaviors, over-imbibing in alcohol, drug use, steroid use, not going to see the doctor on at least a yearly basis because "I'm invincible." I mean, I think it's all about the behaviors, and underlying that is the thought that, "I am impervious to a lot of these issues, and also I don't need to talk about what's bothering me because that would suggest weakness."

And going back to something you said there, Troy, too about some of the advantages, I do think there are advantages, and in many ways I think our society is set up to favor and advantage men who do exhibit these dominant traits. So it's reinforcing, right?

Look at who we see as CEOs and in leadership positions. And that's starting to change, but it tends to be men. And there are some positive characteristics for sure. There are also positive characteristics of . . . and I keep pointing to femininity as sort of the other side of the coin here. Things that we associate with femininity that are also very positive, such as compassion and having a nurturing side, sort of those stereotypical feminine qualities, that many men feel like, "Well, that's not what I'm supposed to do." So they deny themselves the opportunity to explore that side of who they can be.

But in many ways our society is set up to really favor folks who exhibit these dominant alpha male qualities.

Troy: And it seems that in terms of just where masculinity truly becomes detrimental, it may be that it's that masculinity at the point where we really try and push away any sort of feminine qualities within ourselves, any sense of nurturing, any sense of emotion, those kind of things and . . .

Dr. Galli: Except for anger. Anger is okay. Anger is okay for a man.

Troy: It's okay for a man.

Scot: I think that's the only emotion, isn't it?

Dr. Galli: When a woman is angry, oh, there's something wrong. It's so true, right?

Troy: Yeah, but it seems though that that often . . . as I'm hearing you talk about this and talk about these different elements, it seems that when masculinity really becomes an issue and a problem, it is when we, like you said, take that masculinity to the extreme in terms of risk-taking, detrimental behaviors, in terms of how we treat others and interact with others, and then we push aside anything that would be associated with that feminine element, again the nurturing, the caretaking, all those sorts of things.

Scot, as you talked about, the years lost on our life, I would imagine that those are the things that really caused those years to drop off when we are pushing aside our ability to feel emotion and ability to care, and nurture, and those sorts of things, and then add on to that the risk-taking behavior and everything else there. That seems like that combination is what is truly toxic and what really hurts us.

Scot: As we wrap this up, here are a couple of my takeaways, Nick, and I'd love to hear yours as well. So I think the goal of this particular episode is just for those that weren't aware that this is an invisible force in one's life that is actually impacting your decisions or how you feel about yourself, just to become aware that it's out there and it's a thing. I think, obviously, awareness is the first thing.

And then I think developing your own definition of what you are as a person. Maybe just abandon the notion of men and women. What are you as a person? And I'm guessing that the super toxic masculinity individuals have dropped off this episode way before this point. So we're not talking to them necessarily.

Dr. Galli: But we could be talking to parents of children who have a role in shaping them.

Scot: Yeah. I mean, the way you shape them could either empower them to go out and accomplish great things, and feel good about themselves, and be mentally well off, or it can burden them if we're forcing those types of things, I suppose, on kids.

So I think becoming aware and I think realizing that it's okay to be you. I tend to be more sensitive, I tend to be more thoughtful, I don't react and come to anger as quickly as maybe some men, I don't believe in fighting. That's okay. That's my outlook on life, and that's fine.

Troy: Have you ever been in a fight, Scot? I'm just curious.

Scot: Actually, I never have, believe it or not.

Troy: Like a physical fistfight? Not even in elementary school?

Scot: No. I was a "doorman" at a bar for a couple years, and I never got in a fight.

Troy: You were a bouncer.

Scot: I know, right?

Dr. Galli: A bouncer. Yeah.

Troy: Scot is like the world's worst bouncer.

Scot: Actually, I wasn't.

Troy: He's like, "It's all right, guys. Let's talk this out."

Dr. Galli: He's actually willing to talk and . . .

Troy: I know. I was just joking. Yeah, you're totally breaking the mold of the bouncer. You're like the negotiator. I love it. That's great.

Scot: Nick, any final thoughts or takeaways from this episode? What do you hope that it accomplished today?

Dr. Galli: Oh, yeah. Raising awareness primarily. I talk about internalizing, and I think most of us take for granted the things that we see as normal and expected. So hopefully, we've at least sparked a thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from? Maybe more men or women willing to have conversations, like we just did right now, about these topics.

Troy: Obviously, we say, "Be yourself." Sometimes that's hard because it's like, "Well, yeah, but there are different elements of myself." I think it's be your best self. There are elements of masculinity that are, I think, good.

Scot: Yeah, but it's also tough to sometimes be yourself if you're not in the environment. There's no way as a young man I would have been able to buck the trend, I don't think, of what was expected of me. I don't know. Maybe there could have been had I been more confident.

Troy: Still.

Scot: You've just got to try the best you can.

Troy: Yeah, embrace the best of these things and don't . . . I think that's it, too. Again, getting to that thing about, "Well, these things are associated with femininity in terms of emotion and caretaking and all that," but if that's part of you, embrace it. Embrace that and just . . .

I think one takeaway too, like I said, Scot, is just that most men are not that stereotypical man. I think that's been one thing that's come to me in terms of this podcast as we talk to so many experts. It's just opened my eyes and I look at the people I work with, and the patients I see, and all these things. Most men are not the stereotypical manly man that we sometimes think we should be, and that's not the norm. Maybe what's held out there is what we should become, but that's not what most men are.

