A decade after Movember took root in Ireland, it has transcended the gimmick of growing a moustache to encourage men to talk about their health, to become a leading health and social powerhouse.

What started as a joke between mates in Melbourne, Australia, has grown into a global effort to prevent suicide in men, to spread awareness of prostate cancer and testicular cancer. It has opened up discussions that generations of machismo told us should never be uttered.

This effort is still needed today. Although suicide* rates in Ireland are decreasing, a HSE report for 2017 showed that men aged 45-54 were the most susceptible age group, while men are four times more likely to die by suicide than women. In addition to this, 3,600 men are diagnosed with prostate or testicular cancer every year, with many dying due to late detection because they felt uncomfortable coming forward with symptoms.

Beyond stats, the discussion is even more fraught. Post 'Me Too' and the long overdue reckoning it triggered in public and private life, conversations about toxic masculinity, how it works and how it should be quashed are still like battlefields. In many ways, they are becoming more treacherous.

This theme came out when talking to those involved in the movement. Whether intentional or not, military language is often deployed: the moustache is a 'Trojan horse', the Mo Bros (those in the Movember community) are 'on the frontline'.

The war for men’s health is still being fought. Our best men are dead, and more are dying.

Some 10 years later, Movember is still going strong, but what has changed for men in Ireland? What’s next for the organisation that revolutionised charity work?

Something different

Neil Rooney, Country Director for the Irish Movember campaign and member of the Global Innovations team, says that when Travis Garone and Luke Slattery, two friends from Melbourne, Australia, came up with the idea for Movember in 2003, it was almost an accident. They’d met for a pint and got to talking about retro moustaches, thinking it would be fun to encourage their friends to grow one, too. Starting with just 30 Mo Bros, the organisation now numbers 5.5m Mo Bros and Mo Sistas, and has raised well over €500m for 1,200 men’s health projects.

"We’ve come at it from the angle that, Movember started as a group of guys getting together to enjoy themselves", Rooney told RTÉ Lifestyle.

It was this that drew Rooney to the organisation. "They weren’t artificial in the way many other charities were being by targeting a much easier demographic, they were being bold and going out and going after young men in an effort to affect their positive physical and mental good health."

The fun element has proved crucial in reaching out to men, offering a way to engage in complex and difficult discussions through banter and a bit of messing. John Connell, a Movember ambassador, writer and mental health advocate, said "I suppose the big thing about Movember is it’s about fun. You'll have a conversation with someone and they’ll say ‘why are you growing a moustache?’ There’s a positivity in that".

"We talk to men in a language that they understand. We talk in a friendly voice because we are, essentially, targeting ourselves", Rooney adds.

Shut-in mentality

Rooney understands the way men needed to be spoken to regarding health, as he shared the same shut-in mentality that many men do. "Like most other men I had my head in the sand a little bit, so i ignored signs and symptoms. I had that very Irish attitude of ‘ah, it’ll be grand’", he said.

L-R: Sam Donnelly, John Connell and Neil Rooney

Connell, too, had experienced this: "I had my own mental health difficulties about four years ago and it started me on a journey, and when I came through that I decided that the best thing to do was to talk about it in public so that hopefully it would be able to help other people."

There are myriad ways to address your mental health, but often it’s less of a decision than a knee-jerk reaction. Sam Donnelly, the owner of Sam’s Barbers, Mo Bro and Movember collaborator on the Movember Rated Barbers Initiative (a board of barbers, psychologists and other experts that provide feedback to Movember executives on what is needed on the ground) recalls that in the months after the death of his sister, Janet, to cervical cancer he felt his mental health fraying.

"I just didn’t feel right. I’d gone through a hard time with the sickness and the death of my sister and being self-employed and having employees. I felt mentally that I wasn’t in a strong place, and I’ve no problem saying that I suffered with anxiety and panic attacks. I wanted to take control of me back."

He took up running and, like many of us, found physical health to be the key to his mental health. Still, years later, the latent stigma of mental illness shadows our conversation: "But even as I say to you that I suffered with anxiety and panic attacks, I still say ‘oh, God’. But if people like me don’t come up and say we have it, where do we start?"

Silent struggles

More than speaking out, perhaps, a major obstacle is ascertaining what issues men are struggling with. These change with each new shift in society and can be just as imperceptible as the early signs of cancer.

Connell witnessed these shifts personally when giving talks about mental health across the country. "The big thing for younger men and women, teenagers, is the phone and anxiety, the constant pull of social media which is creating a lot of mental health issues. People are constantly contactable and they’re looking for validation outside themselves", he said.

Perhaps more surprising, he said that "people are hungry for inner life and the spiritual world", a unifying community that offered security, validation and guidance, and something that’s slipped from our collective focus in recent years.

Validation and the need for spiritual guidance are two issues men struggle with

Donnelly also has something of a direct line to men’s issues, having spent 30 years cutting men’s hair. "In the barber chair, same as in the salon with ladies", he said, "you’re more inclined to open up because you have to expose your vanity to us to let us do what you want. When a man exposes his vanity to another guy there’s a barrier broken."

In this prime position, with a man potentially opening up and feeling secure and comfortable in an intimate space, how does he encourage them to further open up? Mostly, he stays quiet.

