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Online forums helpful for men facing infertility, new research shows
The new study, by Dr Esmée Hanna and Professor Brendan Gough in the Centre for Men’s Health at Leeds Beckett and published in the latest edition of the Journal of Health Psychology, set out to address the under-researched area of men’s experiences of infertility by analysing the use of a UK men-only online infertility forum. The results suggest changes are needed in the way that health services communicate with men facing infertility.
Dr Hanna explained: “Our previous research has shown that men describe infertility as a deeply difficult experience and seeking help through the men-only forum is a source of real comfort and support in an experience otherwise deeply isolating: for both men and women. Much of the support sought was around helping their partners, which is pertinent given that men are often seen to be suffering in silence as the ‘emotional rock’.
“The men-only nature of the forum gives men confidence to seek support and advice; with many comments being made around the need for collective knowledge above help from friends and family, who were seen as naïve and inexperienced. We also found that there is value for men in being able to remain anonymous when seeking help, perhaps linked to the perceived sensitivity and stigma around infertility.”
Despite infertility affecting both men and women equally, and one in six couples being impacted by fertility issues in the UK, it remains an issue in which stigma is particularly pronounced for men, who can view it as compromising their masculinity. Men also report feeling marginalised by medical professionals during fertility treatment and that their main role is to support their partner.
Professor Gough said: “Through understanding how men seek help and the aspects in which they find value, we learn more about the needs of men in seeking help for sensitive health topics more widely, and how we can best support them in times of significant emotional stress.”
The research highlighted the need for men to receive guidance from ‘insider’ men, with the view that friends and family don’t understand and that counselling isn’t for them, leaving them feeling ‘stuck’ in terms of who to approach for support. The forum appeared to fulfil their needs in this important aspect both in terms of feeling like someone ‘gets it’ and seeking specific help when they moved into new territory, such as deciding to stop in-vitro fertilisation (IVF) treatment, providing validation for their choices.
Similarly, the anonymous nature of the forum created a safe space for men, who may naturally be private, to share their emotions. However many of the regular posters did comment on feeling like ‘the weird ones’ for doing so, when so many subscribers to the forum never posted and shared their own views. Dr Hanna suggested that this may be a way of attempting to ward off possible criticism for overt emoting: “Posters referenced their ‘frustration’ and ‘confusion’ about why the forum was not more readily utilised, with the question remaining as to whether sharing is acceptable for men.”
Analysing the men’s choice of language equally revealed that they were keen to distance themselves from traditional methods of seeking help, with one man writing: “It’s not counselling or psychiatry, it’s just getting it off your chest.”
Professor Gough said: “The phrase ‘getting things off your chest’ distances the forum from the more formal psychological services which may be viewed as feminised; whilst ‘it’s just’ attempts to show that the forum is not excessive in terms of expressing emotions. The word ‘stress’ was also frequently noted throughout the forum, which is a word often used by men as a way of conceptualising vulnerability or in relation to mental health issues.”
The final key finding of the research was the running theme of masculinity when discussing infertility. The men felt the need to be strong and not show their feelings to anyone, recognising the ways that they thought they ‘should’ behave, as opposed to women who they saw as expressive and more emotionally invested.
In spite of this, the men on the forum were able to voice their depth of distress, contradicting the notion that they can detach from the experience and that women feel more in the context of infertility.
Importantly, some men noted that they had not been encouraged by the approach of professionals to seek help or support, with the perception that they should manage their emotions on their own. One man related how he was not offered counselling or put into contact with other men who had been through the experience. Many also noted that their partners had access to several online forums, whereas they had only been able to find the one forum.
“Men are viewed as being neglected in professional healthcare settings and health professionals can be seen as reinforcing masculine ideals about how men should cope,” Dr Hanna added. “Our research shows that health promotion initiatives should sign-post men facing infertility to such forums for informal help and support, targeting them using ‘male-friendly’ language, offering remote, anonymous support and employing peers to help normalise the experience.”