For Some Teens, a Checkup Just Isn't Macho

Adolescent males who hold traditional beliefs about masculinity may think that seeing a physician is unmanly or a sign of weakness, a new report suggests.

Researchers at Johns Hopkins Children's Center and their colleagues analyzed data on about 1,700 males ages 15-19. In addition to noting males' reticence about STDs, birth control, and other health issues, the authors said parents may not be encouraging young men to have an annual physical.

More than half of the males were sexually active. But these males were no more likely to see their doctors than were boys who abstained, the report found. One-fifth of the boys had engaged in two or more risk behaviors, such as drinking, smoking, using cocaine or forcing another person to have sex. One hundred and four reported having had an STD.

Half the boys endorsed what the researchers identified as "traditional beliefs" about being a man, agreeing that "Men are always ready for sex" and "It is essential for a guy to get respect from others." These boys were less likely to see a physician, said lead author Arik Marcell, a pediatrician and adolescent health specialist at Children's Center.

Boys who discussed sexual issues with parents were more likely to visit a doctor, said Marcell. For boys with a traditionally masculine orientation, speaking with their fathers was helpful.

Even at the doctor's office, there may be missed opportunities for communication, said Bill Albert, deputy director of the National Campaign to Prevent Teen Pregnancy. For example, in 2002, among males ages 15-19 who had seen a doctor, fewer than one in five had received counseling about birth control, STDs or HIV. "Parents say, 'Between the doctor and school, I've got this one covered,'" said Albert. "That is not true."

The full report, "Masculine Beliefs, Parental Communication, and Male Adolescents' Health Care Use," appeared in Pediatrics (2007;119(4):e996-e975).

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