A Community Health Perspective on Men and Boys’ Health

Improving the health of men and boys across Canada takes more than just encouraging better individual choices. It is well-documented that health outcomes are shaped by systemic forces like income, race, geography, and language and by situational forces like relationships, community connections, social norms, and gender expectations. In Canada, rising concerns related to mental health, substance use, social isolation, violence, and declining social connectedness underscore the need for a comprehensive approach.

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The strategies developed in Europe, the UK, Ireland, and Australia recognize that improving men’s health requires addressing these underlying social forces that shape masculinity. They fail to recognize, however, that misogyny and homophobia underpin most of the internalized toxic behaviours and perspectives among men (of all sexualities). They also fail to recognize that the health of 2-Spirit, gay, bisexual, trans, and queer (2SGBTQ+) men goes beyond HIV, infectious disease, and homophobic violence.

Canada’s strategy on men and boys’ health presents an opportunity to address these gaps and create a robust and impactful plan. MAX is a community health organization working to improve the lives of 2SLGBTQIA+ people. Our principal area of expertise is on the integrated health needs of 2SGBTQ+ men, including HIV and sexual health, mental health, substance use, social integration, and gender-affirming care.

We recommend that Canada’s strategy include the following:

1. Addressing both misogyny and homophobia within society is critical to improving the health and wellbeing of all men and boys

Our national strategy must examine how homophobia, misogyny, and restrictive gender norms influence the development of masculinity and contribute to negative health and social outcomes through all stages of life.

International frameworks increasingly recognize the importance of moving beyond “gender-blind” approaches toward gender-transformative models that challenge harmful norms and support healthier expressions of masculinity. Particular attention should be paid to major life transitions where social expectations and health risks often intensify. These transition points are often compounded by both internalized and enacted homophobia and misogyny.

Discrimination begins early for boys who do not conform to traditional masculine expectations, while 2SGBTQ+ youth experience significantly higher rates of depression, emotional distress, self-harm, and suicide attempts. It continues through to parenthood, with expectations around how young boys should be raised and the pressure to be a (certain kind of) father. As we age and relationships change, older men experience social isolation and 2SGBTQ+ adults face discrimination by care workers.

Canada’s strategy should take a 360-degree view of masculinity and identify a framework for addressing homophobia and misogyny among boys and men and within society more broadly.

2. Recognize and address the diverse health needs of 2SGBTQ+ men beyond infectious disease

Too often, including in the referenced international strategies, 2SGBTQ+ men’s health gets flattened to HIV and infectious disease. Even when other health issues affecting our communities are raised, they are frequently tied back to HIV as a justification for action.

Canada’s approach should explicitly recognize the diversity of 2SGBTQ+ men and boys’ health needs, including mental health, healthy aging, chronic disease prevention, cancer screening and treatment, housing stability, social connectedness, and access to safe and affirming care.

Addressing these needs would not only improve outcomes for 2SGBTQ+ men but also contribute to improved quality of care for all men.

3. Invest in community development, and health promotion as essential infrastructure

Sustained improvements in men and boys’ health require ongoing, coordinated investments to support health promotion, dedicated services, and community development. These investments must be structured to support the previous two recommendations.

If we want men to seek support for mental health concerns, substance use challenges, or other health issues, services must be designed to meet men where they are, reduce stigma, and create trusted pathways into care. Prevention, peer support, mentorship, and community engagement are often more effective entry points than crisis intervention alone.

Schools, workplaces, sports organizations, cultural institutions, and community groups all have a role to play in helping men build healthy relationships, social connections, and lifelong health habits. Positive male role models of all sexualities—including fathers, coaches, mentors, Elders, educators, and community leaders—can help demonstrate that strength includes compassion, emotional awareness, help-seeking, caregiving, and accountability.

Sustained investments are required to support community-based initiatives that promote physical and mental health, healthy relationships, health and emotional literacy, violence prevention, mentorship, social inclusion, and community participation. They should also support public awareness efforts that amplify positive examples of masculinity and challenge stereotypes—including among women and girls—that discourage men from accessing support.

By addressing the roots of harmful gender norms, recognizing the full health needs of 2SGBTQ+ men, and investing in the community infrastructure that supports healthy development, Canada can build a modern men’s health strategy that improves health outcomes, strengthens communities, and advances health equity for everyone.

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MAX Ottawa Community Health has been working to improve the health and wellbeing of queer and trans people in the National Capital Region and Eastern Ontario for over 20 years. As a community-based organization with a history in the HIV response, MAX is on the ground, meeting community members where they’re at, and offering social and support services, information, and referrals that meet their needs. MAX also works with healthcare and other service providers to improve the quality of care available in the region.