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It’s like taking a bit of masculinity away from you

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Alan Dolan discusses how infertility is perceived as having the potential to fracture current and even future relationships.

Image courtesy of interviewee. April 15, 2024

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This video video is a detailed account of a researcher's insights into men’s experiences with childbirth, particularly focusing on first-time fathers and their emotional responses during the infertility treatment process. Key points include: 1. **Motivation and Background**: The study was sparked by interviews with first-time fathers regarding their childbirth experiences, uncovering a lack of research on men's perspectives during these events. 2. **Research Approach**: The researcher aimed to conduct a prospective study (instead of retrospective) by interviewing men undergoing infertility treatment in real-time, discussing their feelings, anxieties, and experiences. 3. **Hegemonic Masculinity Framework**: The analysis draws on the concept of hegemonic masculinity (by Raewyn Connell), which views masculinity as relational and context-dependent rather than fixed. This video video framework examines how men express their masculinity in relation to societal norms and pressures, while also addressing how such norms can marginalize other men. 4. **Embodied Masculinity**: It emphasizes how men's physical experiences and perceptions of their bodies interact with their sense of masculinity, particularly when faced with infertility challenges. 5. **Health Perspectives**: This video video discusses how masculinity affects men's attitudes toward health and seeking help, often leading to delayed treatment-seeking behaviors. 6. **Study Findings**: The recruitment of participants was challenging, but eventually involved 22 men, mostly with known male infertility issues. Telephone interviews were preferred, with many men choosing private settings to discuss sensitive topics. 7. **Desire for Parenthood**: The men expressed a strong desire for children but often delayed seeking help, which led to emotional distress due to the repeated disappointment of unsuccessful attempts at conceiving. 8. **Control and Vulnerability**: Many men initially felt a loss of control but later described a sense of empowerment upon engaging with treatment and acknowledging their infertility issues. 9. **Relationships and Emotional Expression**: The men tended to avoid discussing infertility with peers due to fears of stigma, ridicule, or feelings of inadequacy concerning traditional masculine roles. Despite this, they recognized a network of support existed among their friends and families. 10. **Concerns for the Future**: Anxiety about potential relationship problems due to infertility loomed large, with fears of being unable to fulfill traditional masculine roles associated with procreation. In summary, the research highlights complex dynamics around masculinity, emotional struggles, and the challenges men face in seeking help and maintaining relationships during infertility, underscoring the need for more awareness and support for men's experiences in these contexts.

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What actually motivated it was a study on childbirth.

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So I did a study on, first time father's,

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experiences of childbirth.

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And what we did was we interviewed them before and after,

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and it was in those before interviews that

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men talked about.

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Um, I'm just glad everything's working, you know, I dunno

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how I'd feel if it didn't.

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And that just generated a thought.

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So I looked into, so my, my, all

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of my research really is around men and masculinity

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and health or fatherhood and things like that.

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So it just sort of sowed a bit of a seed.

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So I went away and had a bit of a look,

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and there was very little in relation to men, at

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that time, men and masculinity and,

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and all of, well, not all,

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but the vast majority of studies at

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that time were all retrospective.

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So it was men looking back,

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talking about their experiences of having been through

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that process, either becoming a father via IVF

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or something, or becoming a father through adoption.

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And what I wanted, well, and, and my colleagues,

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but it's mainly my, I'm driving it, is, is to, is

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to get a sense of the here

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and now in the eye of the storm, so to speak.

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So rather than retrospective to do a prospective study.

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So men who were undergoing infertility treatment, now

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that may, I'll come onto this later,

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but that made it more difficult

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because it was asking men to talk about something

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where they did not know the outcome.

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So hegemonic masculinity is a particular

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theoretical framework by Raywin Connell

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to understand masculinity.

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There are other frameworks available.

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It's the one that just resonates most with me.

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And the thing I like about,

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connell's hegemonic masculinity framework

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is it's relational.

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So it doesn't think about masculinity

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as a something inherent or as one thing.

