Sex, gender and alcohol: implications for males, men and the communication of risk

Sex and gender related factors affect the ingestion and impacts of alcohol. This article explores these factors with a focus on males and men. While alcohol use has more negative health effects for females than males at lower levels of consumption due to sex related factors, gender related factors underpin many of the negative social impacts of alcohol for men. We present a narrative review of alcohol impact literature, apply a sex and gender-based analysis plus (SGBA+), and summarize the health and social impacts on males and men. We make suggestions for communicating risk regarding the impacts of sex/gender on men's alcohol use. Messages are most needed that undermine hegemonic masculinities that link alcohol use to male camaraderie, differentiation from the feminine, drinking to excess and intoxication, along with information on the impacts of alcohol on aggression, fathering and intimate partner violence. Sex specific messaging on the male-specific health impacts of high tolerance and risky drinking on male reproductive health, and a range of diseases and conditions including cancer and alcohol use disorder, is also required. The impacts of social context are highlighted, and suggestions made for shifts in drinking norms that reflect gender transformative approaches that foreground gender equity. Similar to women, risk communications need to include sex/gender related factors that affect men, and fundamentally be health and equity promoting.