"Being there for a client doesn’t necessarily mean just talking to them. Being there for a client is listening."

Wearing your heart on your lip

Just as listening to a person is a silent acknowledgement of their struggles, so too is the Movember moustache, the jokey gimmick-turned-symbol that triggered everything from novelty moustaches in your corner shop to decreased sales in razors.

The gimmick is an ingenious one, upending the traditional association between impressive facial hair and manhood to create a critique on toxic masculinity, fully in view of whoever may pass you on the street. As Donnelly put it: "You’re wearing this on your face for a month and that’s a reminder everywhere you go for a month." It’s inclusive: whether you look like Burt Reynolds or the prepubescent kid from around the corner, most men can grow a moustache.

But the best part? It’s a bit of fun. It’s an invitation to others to laugh with you and connection with you. As Connell said "you’re making fun of it, saying ‘I’m in on [the joke]’".

From a campaign perspective, it’s a triple threat and incredibly successful. "We talk about the moustache as being something like a Trojan horse that opens up often ignored conversations", says Rooney. "So you can be sure that when guys are going around with the dodgy little moustache people will start joking  but eventually, when they’re able to say ‘I’m doing this for prostate cancer, testicular cancer and mental health, people tend to change their tunes and put their hands in their pockets."

A masculinity detox

In the year since the Me Too movement exposed layers of abuse, both sexual and emotional, of women by men - and even earlier than that with the election of Donald Trump as President of the United States amid a deluge of assault allegations by women - society has been steadily and laboriously unlearning the allowances it gave men of a certain level of power. One of the most insidious aspects of this toxic masculinity was the dominance it held over men: it was the stern, braggadocious voice that told them they couldn’t appear weak or inferior, even if that cost them their lives. This led to greater numbers of suicide, substance abuse or, quite simply, not asking for help when they needed it.

Movember tackles this in relation to prostate cancer and testicular cancer detection. Once caught early, those forms of cancer are highly treatable and will not impact on a man’s life, which wasn’t always the case. "Ten years ago, if you had prostate cancer, you went in and you had a prostatectomy, and that can have many side effects for men", Rooney explained. "You have more than 50 per cent chance of bowel dysfunction and erectile dysfunction [after a prostatectomy], and they of course can lead to mental health difficulties."

"if you present early enough, they’re highly treatable. It’s people presenting too late that’s the real problem at the moment", he added.

As Connell put it: "Toxic masculinity is what’s killing these men, because they feel they can’t talk about these issues because it’s not a "manly" thing to do. The masculinity that we understand is a very contrived thing."  

Tangible change

The campaign is working, in ways that all three men have seen. From an advocacy point of view, Movember has held a megaphone up to a voice that was once too afraid to speak. Ten years ago, Rooney said, there were "no men’s health initiatives out there, funding was very low, awareness was very low, more men were dying in silence because they weren’t informed with their health issues".

Now, Movember Ireland’s Irish Prostate Cancer Outcomes Research (IPCOR) initiative is leading the charge in tracking men from diagnosis to five years afterwards in order to monitor the health outcomes they’re having. It’s the largest study of its kind in the world, and will allow men to make more informed choices about their health.

Donnelly sees it on the ground, and recalled a story about a man who had seen a flyer about prostate check ups pinned up in the canteen in work and decided to get one. He turned out to be positive and, as it was detected early, was treated without hassle.

"That man is probably alive today", Donnelly said. "One life is changed and one life is enough."

Some are even more deeply personal. In 2015, around the time of the release of his memoir The Cow Book, Connell was invited onto The Ryan Tubridy Show to discuss it and his struggles with mental health.

"A man heard me speak about my experiences and he was on his way to take his life and he decided not to", Connell recalled. "So to me, I said ‘well, if I can make a difference with one person I could make a difference with other people as well.’"

What’s next?

Given the nature of what Movember advocates for, it is to be expected that the organisation will have to adapt as the culture, research and mentality around mental health, prostate cancer and testicular cancer does. A high priority is facilitating greater research into the area, particularly into that of the cancers.

Rooney sees an opportunity to combine the research bases in countries where Movember operates to create a network. "What Movember’s trying to do is connect the dots, to do what a lot of other charities haven’t had the scale to do", he said.

In addition to this, there are a number of inventive schemes being dreamed up by Mo Bros around the world. One such scheme Donnelly mentions is to include signs in Movember Rated Barbers (barbers that are affiliated with the organisation) that say "We’re Open".

"And that’s not just ‘we’re open for business, but we’re open for talk, we’re open for discussion", he said.

There’s a similar scheme involving a pin worn by barbers that signal they are available for a chat if needed. Just like the moustache, these are signposts toward a grander conversation that is possible and in safe settings, and will continue even if the person isn’t ready to engage just yet.

There are arguments for greater government assistance, or teaching mindfulness in schools and they would be extremely beneficial. Ultimately, however, it’s the stigma that must be exorcised.

"Suicide is a solo act, it’s an act that occurs by yourself", Connell said. "By normalising the conversation and destigmatising it, we can hopefully make the difference for that one person for them to then say I’m going to go to the doctor instead of getting a rope or taking tablets or whatever it is."

*If you are affected by any of the issues raised in this article, you can contact; The Samaritans (phone 116123), or Pieta House (1800247247).