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So men demonstrate, perform whatever words we want to use

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masculinity in relation to those around them.

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And the thing about connell's framework is

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because it, it's cross cut with class

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and ethnicity, sexuality, age, what it,

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what it gives us is a theory of masculinity that both

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recognizes dominant hegemonic notions of what it means

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to be male, whether we agree with them or not.

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And, but also it's so that, so it allows us

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to understand how men dominate or have power over women, but

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It also enables us to think how men are,

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what in connell's terms may be subordinated

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or marginalized in relation to other groups of men.

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So it isn't just about men, women relationships,

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it's also about how men maintain

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or live up to the ideals, hegemonic ideals

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of masculinity and how these can change.

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They're context dependent.

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So men don't demonstrate masculinity in the same way in all

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contexts, but they, we recognize

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that there are these certain dominant aspects,

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whether we wanna call it success or stoicism

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or, you know, get into the front problem solving,

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being in control, stoic,

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however, we want to think about some

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of those dominant ideals.

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And men either can't

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or choose not to live up to those at different times

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and in different places.

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And the, what I like about that

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as a framework is it enables us to see in which,

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in the ways in which men can be,

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can demonstrate ideals in, in certain ways,

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or not be able to, particularly in the field of infertility,

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but can, but can hold onto

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or demonstrate parts of their

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masculine identity in other ways, in keeping control

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or not showing, emotion or whatever it is.

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So I like that as, that's a particular theory

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of, of masculinity.

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Embodied masculinity is really the notion of how men,

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how the body is used to maintain and demonstrate.

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So it's the body we have, the one that we see, the one

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that others see, how it can de it can enable us

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to demonstrate certain masculine ideals,

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but also the body we have.

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And that's where I think,

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and that's the body that we would, I, we have.

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And that in the sense of when it begins to go wrong, it can,

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I, on one sense, he can help us to maintain,

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to demonstrate those ideals.

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And in other ways, when it begins to go wrong,

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it makes us vulnerable

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and, you know, we might lose our position.

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So it, it means that particularly in the field of,

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of infertility, the ways in which the body suddenly

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came to the form, men, men

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who had thought they were fertile, everything was working,

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and no sense that this was going to be a problem.

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And then it, you know, we can come to that.

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And then the fi the third sort of element, this, the,

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aspect of the theoretical framework is this notion of

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how men masculinity means that men view

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and think about their

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Health in different ways,

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and is often used as a,

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the reason why men die earlier.

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Um, those kinds of things that men don't tend

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to look after themselves.

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And, you know, the headline figures that men are half

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as likely to get, I dunno whether this is still the case,

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but it used to be half as likely to get skin cancer,

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but twice as likely to die from it.

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The idea that men leave things

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and it becomes so, so bad that it's then not treatable.

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Now actually, it's not as simple as that.

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And I, you know, it, it, it's far more,

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there is a complexity to it.

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But the idea that the ways that men, understand health,

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their relationship with their health has to be

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understood in a context of being a man.

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It can't simply be, you know, well,

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women can do this then why don't they,

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it's a relatively small study.

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But, so we set out to, to, recruit

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as many men as we could,

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and we wanted, men with,

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male infertility, if ideally.

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Um, so we, we made, connections

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with an infertility clinic, and we used posters

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and flyers and information sheets,

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and we left them in the, main waiting area.

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And then we also had, so, and,

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and it said on it, you know, do you, they had

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to self-identify, they, you know, it was like,

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we are interested in men's experiences.

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Do you wanna talk to us about it? Uh, please contact me.

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Okay. Um,

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and then we also had a consultant gynecologist

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who ran a male factor, clinic.

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Okay. And a research nurse

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and a embryologist.

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And between those three, they would ha give

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and talk to men, who came

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to them about the study.

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And the interesting thing is,

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is the consultant gynecologist was great.

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And he would talk

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and he would mention the study to every man.

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And he would, he would say to us, it's going great.

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They're all really interested.