Scot: And there's a certain strength . . . I guess if I was to give advice to young Scot, like how you could still be yourself and be in an environment where there's a different definition of masculinity, I think . . . and I could be completely full of crap and might get the crap kicked out of me. I think there's a certain strength in knowing who you are and owning that and making no apologies for it.

I think you can stand up to people, most people. I mean, there are going to be outliers, like anything, but I think there's a certain strength in that. And I think if you do it enough and you're resolved enough, that can help.

Nick, what do you think? Am I completely crazy?

Nick: I think for the most vulnerable people, which is kids and adolescents, they need support from parents, from teachers, from church leaders, because . . . I mean, when you're 8, 10, 12, 14 years old, we could be delivering this message to them all day, "Love who we are, own it, be okay with it," but they need to see more than that. And they need role models who they can look up to, who are confident, but also caring, but also strong, but also compassionate. They need to see that, I think, to really buy in.

Troy: Yeah. And it's a lot easier as an adult I think to do that than as a kid with the perils of just the peer groups and all that. That's a tough place to be.

Scot: Yeah. As an adult, you to some extent can choose where you go. As a kid, you can't. You have to go to this place called school and everybody's thrown in there, and it's just a big old free-for-all. But I can avoid the type of people I want to avoid in my work life.

Troy: Yeah. It's a lot easier, but for those listening who you're an adult, you can embrace that. And if you're in a work . . . because there are certain work environments where I think it's difficult. I think certain work environments it may be difficult to truly be who you are, and maybe certain co-workers, but you can always find a new job or even switch professions, or all those sorts of things.

I think it's a lot easier as an adult, but I think that's probably the point, is to really embrace that, embrace who you are, and not feel like you have to fit a certain mold that's held out there.

Scot: Yep. Realize that masculinity is a thing. It's not a real thing. It's just created by all of us in society that have come to these assumptions, and these assumptions can be challenged, and you can define your own way.

One of the things I love that you said, Nick, is question why we call things normal. I think that can even go beyond this notion of masculinity. Why is this considered normal? Do I subscribe to this thought that this is normal? What are my thoughts on it? When you start asking those questions, I think you can start really kind of building your own confidence and go in your own way.

Nick, thank you very much for this conversation. Appreciate it as always for being on the podcast, and thanks for caring about men's health.

Dr. Galli: Absolutely. Thanks for having me.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or maybe it's just a random thought that's kicking around in our brain that we need to let free. Troy, do you have any random thoughts you need to set free?

Troy: Totally random thought, Scot. I am . . . and you probably are too. But I'm kind of a grammar nerd. So this is a grammar issue that has really bothered me and I've got to get your insight on this. So if I sent you a text message yesterday, how would you say that phrase? "I text you yesterday" or "I texted you yesterday"?

Scot: The thing that feels natural and normal is "I texted you yesterday."

Troy: I know. Me too. I mean, text has become a verb. It's a noun. A text is a noun. It's become a verb. In our daily usage it's become a verb. But people say "text" all the time, like, "Oh, I text you last week," "Oh, I text you yesterday," "Oh, I text . . ." And they're not saying texted, they're just saying text. I looked this up. I'm like, "What's the proper use of the verb text if I sent you a text yesterday, if I texted you?" And there is no proper use because it's just this noun we've turned into a verb, and we're all just using it. Some people are saying, "I texted you," and some people are saying, "I text you." Probably the best way to say it is, "I sent you a text message yesterday."

Scot: Yeah. I mean, if it's a noun, that's how you would say it.

Troy: Yeah, be on the lookout. Now it's going to start driving you crazy. You're going to hear people saying it all the time, like, "Oh, I text you this picture," or, "I text you this whatever." And you're like, "Text me right now, or you texted it two hours ago?"

Scot: I'm just going to leave this here. Thunder Jalili, our nutrition expert, has talked a couple times about time-restricted eating. So there's a lot of confusion when it comes to fasting because it can mean a lot of different things, but time-restricted eating is just taking the time that you allow yourself to eat during the day and keeping it limited to 12 hours or 10 hours or 8 hours so then you have a fast between then and when you eat again.

I started doing this when COVID first started, just before COVID first started. I've actually loved it. I felt great. I felt clear in my brain. I slept better. So I've started doing that again after Thunder came on, and it's only taken a couple days and already I feel so good.

Troy: Oh, nice.

Scot: So if you've ever considered time-restricted eating, there's also a documentary out there I just watched. I'm going to say right now that this documentary probably only needed to be about 40 minutes long, and it's an hour and a half. So you can just fast forward through the stuff you're not interested in.

Troy: One of those. I've seen too many of those documentaries.

Scot: Right? But it's called "Fasting" and it's on Netflix.

Troy: Nice.

Scot: First of all, go back and listen to some of our Thunder episodes. But if you're interested in time-restricted eating and fasting in general and why it works, you might want to check out that Netflix documentary.

Troy: So what are you restricting yourself to? Ten hours or 12 hours? What's your . . .

Scot: Yep. I've started it at 12, and I'm going to see how that goes. Now, Thunder has said that's a good maintenance kind of timeframe. And then in a couple of weeks I think I'm going to move to 10 or 8 because I have some body fat that I'd like to lose. So I decided to start with 12 because I thought that was doable, and then I'm going to try to get it 10 or 8. That's the plan.

Troy: Nice. That's great.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55-SCOPE. That's 601-55-SCOPE, and leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you for caring about men's health.

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