Selected publications
- Let’s talk about sex in a world of porn/a> — The Guardian, 17 April 2026
- Urology Awareness Month: Shining a spotlight on urological diseases — Centre for Policy Research on Men and Boys, 25 September 2025
- I took a fertility test for the sake of my health—here is what I learnt — Men’s Health Magazine, 6 June 2025
- Declining birth rates are a symptom of a male malaise — The Financial Times, 26 February 2024
Declining birth rates are a symptom of a male malaise
This letter was originally published in The Guardian on 17 April 2026.
Luke Kennard’s thoughtful piece on straight male authors avoiding writing about sex is well taken (Too hot to handle? Why it’s time for straight male authors to rediscover sex, 12 April). We should welcome more literary courage. But the more urgent conversation isn’t in the pages of fiction – it’s happening (or failing to happen) on dating apps, in classrooms and at parties.
Research shows that we need to rethink sexual pleasure in research, healthcare and society. There is growing evidence on the bidirectional links between sexual function and mental health. Yet many young people are not equipped by their teachers or parents with honest, embodied knowledge about sex and pleasure, let alone that of their partners.
Pornography has filled this vacuum badly. A recent survey from FFS Productions found that one in two young people say porn was their first exposure to sex, with 60% of daily viewers reporting it shaped their expectations of real-life sex. Given how problematic those expectations often are, we need better alternatives.
Here are five starting points for improving sexual knowledge and pleasure. First, explore evidence-based sex education resources like the award-winning OMGYes, which offers interactive, research-led content. Second, talk more openly with friends and partners – The School of Life’s Pillow Talk cards offer a gentle entry point. Third, discover erotic fiction and nonfiction: from Emily Nagoski’s Come Together to classics like The Sexual Life of Catherine M, there is a vast world beyond what most of us were taught in school. Fourth, seek out ethical alternatives to mainstream pornography like feminist site Erika Lust Productions. Fifth, consider getting involved in advocacy: the Pleasure Fellowship supports those who want to champion sexual wellbeing in their communities.
Yes, sex in novels is exciting, and we can use more of it. But let’s start with where it can be even more transformative: off the page.
Urology Awareness Month: Shining a spotlight on urological diseases
Half of us will experience a urological condition in our lifetime — yet awareness remains low.
This article was originally published by the Centre for Policy Research on Men and Boyds on 25 September 2025.
- 1 in 2 people will experience a urological condition in their lifetime.
- 10% of all daily medical care involves urology.
- 25 million Europeans (16% of people aged 40+) live with urinary incontinence.
- Prostate cancer is now the most commonly diagnosed cancer in the UK.
- 1 in 8 men in the UK will be affected by prostate cancer during their lifetime.
- Black British men are twice as likely to die of prostate cancer as white British men.
September marks Urology Awareness Month in the UK and European Urology Awareness Week (22–26 September) across Europe. Both campaigns aim to raise understanding of urological diseases — conditions affecting the urinary system and male reproductive organs.
The word urology comes from the ancient Greek ouron (οὖρον), meaning urine, and the suffix -logia (-λογία), meaning the study of. Today, urology covers a vast area of medicine: from urinary tract infections and incontinence, to kidney stones, sexual health, infertility, and cancers of the urinary and reproductive organs.
Despite their prevalence, urological diseases often remain taboo topics, leading to delayed diagnosis and treatment, avoidable suffering, and higher health costs.
Why urology matters
- Life expectancy gains bring new challenges: more men and women are living longer with complex, costly urological health needs.
- Urological conditions affect both sexes, but men face particular risks from prostate, bladder, and testicular cancers, as well as fertility and sexual health issues.
- Prostate cancer has become the most common cancer in the UK
Prostate cancer: the leading urological cancer
Prostate cancer affects around 1 in 8 men in the UK during their lifetime (Urology Foundation). While many cases are slow-growing, others are aggressive and life-threatening if diagnosed late.
Importantly, not all men face the same risks. Ethnicity, age, genetics, and wider social factors all interact to shape outcomes (Dee et al., 2025). Recent registry data reveal stark inequalities: using case counts from the National Disease Registration Service (2021) and denominators from the Census 2021, crude prevalence per 100,000 males is significantly higher among Black men compared with other ethnic groups.
This underlines the need for an intersectional approach to awareness, prevention, and treatment — recognising how biology, ethnicity, and socioeconomic context overlap to drive disparities.
Research gaps and policy implications
Important gaps remain in understanding urological and reproductive health. Black men’s higher prostate cancer risk is still poorly explained, as most genetic studies over-represent White populations. The interplay between mental health, fertility and urological symptoms is under-researched (Straub et al., 2025), and the effects of alcohol, smoking and drug use on men’s reproductive health require further investigation (Lo et al., 2024).
Outcomes also differ sharply by ethnicity, age and deprivation, yet men are too often studied as a single group. Policymakers can help close these gaps by backing targeted awareness campaigns (especially for Black men), ensuring equitable access to early detection and treatment, and investing in inclusive research that connects genetics, behaviour, mental health and inequality.
Thankfully, new initiatives such as Prostate Cancer UK’s TRANSFORM trial, the biggest prostate cancer screening trial in 20 years, offer real promise — showing how research, policy and practice can come together to improve outcomes and reduce inequalities in men’s urological health.
