For boys, a checkup just isn’t macho

As boys grow up and become sexually active, they cut back on regular visits to the doctor, sometimes for reasons of cost and lack of health insurance. But a new study cites another factor: boys’ beliefs about what it means to be a man.

The study of 15- to 19-year-olds, led by researchers at Johns Hopkins Children’s Center, suggests that young men view visits to a healthcare provider as a sign of weakness. In addition, young men frequently don’t talk openly about health issues such as birth control and sexually transmitted disease to their parents, who, the study’s authors report, may not be encouraging annual exams.

The investigation, reported in the April issue of Pediatrics, analyzed data on almost 1,700 young men. More than half of the subjects said they had had sex, and they were no more likely to see a physician than those who abstained. One in five had taken part in two or more risky behaviors such as drinking, smoking, cocaine use and forcing someone to have sex. One hundred four young men reported having had a sexually transmitted infection.

About half of the study group held what the researchers called “traditional beliefs” about manhood, responding positively to such statements as “Men are always ready for sex” and “It is essential for a guy to get respect from others.” Those were the boys who were less likely to report regular exams, according to lead author Arik Marcell, a pediatrician and adolescent health specialist at the Children’s Center.

“The underlying issue is how to do a better job socializing boys into health,” Marcell said in an interview. Mothers encourage their daughters to see physicians regularly once they get their menstrual period, he said. Boys are not similarly instructed once they start having wet dreams, their introduction to sexuality.

Marcell’s study found that boys who talked to their parents about sexual issues were more likely to see a physician. For the most macho boys, talking to a father was particularly helpful. But what a boy learns -- or doesn’t learn -- at the doctor’s office can be a problem, says Bill Albert, deputy director of the National Campaign to Prevent Teen Pregnancy.

“Doctors are not talking to boys about birth control, at least as much as they talk to girls, or about STDs,” he says. The take-away message for parents? They’ve got to talk about the consequences of sex.

“Parents say, ‘Between the doctor and the school, I’ve got this one covered,’ ” Albert says. “That is not true.”