Overlooked Health Risks and Care Gaps Facing Young Males

Mental health

• Depression often looks different in males. Depressed men are more likely than depressed women to report anger, aggression, substance use, and risk-taking, symptoms that standard depression screening does not capture; when these symptoms are counted, the sex gap in depression largely disappears.¹ Most of this evidence comes from adults, however, and studies of adolescents find that boys’ and girls’ depressive symptoms are largely similar.²

• Diagnostic overlap. In young people, depression can show up as irritability and inattention rather than sadness and be mistaken for ADHD, and telling the two apart appears to be harder in boys than in girls.³

• Suicide. Young males die by suicide at more than three times the rate of young females: 20.2 per 100,000 for males ages 15–24 in 2024, compared with 5.9 for females.⁴

• Psychotic disorders. Schizophrenia typically begins three to five years earlier in men than in women, with a single peak in men between ages 21 and 25, during peak years of education and vocational development.⁵

• Autism. Boys are identified with autism about 3.4 times as often as girls (49.2 versus 14.3 per 1,000 at age 8 in 2022). The gap has narrowed from about 4 to 1 in earlier years as identification in girls has improved.⁶

• Substance use disorders. Among adults, males are more likely than females to have had a substance use disorder in the past year (21.4% versus 14.6% in 2022–2024). Among adolescents ages 12–17, however, the pattern has reversed: 6.8% of boys and 9.9% of girls.⁷

• Eating disorders. Males account for about one in four people with anorexia or bulimia and a larger share of those with binge eating disorder,⁸ yet they are far less likely to be screened, diagnosed, or treated.⁹

• Muscle dysmorphia and steroid use. Muscle dysmorphia, a form of body dysmorphic disorder marked by preoccupation with being insufficiently muscular, is a growing concern among adolescent and young adult males,¹⁰ and in 2017 more high school boys than girls reported ever having used anabolic steroids (3.5% versus 2.4%).¹¹

• Reluctance to seek care. Among adults with a mental illness in 2024, 42.1% of men received treatment, compared with 59.2% of women. Among adolescents with a major depressive episode, boys had about half the odds of girls of receiving treatment.¹²

Accidents and violence

• Unintentional injury. Among ages 15–19 in 2023, the unintentional injury death rate was 31.1 per 100,000 for males and 13.² for females, about 2.4 times as high.¹³

• Traumatic brain injury. Traumatic brain injury rates are higher in males than females in every age group, and male hospitalization rates for these injuries are about twice female rates, although the most recent national figures by sex are now dated.¹⁴,¹⁵ In sports that both sexes play, however, girls’ concussion rates are higher.¹⁶

• Homicide. Young males are homicide victims at five to more than six times the rate of young females: 20.4 versus 3.2 per 100,000 at ages 15–19 in 2023,13 and 23.4 versus 4.5 at ages 20–24.¹⁷

• Leading causes of death. For each of the three leading causes of death at ages 15–19 (unintentional injury, homicide, and suicide), the male death rate is between 2.4 and 6.4 times the female rate.¹³

• Dating violence. Boys and girls in high school report physical dating violence at statistically similar rates, so boys make up roughly half of victims.¹⁸ In a national sample of U.S. students ages 12–17 who had been in a romantic relationship, boys were more likely than girls to report digital dating abuse (32.3% versus 23.6%).¹⁹

• Justice involvement. About 85% of youth held in juvenile residential placement are male.²⁰

• Physical fighting. In 2021, 23.2% of male high school students had been in a physical fight in the past year, compared with 13.1% of female students.²¹ Girls, however, report more bullying and sexual violence.²²

Cancer

• Testicular cancer. The most common cancer in males ages 15–35.²³ There is no routine screening for it; the U.S. Preventive Services Task Force recommends against screening males without symptoms,²⁴ which makes awareness of symptoms and prompt evaluation especially important.

• HPV-related cancers. There is no male equivalent of the Pap test, so HPV infections in males that progress toward throat, anal, or penile cancer usually go undetected until symptoms appear. Anal cancer screening is now recommended only for certain higher-risk groups, such as people with HIV.²⁵ HPV-associated throat cancer occurs about 4.9 times as often in males as in females.²⁶

Physical health

• Blood pressure. Elevated blood pressure is about twice as common in boys as in girls: 12.9% versus 6.5% of U.S. children and adolescents ages 8–17 in 2009–2012.²⁷

• Type 2 diabetes. Youth-onset type 2 diabetes is diagnosed more often in girls than in boys.²⁸ In adults, however, men tend to develop type 2 diabetes at a lower body mass index than women.²⁹

• Disabilities and school discipline. About two-thirds of students who receive special education services are boys,³⁰ and boys are disproportionately removed from classrooms through suspension.³¹

Sexually transmitted infections and vaccine-preventable disease

The absence of a consistent primary care entry point for AYA males has direct clinical consequences.

• STI testing. Among sexually active high school students in 2019, 26.1% of girls but only 13.7% of boys had been tested for an STI in the past year.³² In a national survey of 15- to 25-year-olds, 16.6% of females and 6.1% of males had been tested in the past year, and confidentiality concerns deterred many young people from testing, males significantly more often than females.³³

• HIV. In 2023, the HIV diagnosis rate among young people ages 13–24 in the United States was 23.6 per 100,000 for males and 3.1 for females, and 88.7% of those diagnosed were male (6,310 of 7,117).³⁴

• Meningococcal disease and mpox. Males who have sex with males have had higher rates of meningococcal disease than other men, largely because of outbreaks,³⁵ and in the early months of the 2022 U.S. mpox outbreak, 99% of cases were in men, nearly all of whom reported recent sexual or close intimate contact with other men.³⁶ Both point to gaps in vaccine access for this population.

Sources

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