Men's Sexual Health Needs Often Ignored

Medically Reviewed by Gary D. Vogin, MD
From the WebMD Archives

March 5, 2002 -- We can't agree on what men's sexual health is. We can't agree who's responsible for it. But just hoping it will happen isn't working, a new report concludes.

The study, "In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men," is the work of the nonprofit Allan Guttmacher Institute. One of the report's authors is David Landry, senior research associate at the institute.

"One of the critical factors is that there is no place for men to go for sexual and reproductive health care," Landry tells WebMD. "Men need to be aware, their partners should be aware, that women don't have to assume responsibility alone."

The problem isn't exactly hidden. In fact, it's often front-page news:

  • Record rates of sexually transmitted diseases and HIV
  • More teen pregnancies and births in the U.S. than anywhere else in the developed world
  • Fathers failing to fulfill their responsibilities as parents
  • Continued high divorce rates

What would men's reproductive healthcare look like? Sarah S. Brown, director of the National Campaign to Prevent Teen Pregnancy, says the report paints a vivid picture.

"It looks like good education in schools; it means reimbursement for counseling and care for men as well as for women; it means training for physicians in men's and women's sexual health issues," Brown tells WebMD.

Providing more reproductive health services to men shouldn't mean cuts in services to women, Landry is quick to point out.

"Clearly women do need special clinical and diagnostic services," he says. "But the principle types of services we are talking about for men are awareness raising and counseling. These are services which tend to be the least expensive to provide. By providing for men we are also doing something good for women."

One focus of the report is on men in their teens and early 20s. Some findings:

  • One in four teens are sexually experienced by age 15. Nine out of 10 men have had sex by their 20th birthday.
  • Poor and minority youths begin sexual activity at a younger age than more affluent or white teens.
  • More often than not, a man will use a condom during his first sexual experience. Later, condom use declines.
  • Only 7% of births involve teenage men.
  • Each year, 13% of all abortions involve teenage men. More than half of teenage pregnancies involving teenage men result in a birth.
  • Men in their 20s are involved in half of all U.S. births -- and half of all U.S. abortions.
  • Eight out of 10 children fathered by men in their early 20s are born out of wedlock.

The report also considers the needs of older men:

  • Half of all men father a child by the age of 30.
  • Eight of 10 men in their 40s are married or living with a woman.
  • By age 49, the average man has had two children.
  • More than one in 10 men in their 30s has a child he does not live with.
  • Eight of 10 U.S. adults with AIDS is a man.
  • Half of all men who use condoms do so for birth control, not disease prevention.

"The value of this report is that it takes a life span perspective," Brown says. "What I love is that it addresses the whole life span of men."

So what do men need? The report says men have several unmet needs. The first of these is the need for better information. Parents, doctors, teachers, and community leaders must be involved in ensuring access to essential information. This includes education on:

  • Basic sexuality and reproductive health
  • Genital health
  • Healthy relationships. Topics should include when sexual involvement is appropriate; forms of sexual expression; sexual coercion and violence; and the influence of alcohol and drugs on behavior.
  • Pregnancy prevention, including abstinence and condom use
  • Prevention of sexually transmitted diseases and HIV
  • The responsibilities of fatherhood
  • How to obtain other services

Men also need to learn specific skills. These include skills in preventing pregnancy and disease, and fathering skills.

Men often need counseling. This should include:

  • Help developing self-esteem and gaining a sense of control over one's life and one's decisions
  • Help getting through major life events and decisions
  • Mentoring in developing values and motivation

Men need healthcare. This should include preventive services beginning prior to adolescence and continuing throughout life. Doctors should follow AMA guidelines in obtaining a sexual history and in testing for sexually transmitted diseases.

"What we call for is a communitywide effort," Landry says. "We need to raise awareness to a broader extent."