Abstract
BACKGROUNDCeliac disease (CD) is an autoimmune condition, managed by strict adherence to a gluten-free diet (GFD). Dietary choice has gendered connotations, and men with CD may face judgment from others when following a GFD. However, little is known about health-related stigma in men with CD.OBJECTIVESThe study aim was to explore the health-related stigma and challenges faced by men with CD, and the impact of CD on their lives.DESIGNQualitative semi-structured online interviews were conducted with men living with CD.PARTICIPANTSTwenty adults (≥18 years old) identifying as men living in the United Kingdom, with self-reported CD, were recruited using social media and opportunistic sampling.ANALYSESParticipants provided rich, detailed discussions about aspects of their experience of living with CD. Reflexive thematic analysis was used, with a critical-realist lens which enabled researchers to connect men's experiences within wider socio-cultural constructs such as masculinity and social identity.RESULTSThree themes were identified: (1) CD threatens social inclusion; (2) Others' assumptions about CD and microaggressions have a psychological impact, and (3) Masculine norms, health-related stigma, and power dynamics impact men's health behaviors and everyday experience. Health-related stigma was found to be interconnected with these men's gendered social environment, suggesting that gender may be an important social and structural determinant of dietary, health-related, and health support-seeking behaviors in men diagnosed with CD.CONCLUSIONSContrary to prior assumptions, health-related stigma affects men with CD of all ages, particularly in social settings. The study unveils the complex interplay of individual beliefs, social norms, and power dynamics, in particular with other men, that affect individual beliefs, and emphasize the performative aspect of food consumption. Internalized stigma and microaggressions impact men's wellbeing. To better support men with CD, health providers, charitable organizations, and the food industry should address the social impact of adherence to a gluten-free diet, in particular perceived threats to social status and inclusion, which may cause concern, influence food choice, and impact dietary adherence.