The Lancet’s First Men’s Health Series: Why Men Lose More Healthy Years and How the Manosphere Cashes In

The first rule of men’s health, to paraphrase Fight Club, is that you do not talk about men’s health. Tomorrow half the internet will start growing moustaches for Movember, which is charming and useful. But this week The Lancet did something less photogenic and arguably more important. One of the world’s oldest medical journals published its first ever series on men’s health. Its central message is uncomfortable for everyone: men’s poorer health is shaped heavily by how they live, work and are treated, not by some unfixable flaw in the Y chromosome.

The three papers, released on 29 October, arrive alongside a sharply worded commentary about the so-called manosphere, the online ecosystem of influencers and platforms selling young men grievance as a lifestyle. Put together, they read like a diagnosis of two problems feeding each other. Health systems have largely ignored men as a group with specific needs. Into that silence, someone else has started talking.

What the numbers say

The research team analysed Global Burden of Disease data from 1990 to 2023. The headline figure: in 2023, disability-adjusted life years, a measure of healthy years lost to illness and early death, were 16 percent higher among males than among females. That is not a rounding error. It is a gap in lived health that shows up across most of the world.

The more interesting finding is where that gap comes from. According to the authors, employment and education strongly shape men’s life expectancy and disability in most countries. Men pushed to the margins, for example through incarceration or homelessness, fare worse still. Professor Vittal Katikireddi of the University of Glasgow, one of the authors, summed it up: “poor health outcomes occur most often among men experiencing poverty, discrimination or other forms of social disadvantage.”

In other words, the man most at risk is not the gym influencer with a cold plunge and a supplement discount code. He is the one without a stable job, a degree or anyone checking on him.

Gender, not just biology

The series deliberately frames men’s health through gender rather than sex alone. Biology matters, but so do the expectations attached to being a man: do not complain, do not see a doctor until something falls off, work through it, drink through it. The authors name social expectations of masculinity, male-dominated power structures and commercial interests among the preventable drivers of poor health. Think less Don Draper as a style icon and more Don Draper as a health warning.

Policy has barely caught up. The first dedicated national men’s health policy was adopted by Ireland in 2008. Only a handful of countries have followed since. England published its first men’s health strategy in November 2025. For most of the world, men appear in health statistics constantly and in health planning rarely.

The authors propose three shifts. First, embed men’s health in existing structures such as universal health coverage and wider social policy instead of building a separate silo. Second, collect better data that is broken down by factors like income, ethnicity and circumstance, so that marginalised men become visible. Third, present men’s health as a public good that supports economic security and social cohesion, rather than a new claim on scarce budgets. Crucially, the series argues this is not a zero-sum game. Better health for men does not come at the expense of women.

The manosphere as a business model

This is where the accompanying Viewpoint by Professors Sarah Hawkes and Kent Buse, co-founders of the think tank Global 50/50, gets pointed. They argue that the manosphere should be treated as a public health problem, in the same way public health once treated tobacco. Their logic is commercial rather than moral. “This is a business model, not a fringe,” Buse said. “Outrage and grievance are good for business, so the system rewards the most extreme content.”

Hawkes describes what these spaces offer in terms any marketer would recognise: “belonging, identity and an explanation for why life feels hard.” That is a powerful product if you are lonely, broke or disengaged from school. The authors stress that deleting content or restricting access will not solve this on its own. They want governments to tackle the underlying conditions, including educational disengagement, money worries, isolation and exclusion, while regulating the platform incentives that amplify extreme content.

One of their six priorities is worth highlighting because it cuts against a common reflex: avoid framing masculinity as inherently toxic. Or as Buse put it, “Boys and men are not the problem.” If the only message young men hear from mainstream institutions is that they are a risk factor, it should not surprise anyone when they go looking for someone who tells them they are heroes.

Reactions in the UK came quickly. Jake Richards, the minister with responsibility for men and boys, said the paper “lays bare the impact of toxic online influences and why action is needed now.” It is worth being clear about what the Viewpoint is, though. It is an argument for a policy approach, not a study measuring the manosphere’s health effects. The strength of its case will depend on what governments actually do with it.

What this means for you

If you are a man reading this, the practical takeaway is less dramatic than the headlines. The research does not say men are doomed. It says much of the gap is shaped by conditions that can change. That includes the ordinary things you control, like actually booking the check-up you have postponed since roughly the last World Cup. It also includes the bigger things you do not, like whether your country treats men’s health as a policy priority at all.

If you are not a man, the message still applies to you. The series makes the case that men’s poor health has knock-on effects for families, workplaces and social cohesion. Fixing it is not a favour to men. It is maintenance on the whole system.

The series will be formally launched on 5 November at the Liverpool School of Tropical Medicine. Expect plenty of debate, some of it in comment sections that prove the authors’ point about outrage being good for engagement. The more useful conversation will happen elsewhere: in clinics, schools and job centres, where the gap actually opens up. A moustache in November is a nice start. A doctor’s appointment in December would be better.

This article is for general information only and does not replace professional medical advice. If you have concerns about your physical or mental health, please speak to a doctor or another qualified health professional.