Does gender matter? An analysis of men's and women's accounts of responding to symptoms of lung cancer

Alice Maclean,Kate Hunt,Sarah Smith,Sally Wyke

doi:10.1016/j.socscimed.2017.09.015

Abstract

Men are often portrayed - in research studies, ‘common-sense’ accounts and popular media - as reluctant users of health services. They are said to avoid going to the GP whenever possible, while women are portrayed, in presumed opposition, as consulting more readily, more frequently and with less serious complaints. Such stereotypes may inadvertently encourage doctors to pay greater heed to men's symptoms in ‘routine’ consultations. Although previous research has challenged this view with evidence, and suggested that links between gender identities and help-seeking are complex and fluid, gender comparative studies remain uncommon, and particularly few studies (either qualitative or quantitative) compare men and women with similar morbidity. We contribute here to gender comparative research on help-seeking by investigating men's and women's accounts of responding to symptoms later diagnosed as lung cancer. A secondary analysis of qualitative interviews with 27 men and 18 women attending Scottish cancer centres revealed striking similarities between men's and women's accounts. Participants were seen as negotiating a complex and delicate balance in constructing their moral integrity as, on the one hand, responsible service users who were conscious of the demands on health care professionals' time, and as patients who did not take undue risks with their health, in the context of an illness for which people are often held culpable, on the other. In accounting for their responses to symptoms, men and women drew equally on culturally-embedded moral frameworks of stoicism and responsible service use. Regardless of gender, the accounts portrayed participants as stoic in response to illness and responsible service users; and as people seeking explanations for bodily changes and taking appropriate and timely action. Our analysis challenges simplistic, 'common-sense' views of gendered help-seeking and highlights that both men and women need support to consult their doctor for investigation of significant or concerning bodily changes.

Highlights

Galdas and colleagues note that “much of the empirical literature suggests that stereotypical gender roles and norms e culturally dominant behaviour considered to be essentially “masculine” and “feminine” e are an important factor that shapes both men's and women's health help-seeking behaviour” (Galdas et al, 2010, p19)
We present results of a secondary analysis of men's and women's accounts of the lead-up to consulting their GP with symptoms later diagnosed as lung cancer (LC)
Despite concerns about men's help-seeking behaviours anduse of health care having long been at the forefront of the men's health agenda (Galdas et al, 2005; Hunt et al, 2010), research has shown that the links between performances of gender and accounts of help-seeking for illness are far from simple and static

Summary

Introduction

Galdas and colleagues note that “much of the empirical literature suggests that stereotypical (or “traditional”) gender roles and norms e culturally dominant behaviour considered to be essentially “masculine” and “feminine” e are an important factor that shapes both men's and women's health help-seeking behaviour” (Galdas et al, 2010, p19). (under)use of health care is problematic, consulting for serious symptoms at a later stage, while women are presumed to consult more readily, frequently and with less serious complaints (Hunt et al, 2010) and perhaps by implication to be ‘over-users’ of health service resources Such stereotypes, and the evidence on which they are based, are themselves problematic, as we argue below, and can have far-reaching implications, on men's and women's understandings of ‘gender appropriate’ consulting behaviours, on doctors' interpretations of symptoms according to gender (Arber et al, 2006; Lyratzopoulos et al, 2012; Schoenberg et al, 2003) and potentially on the ways researchers investigate, understand and draw conclusions from evidence relating to helpseeking for illness among men and women. Galdas et al (2010) argue for a need to go “beyond the masculine-feminine binary” of stereotypical gendered constructions of “stoic men” and “vulnerable or accommodating women”

Methods

Results

Conclusion