Passing as normal: Negotiating boundaries and coping with male breast cancer

Background and objective: Male breast cancer is a rare and understudied disease. In addition to coping with cancer, suffering from what is perceived as a “woman's disease” significantly burdens men's illness experience and can lead to stigmatization. The way men cope with these challenges has not been studied to date. Drawing on stigma, coping, and destigmatization theories, this study aims to explore how men experience and respond to the diagnosis of an illness typically associated with women. Methods: In-depth interviews were conducted with 16 Israeli men who were diagnosed with breast cancer within the past 10 years. Thematic analysis was performed, focusing on participants’ references to experiencing and managing the psychosocial implications of being a male breast cancer patient. Results: Results demonstrated that participants faced stigmatizing situations both inside and outside healthcare settings. In addition, findings revealed four main responses to stigmatization: (1) selective disclosure, (2) concealment practices, (3) universalizing, and (4) making comparisons. Whereas the first two are strategic reactions to specific situations, the latter two are general conceptual destigmatizing responses. Conclusions: Men's coping styles reveal their efforts to disengage from the discrediting attributes of male breast cancer, to distance themselves from female breast cancer, and to avoid emasculation. They manage stigmatizing situations using disengagement situational responses, such as concealment and selective disclosure, and negotiate group boundaries with the goal of destigmatizing male breast cancer. Beyond broadening the understanding of coping with male breast cancer, this study also illustrates the significant place of boundary work as a destigmatization practice about illness-related stigma.