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And I'm saying they are, when they're with you, they're not,

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they roll the bit of paper up

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and they throw it away as soon as they leave.

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Um, and even with the, the nurse

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and the embryologist, they would pass.

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So they would take, the consultant didn't do this,

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but the other two would take the details of men

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who were willing to be contacted, and then at the time,

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and then we, I would ring them or email them.

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And again, at the time, people are trying, you know,

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they're in a particular sense of circumstances.

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So it's like, of course, yes, well think about it.

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And then I'd ring or email

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and it'd be like, no, I'm busy shopping that day.

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Or, or whatever the actual, you know,

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the men would be busy

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or there'd be something that would prevent them.

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So it took us a long time to generate 22,

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men.

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But these men were, were, so the, the majority

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of them were male factor.

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They knew they were male factor.

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There was a couple that were un undiagnosed.

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There were a couple, so unexplained, shall I say.

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So they, the, the, they couldn't, they didn't know

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what the problem, so it was slightly to be, to be them.

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And then there was a couple of men also who had,

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who'd had a vasectomy, who'd had,

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who'd previously had children,

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and who had a, with a new relationship

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and were, wanting, needing to go via the IVF route to,

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to conceive a child with their knee partner.

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Just to say that one of the,

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'cause I've interviewed many men for different studies,

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and one of the things that with this study is that the, we,

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we were allowed, we were given ethical clearance to

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use telephone interviews.

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And all of the men bar one chose telephone interviews.

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So I never met nine, the 99% of these men.

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And the interesting thing for me as a,

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as a researcher who's interested in men

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and aspects is, is where these men took the call.

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I, you know, they, they, so many of them were taking their,

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were doing the interviews in their car

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or on their, on their drive, or in a, in an office.

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And it was, and it was, to me, it was very striking

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that they chose places where they were not going

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to be interrupted.

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So, you know, you clearly got a sense

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that this was not gonna be easy for them.

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So we, we, we started, I started the interviews

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by talking about their desire to have children.

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Had they had the desire, had they, you know,

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what were they, this help seeking?

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When did they find out?

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How long did it take them to, to make, contact

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with health professionals?

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And, and, and not surprising.

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I mean, what they were saying was, I, they think that,

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you know, men may not have the same biological drive,

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but actually men have a, a real desire to have children.

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Lots of men do. Um,

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but then they were trying to weigh that all with the fact

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that some of them had taken up

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to five years to seek treatment.

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So on the one hand, yes, we desire children,

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on the other hand, they're delaying the

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first nothing's happening.

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They can't get pre their, their partner can't get pregnant.

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So they're, so they're, but they're delaying that.

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So they were trying to make sense of that to begin with.

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And a lot of that was about men, wanting to say, look,

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we, we do desire, clearly we want children.

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Um,

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And it's within us as much as it is within women.

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Maybe not, you know, women have a biological clock,

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which is often the reason thing that that's talked about.

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So they talked about how they, you know, they desired,

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but also about how they delayed.

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And often it was because everything was working.

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So it, it couldn't, why there, there, there was no signs,

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there was no legitimate sign as to why they might need,

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why there might be a problem.

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So, and they weren't, they were fully aware that men tend to

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think about health as well.

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If there's a problem, you may evaluate it.

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If you think it's serious, you will go.

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If you think it might not be serious,

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but it's an issue, you might see how it plays out.

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And they were very similar to that.

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Let's see how it plays out.

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But of course, the difference within fertility is

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that they weren't on their own.

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So they were continually having to deal with the,

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the disappointment each month

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or so that their partners were not pregnant.

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So there was a continual pressure on them to do something.

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Um, and eventually that,

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and they knew, they, they weren't looking forward to the, to

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what they might have to do.

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They weren't looking forward to the particular questions.

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They weren't looking forward to have, to finding out

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that their body wasn't working

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as they had expected it to be.

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Um, but once they'd made that, that step,

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they then framed it as being in control.

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So they were on the one hand sort of losing a bit

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of control, but once they had access,

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they were very much about, right now we're gonna address it.

