Suffering in silence - Shame stopping infertile men from seeking help

Jamaica's declining population has long placed the spotlight largely on women, but the silence surrounding men has become impossible to ignore.

Behind the jokes that 'men are firing blanks' is a growing reality that many Jamaican men are quietly struggling with infertility. According to Health Minister Dr Christopher Tufton, stigma and denial remain major barriers preventing men from accessing care.

"People feel it just can't be them. These are issues we have to confront as a society if we are to address all components of health and good health," he said. The scale of the problem came into focus earlier this year. In February, a series of STAR articles revealed an urgent demand for locally sourced sperm, as fertility clinics increasingly struggle to meet the needs of couples trying to conceive. For years, clinics have relied heavily on imported sperm from countries such as the USA and Denmark.

When a call was made for healthy young Jamaican men to donate, the response was strong. The results, however, were deeply troubling. Dr Kamali Carroll, founder of the Jamaica Fertility Clinic, revealed that up to 80 per cent of men who stepped forward were found to have very low-quality sperm. Now, in December, Tufton confirmed that male infertility is common and opined that it should be a concern for all. He disclosed that one in four couples seeking medical help for infertility are told they cannot conceive naturally. Nearly half of those cases involve male infertility. But he fears that the crisis is not just the statistics, it is the silence surrounding the condition.

"Some people suffer in silence because there is a stigma attached to infertility and, when it affects them, they hide from addressing it," said Tufton. He added that open discussion and public education are critical to changing that reality, noting that encouraging men to seek help can both reduce risks and lead to earlier treatment. Tufton explained that deep-rooted ideas of masculinity further complicate the problem. In a society where extreme masculine identity is encouraged, men may struggle to accept fertility challenges.

"In a macho society, men feel they cannot 'fire blanks'," Tufton said, pointing out that such language is often used in a derogatory way, reinforcing shame and discouraging men from seeking medical support.

"We have to almost socially re-engineer how we think, at the community level and within relationships, we need to encourage conversations from a public health perspective, moving beyond just taking medication to include family health planning." He noted that while conversations around family planning do take place, sensitive issues such as infertility are not usually placed on the public agenda.

According to official data, Jamaica's crude birth rate declined from 21.7 live births per 1,000 people in 2000 to 11.4 in 2022. The country's fertility rate has also fallen below the replacement level of 2.1 and now stands at 1.9. Tufton pointed out that declining birth rates are a global trend, but said that, when combined with high levels of migration, the impact becomes even more troubling.

"You end up with a stagnant society from a population standpoint," he said. "That has significant implications for the ageing of the population, the types of services that will be needed, the labour force and the wider economy. It is a very real problem that we will have to confront."