Males bear the burden of X-linked recessive gene disorders, which always manifest as there is no normal gene on the additional X chromosome (as there is in the female) to counteract the action of the abnormal gene.
Occasionally a gene can be carried on an autosome but manifests only in one sex. An example is male-pattern baldness, manifesting as an autosomal dominant disorder in males but as a recessive disorder in females.
Examples of X-linked disorders significantly affecting males include:
There is an increasing emphasis on and interest in men’s health. In 2008, in response to the growing awareness of men’s health issues, the first Australian National Male Health Policy14 was developed. Initiatives that have emerged from and been enhanced by this policy include programs and campaigns that focus on male mental health, work safety, male health in particular risk groups and prevention of chronic disease and injury. Examples include the Men’s Sheds, Man Health and Strong Father Strong Family programs. Also available are information sources and links, resources and research on male health issues.
Many of these programs, especially those concerning mental health and psychosocial aspects such as family relationships and risk behaviour, focus on issues such as what it means to be male. Topics explored include the positives of maleness, the behaviours males should be avoiding and personal responsibility.
The GP is in an ideal position to identify, assess and manage significant health problems in males. Men’s reluctance to access health services when they need them makes the GP’s role all the more important. Opportunities should be grasped to discuss health issues with male patients and foster preventive issues where appropriate.