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Now we can do something about it.

13:44.145 --> 13:47.885
So they were sort of regaining some sense of,

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of authority

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or a sense of, you know, what was gonna happen next.

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So that was quite interesting,

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in and having got the diagnosis

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okay, which was clearly a in, in,

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in every case that I, the men

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that we had in this study was all came as a shark,

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apart from the two with the vasectomy, there was no warning,

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there was no family history of infertility.

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There was no underlying health reasons as to why they,

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they might, be infertile.

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And that came as a, as a shot.

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One chap described it as a sledgehammer blow. Okay?

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The thing that they thought would be, as he said,

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like flicking a switch didn't work.

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And,

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and in that sense, it, it was, they did feel

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That for the, for, for all of those reasons,

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that their sense of self, sort of an existential crisis

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as such as a man, their sense of self was very much,

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you know, taken from under them that they needed.

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They, they, they were struggling with the idea that the man

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that they thought they had,

15:13.945 --> 15:16.445
the body they thought they had was no longer

15:16.875 --> 15:18.005
what was the reality.

15:18.345 --> 15:20.965
So they were having to deal with those sorts of things.

15:21.825 --> 15:23.405
So there was two aspects.

15:23.665 --> 15:25.965
One, there was the sense of men,

15:26.225 --> 15:28.365
and it goes back to that thing about losing

15:28.435 --> 15:29.765
control in one aspect.

15:29.785 --> 15:32.405
So losing that sense of sort of alpha male,

15:32.545 --> 15:33.685
if you want to call it that.

15:34.425 --> 15:37.205
But also ga having, gaining control

15:38.025 --> 15:42.245
within their relationship by not demonstrating emotion.

15:42.755 --> 15:46.845
Okay? Even though their partners often perhaps wanted them

15:47.185 --> 15:50.845
to demonstrate emotion to the extent that one chap says,

15:51.795 --> 15:55.165
when, when this happens, women should have, should be able

15:55.165 --> 15:59.445
to go somewhere and be told how difficult it is for men.

16:00.085 --> 16:02.645
'cause we aren't able to explain it to them.

16:03.385 --> 16:05.045
So there was that aspect of it.

16:05.305 --> 16:07.405
And then there was the aspect of, well,

16:07.795 --> 16:10.805
what happens about those other relationships,

16:11.295 --> 16:13.245
men's relationships with other men?

16:14.065 --> 16:16.725
And they all,

16:17.715 --> 16:20.885
made a conscious decision that they were not going

16:20.945 --> 16:22.685
to talk about it.

16:23.825 --> 16:26.765
But, and this is the bit that, that, that, that often,

16:26.765 --> 16:29.565
that means that, that men have, are, are, are,

16:29.625 --> 16:30.685
are in isolation.

16:31.075 --> 16:33.165
That didn't mean that other men didn't know.

16:34.355 --> 16:38.925
Lots of other men in their circle knew if their partners,

16:38.925 --> 16:42.285
their, you know, relationships, their friends, their family,

16:42.915 --> 16:43.965
they all knew.

16:44.675 --> 16:46.685
They would all talk about it,

16:47.225 --> 16:49.605
but they wouldn't necessarily talk to him

16:50.025 --> 16:54.205
or them about it as a, on their own.

16:54.625 --> 16:56.005
Now they saw that as both.

16:56.075 --> 16:59.105
They didn't wanna, they didn't wanna talk about it.

16:59.505 --> 17:02.305
A to protect other men, what are they gonna say?

17:02.535 --> 17:04.185
It's gonna put them on the back foot.

17:04.185 --> 17:06.545
They're gonna feel embarrassed.

17:06.905 --> 17:10.145
Secondly, even with their close friends, there was always

17:10.145 --> 17:13.425
that concern that they could be used to, to a little bit

17:13.425 --> 17:16.985
of ridicule, a little bit of a, you know, well, you know,

17:16.985 --> 17:18.825
if you, if you ever, you need a hand,

17:19.325 --> 17:20.625
you know, I'll always pop around.

