Beneath the Surface: Men’s Health, Neurodiversity, and the Cost of Being Unseen

Each November, moustaches sprout and conversations about men’s health widen for a moment: we talk about prostate and testicular cancer, we share links to screening reminders, and we check in on the men we love. Movember’s invitation is simple and powerful—notice what’s changing, ask the hard questions, and take action early. Yet in the quiet space beneath these reminders lives another set of truths that rarely make it into the exam room: the weight of stigma, the exhaustion of masking, and the way Canadian health systems—designed around compliance and certainty—can miss the lives of men who do not fit the script.

At InFocus, we meet these stories every day. A man arrives describing poor sleep, headaches that won’t let up, or a sudden drop in motivation. On paper, the symptoms point to depression or stress; the prescription pad comes out; a follow-up is booked in six weeks. But the fuller story, the one that doesn’t fit neatly into a checklist, is often about a nervous system that has been working in overdrive for years, about attention that scatters under fluorescent lights and noise, about sensory overwhelm that masquerades as irritability, about a childhood of “try harder” and “why can’t you just sit still?” that calcified into shame. When neurodivergence is unidentified—ADHD, autism, or other brain-based differences—what looks like “noncompliance” may be the body’s best effort to cope.

Beneath the Diagnosis

Consider Malik, a 34-year-old Black father who has learned the choreography of the clinic the hard way. He arrives with his words rehearsed in his head, his tone even and careful. He knows what happens when frustration slips through: the room cools, the notes change, referrals stall. He is offered an antidepressant and a mindfulness app. He is not asked about the four alarms he needs to start his day, or the way noise at work frays him to the edge, or why he sits in the car for ten minutes before going inside, gathering himself for the chaos of dinnertime and homework. He nods because nodding shortens the visit. He leaves carrying the same invisible load he brought in.

MAR hears versions of Malik’s story across communities. The language changes with culture and geography, but the pattern is familiar: men, particularly Black, Indigenous, and other racialized men, are expected to present calm, concise, and agreeable in systems that still read difference as risk. A white patient who paces may be described as intense or high-strung; a racialized patient who paces may be charted as oppositional or volatile. These are not just unkind words; they are barriers that shape who is believed, who is referred, and who is quietly discharged back to the same strain.

Beneath the Numbers

Movember reminds us that early detection saves lives. That is as true for mental health and neurodevelopmental care as it is for cancer. Men account for nearly 75% of all suicide deaths in Canada, according to federal data. In 2022 alone, there were approximately 4,850 suicide deaths nationwide, the vast majority among men (Health Infobase Canada, 2024). Men are also about three times more likely to die by suicide than women (Government of Canada, 2024). Behind those numbers are countless “I’m fines” and missed moments where a different question might have changed the course. If we are serious about prevention, the lens must widen. Screening needs to include not only mood and risk but regulation, sensory profiles, attention patterns, and the cultural contexts that shape how distress is expressed. Otherwise, we keep treating symptoms at the surface while the conditions beneath go unaddressed.

This is where a neuroaffirming, trauma-informed approach matters. When we ask, “What has your body been trying to tell you?” we often hear a lifetime of strategies that kept someone afloat—fidgeting that steadied focus, humor that defused conflict, withdrawal that protected from overstimulation. When we ask, “What support has been out of reach?” we hear about long waitlists, intake forms that assume a single way of communicating, and the hazard of being misread in the wrong room. Tools that track regulation over time—InFocus uses measurement-based approaches, including platforms like HiBoop—can help clinicians see patterns they might otherwise label as resistance or noncompliance. What changes is not merely the treatment plan; it’s the stance. Curiosity replaces correction. Collaboration replaces compliance.

Beneath the Standards of Care

The stakes are not abstract. Delayed recognition of ADHD, for example, is strongly associated with chronic anxiety, workplace instability, and relationship strain; years of masking can translate into hypertension, insomnia, and substance use that appears “sudden” only if we ignore the long prelude. For racialized men, these health impacts are compounded by racism within and beyond the clinic: being followed in stores, stopped in cars, overlooked at work, or scrutinized in schools—all of which train the body to anticipate harm and the mind to prepare a defense. The question is not why some men avoid care; it is how they have managed to keep going without it.

InFocus’s work begins from a different starting line. Real care does not open with “What’s wrong with you?” It opens with “What happened to you?” and “What’s been helping you get through?” It assumes that behavior is communication. It recognizes that a diagnosis, when offered respectfully and in context, can be a key to self-understanding rather than a label that closes doors. We have watched men exhale when they realize their “too much” has been survival, their “laziness” a sign of executive overload, their “anger” a language for years of being misunderstood. We have watched partners and families soften as they learn to translate what looked like avoidance into a nervous system seeking safety.

Beneath the System

From MAR’s vantage point, equity is where this clinical work meets community change. Building systems that truly see neurodivergent, racialized men means more than a set of techniques; it means reshaping the conditions that make care feel dangerous in the first place. Culturally safe spaces, interpreters who understand both language and meaning, staff trained to recognize bias in themselves and in the tools they use, referral pathways that do not punish a missed appointment, and outreach that meets men where they already are—barbershops, community centers, locker rooms, workplaces, and living rooms. It also means talking openly about masculinity without shaming men for the armor they were taught to wear. Movember’s invitation to grow a moustache is playful; its deeper message is serious: talk to each other, notice changes, and seek help early.

So what does “real care” require in practice? It looks like routine, neuroaffirming screening in primary care and oncology, not just mental health settings. It looks like clinicians trained to read regulation and culture, not just symptom checklists. It looks like measurement-based care that tracks functioning over time and adjusts the plan with the person, not to the person. It looks like reframing diagnosis as access—access to strategies, accommodations, and a language for asking for what you need. And it looks, above all, like listening long enough to hear what the body has been saying for years.

Beneath the Surface

Strength, in this frame, is not stoicism. It is the courage to be seen as you are, without apology for how your brain works or how you have survived. It is a son telling his father that therapy helped him sleep for the first time in months, and a father deciding that maybe it could help him too. It is a coach reminding a team that checking in on a teammate is as important as checking the scoreboard. It is a clinician who pauses when a patient goes quiet and says, “Take your time. I’m here.” It is a system willing to trade speed for understanding when understanding is what keeps people alive.

If you are growing a moustache this month, grow a conversation with it. Ask the men in your life what has felt heavy and what has helped. If you are a clinician, widen your intake and your patience. If you lead a workplace, make accommodations normal and early rather than exceptional and late. If you are a policymaker, fund models that shorten wait times and embed culturally safe, neuroaffirming care across the system. Prevention is not only about catching disease early; it is about recognizing people fully, before crisis becomes the only door left open.

If you need support (Canada):

●      Talk Suicide Canada: 1-833-456-4566 (24/7)

●      HeadsUpGuys.org: Evidence-based resources for men’s mental health & suicide prevention

●      Black Mental Health Canada: culturally responsive support for Black communities

●      Hope for Wellness Help Line: 1-855-242-3310 (for Indigenous peoples)

●      Canadian Cancer Society: information on prostate and testicular cancer screening

●      Wellness Together Canada: free mental health and substance use supports