What Manning Up is Costing Men

Every June, the world spends one Sunday celebrating fathers. Cards are bought. Phones ring. The men who raised us are told that they are appreciated. Then comes Monday. Everything goes back to normal. Back to silence. Back to the idea that men who admit they are struggling are somehow less for saying so. That idea […]

Every June, the world spends one Sunday celebrating fathers. Cards are bought. Phones ring. The men who raised us are told that they are appreciated. Then comes Monday. Everything goes back to normal. Back to silence. Back to the idea that men who admit they are struggling are somehow less for saying so.

That idea is killing people. Not slowly, not quietly, but in ways health systems have been documenting for decades. The World Health Organization estimates that men die younger than women in every region on earth. In high-income countries, men are 3-4 times more likely to die by suicide than women. They are less likely to visit a doctor, less likely to report pain, and far less likely to seek help for mental health concerns. The gap is not just biology; much of it is culture.

Now, the phrase “man up” sounds harmless. It is used in locker rooms, at dining tables, and in the kind of casual conversation nobody thinks to examine. However, what it actually communicates is a set of instructions. Do not show weakness. Do not ask for help. Do not make anyone uncomfortable with your difficulties. For a boy transitioning into manhood, hearing such messages repeatedly has a significant impact. It teaches him that his body and mind are problems to be managed privately, not conditions that deserve care.

Masculinity and health research shows that men are socialised from early childhood to associate help-seeking with weakness. By the time a man reaches his 30s or 40s, he has typically spent years ignoring symptoms, postponing appointments, and cooking up excuses for the things that demand attention. A persistent cough becomes dust. Chest tightness becomes a sign of stress at work. A lump becomes something to watch indefinitely. The result is that men are often diagnosed later. That means they are treated at more advanced stages.

In Nigeria, this picture is further complicated by a mix of practical and cultural barriers. The country carries a heavy burden of non-communicable diseases. Among them are hypertension, diabetes, and prostate cancer. All three disproportionately affect men, but they all respond well to early detection. Yet data from Nigerian primary healthcare facilities consistently show that men make up a minority of outpatient visits. When you ask health workers about this, the answer is rarely that men are healthier. It is that many of them do not come.

Hypertension is perhaps the clearest example. A 2026 meta-analysis in BMC Cardiovascular Disorders found that more than 1 in 3 Nigerian adults is hypertensive, a pooled prevalence of 34%. It is a condition that typically produces no obvious symptoms in the early stages. The only way to know you have it is to check. Men who do not go to clinics do not check. They carry elevated blood pressure for years, sometimes until the consequence manifests as a stroke or heart attack. The tragedy is not that hypertension is untreatable. It is highly treatable. The tragedy is that it goes undetected. The people who have it have been told, in many different ways, that a doctor is for when things are truly dire.

Prostate cancer tells a similar story. It is the most common and deadliest cancer among Nigerian men, with mortality rates more than double those in North America. Around 80% are diagnosed at an incurable stage. Part of that is access and cost. However, part of it is the discomfort many men have with a prostate examination, something public health messaging has never quite addressed directly. Men will go years without a PSA test because nobody told them it mattered, or because asking felt like an admission of vulnerability they were not ready to make.

Mental health sits comfortably at the sharpest edge of all this. Nigeria has a significant mental health treatment gap, as do most low- and middle-income countries. The WHO estimates that more than 80% of people with severe mental illness in such settings receive no treatment. Among men, that gap is wider still. Stigma around psychological distress carries an added weight: the suggestion that a man who cannot hold himself together is failing at something fundamental. In a society where a man is expected to be the provider and the protector, admitting to depression or anxiety can feel like a betrayal of the role he has spent his whole life preparing for.

Now, this is not a Nigerian or an African problem. In the United Kingdom, men account for three-quarters of all suicide deaths. In the United States, men are nearly half as likely as women to have received mental health treatment in the past year. The same picture holds true in Australia, Japan, and Brazil. The specifics differ, but the dynamic is the same: cultural expectations that define masculine strength as the absence of need.

It would be easy to frame this as a systems problem only. Health systems need to reach men where they are. That means workplace screenings, clinic environments that feel less intimidating, and workers trained to communicate with people who have spent years not used to talking about their health. Community approaches that use trusted figures, such as religious leaders, coaches, or elders, have shown promise. However, the systems argument, on its own, lets individuals off the hook.

The truth is that men also carry a personal responsibility in all of this. Not blame. Responsibility. A man who notices a symptom and waits 6 months to mention it is making a choice, even if that choice is shaped by everything he has been taught. Consider the man who has not had a blood pressure check in 5 years, who has never asked about his prostate, who would rather say he is fine than tell a doctor he has not slept properly in months. He is participating in something that is harming him. The conditioning is real. The structural barriers are real. And still, there is a moment in which a person can decide to do something differently.

The fathers celebrated in June must have given a lot. They showed up. They worked. They held things together as much as they could. Many did this while struggling with issues they never spoke about. Health conditions noticed and set aside. Feelings they had no framework for expressing. So, honouring them means more than a phone call once a year. It means building a culture where men do not have to choose between appearing to be strong and actually being well. That is because the real cost of manning up is paid quietly, over years, in conditions that could have been caught, in distress that could have been addressed, and in years that could have been lived.

Ojenagbon, a health communication expert and certified management trainer, lives in Lagos.