17:20.625 --> 17:22.465
There was that link between validity

17:22.965 --> 17:26.065
and infertility, which they were always a little

17:26.065 --> 17:27.105
bit concerned about.

17:27.965 --> 17:31.945
And, and then there was the notion of, you know, I don't, I,

17:32.265 --> 17:35.225
I don't want to have those conversations.

17:36.325 --> 17:40.905
Um, but I know I could have them with certain

17:41.615 --> 17:45.225
male friends if I wanted it.

17:45.245 --> 17:48.225
So there was the, they knew that the support was likely

17:48.325 --> 17:51.325
to be there if and when they wanted it.

17:52.345 --> 17:56.005
But the thing that was also in terms of underlying some

17:56.005 --> 17:58.925
of this was the, was their concern about the future.

18:00.025 --> 18:02.565
Uh, remember they were traveling in hope.

18:02.795 --> 18:06.845
They were in, they, they may have had one cycle

18:06.985 --> 18:10.365
of IVF that hadn't worked, but they were going into another,

18:10.865 --> 18:14.805
or they were about to have their first, the thing

18:14.805 --> 18:17.365
that they also had to deal with was

18:17.395 --> 18:20.605
that not just the current situation, but the future.

18:21.145 --> 18:24.325
And that is that they, particularly those men

18:24.345 --> 18:28.245
who had male infertility, there was always the threat about

18:28.475 --> 18:30.565
what might happen to their relationship.

18:31.295 --> 18:32.325
There was the threat.

18:32.425 --> 18:34.285
And we, there's, you know, the, the threat

18:34.305 --> 18:38.165
of the fertile man, you know, I, I,

18:38.645 --> 18:43.525
I can't have, I know that I can't have children,

18:43.525 --> 18:47.185
without, without treatment, but my partner can.

18:48.055 --> 18:51.095
So she may choose to have

18:51.435 --> 18:53.935
to end our relationship in some way.

18:54.255 --> 18:56.055
I know she won't, but she could.

18:56.755 --> 18:59.855
So there was always, in that background, was the threat

18:59.875 --> 19:04.495
of the fertile man, the man who could,

19:04.685 --> 19:07.175
provide what they couldn't.

19:07.555 --> 19:11.135
And that was the, that was the sort of ultimate sort of

19:12.095 --> 19:15.815
masculine bit that, that that was always underpinning their,

19:16.315 --> 19:19.695
you know, some, some voiced it more,

19:20.645 --> 19:21.935
more directly than others.

19:22.395 --> 19:25.215
But it was clear that when we were, I was talking

19:25.235 --> 19:28.815
to these men, it was clear that, that, that that was a,

19:28.885 --> 19:31.895
that was a concern that they would,

19:31.895 --> 19:34.735
they would say things like, you know, if this doesn't work,

19:34.835 --> 19:36.975
and of course they, they made, you know,

19:37.275 --> 19:38.815
I'm the more rational one.

19:39.315 --> 19:43.055
You know, my, my partner gets a bit emotional sometimes,

19:43.195 --> 19:45.855
understandably, they're going through all of the treatment.

19:45.855 --> 19:47.655
They all felt guilty. They weren't trying

19:47.655 --> 19:48.815
to put their partners down,

19:50.245 --> 19:52.225
but they often said, I'm the rational one.

19:52.245 --> 19:54.505
I'm the one who says, let's just keep calm.

19:54.795 --> 19:57.705
Let's not, you know, if, if this doesn't work,

19:57.835 --> 20:00.465
we've still got a great life ahead of us.

20:01.695 --> 20:06.345
Okay? But some were a little bit more like, you know,

20:06.425 --> 20:10.825
I am fearful, I am fearful that this, this might not,

20:11.135 --> 20:14.625
this might end, you know, badly in every which way.

20:14.645 --> 20:16.385
And that's not quite what they said,

20:16.405 --> 20:19.705
but that's the, the gist of what they were saying.

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