Where to find out more
Patients & the public: European Association of Urology patient hub
Policymakers: All-Party Parliamentary Group on Prostate Cancer — Reducing the Risks report
Healthcare providers: Prostate Cancer UK — primary care risk awareness
Researchers & funders: The TRANSFORM trial, evaluating new approaches to screening
References
The Urology Foundation. Urology Awareness Month 2025. Available at: https://www.theurologyfoundation.org/impact-achievements/campaigns/urology-awareness-month/ (Accessed 21 September 2025).
Dee, E.C., Todd, R., Ng, K. et al. Racial disparities in prostate cancer in the UK and the USA: similarities, differences and steps forwards. Nat Rev Urol 22, 223–234 (2025). https://doi.org/10.1038/s41585-024-00948-x
Straub, V.J., Mills, M.C. The interplay between male fertility, mental health and sexual function. Nat Rev Urol 22, 1–2 (2025). https://doi.org/10.1038/s41585-024-00936-1
Lo, J.O., Hedges, J.C., Chou, W.H. et al. Influence of substance use on male reproductive health and offspring outcomes. Nat Rev Urol 21, 534–564 (2024). https://doi.org/10.1038/s41585-024-00868-w
I took a fertility test for the sake of my health—here is what I learnt
This article was originally published in Men’s Health Magazine on 6 June 2025
As someone who researches reproductive health, I spend my days looking into sperm counts, lifestyle factors and reproductive aging. Yet, ironically, I’d never stopped to think about my own fertility. So, earlier this year, I decided to run an experiment on myself and take an at-home fertility test.
When I told my mates about my experiment, it’s fair to say, they had questions. ‘Why now? You’re not trying to have kids anytime soon.’ ‘Is this about sperm banking?’ Spoiler: it wasn’t. Fertility isn’t just about fatherhood; it’s increasingly seen as a reflection of overall health. Research has linked poor sperm quality to everything from health risks like cardiovascular disease and metabolic disorders, while a low sperm count can be an early warning sign of underlying health issues — not just a barrier to conception.
Taking the test was simple. I followed the kit’s instructions, collected a semen sample, and let it sit for 15 minutes to liquefy—thinning from a gel-like state to a fluid one. Using the built-in pipette, I transferred a small amount onto a slide, wiped away any excess, and inserted it into the analysis device. With my phone on top, I recorded a short video through an app, which analysed the sperm. Minutes later, my results appeared—giving me insight into my reproductive health without a clinic visit.
Currently, there’s more than one way to measure sperm health, with the World Health Organization (WHO) setting the global standard. Clinical tests assess semen volume, sperm concentration (how many sperm are present), motility (how well they swim), and morphology (their size and shape), among other factors. At-home tests, designed for convenience, typically measure only concentration or motility, overlooking things like morphology. While they offer ease and privacy, they can give an incomplete picture, reassuring users with a “normal” result that may miss key fertility factors best assessed in a lab.
Despite knowing the drawbacks of the test, as I waited for my results, I realised that, like most men, I ultimately had no idea what to expect. And I have to admit, questions about my fertility did come up.
One in six heterosexual couples faces infertility, and in about half of those cases, the problem lies with the man. Yet fertility — and reproduction — has long been treated as a ‘women’s issue’. Clinics are built for women, medical literature is predominantly written with women in mind and men are often left out of the conversation entirely.
Thankfully, the narrative is changing. Researchers are delving into male reproductive health, and they’re finding that lifestyle factors are significant players. Smoking, drinking, poor diet, heat
and stress can affect semen quality, which can act as a marker of broader health. That post-work beer? Not always harmless. Mental health matters, too — depression and anxiety, including being worried about sexual performance, can reduce testosterone and impact fertility.
To measure semen quality, my test relied on measuring semen volume and sperm concentration. On average, there are between 15 million and over 200 million sperm per millilitre (ml) of semen. Anything under 15 million sperm per ml is considered low.
When I took the test, I wondered where I stood. I don’t smoke, but my stress levels aren’t ideal. I also spend too much time on my laptop and have had my fair share of late nights and skipped workouts. While I’m not planning to have kids soon, understanding where I stand felt like taking control of something I’d never thought to measure.
But sitting with my test kit, I was confronted by how much my view of masculinity had shaped my fears about fertility. Growing up, I’d been taught that fertility was a marker of manhood — tied to sexual performance and the ability to conceive. The idea that I might be infertile, even if unlikely, was scary. I feared that any result outside the ‘norm’ would undermine my sense of self-worth. But then, I remembered: what matters isn’t some outdated idea of masculinity: it’s my health, and the health of my loved ones — including my male friends regardless of fertility issues.
I also know that sperm health isn’t fixed and the good news is that many factors affecting fertility — diet, exercise and stress — are within our control. By normalising conversations about fertility, we can empower men to take charge of their health before problems arise.
That being said, it’s still unclear whether men should do what I did and take a fertility test as a health measure. At-home sperm tests can provide insight, but they may miss important markers like sperm morphology, leading to incomplete or inaccurate results. These tests can offer some early indications, but they’re no substitute for professional medical advice — especially if you’re actively trying to conceive. If fertility is a concern, it’s best to consult a GP or visit a clinic for a thorough evaluation.
So, what did my results show? Let’s just say there’s room for improvement. But the real win wasn’t the numbers, it was breaking down the silence around male fertility and broaching the topic of fertility, health and sexual performance with my mates.
Here’s my challenge to you: take control of your fertility — not out of fear, but out of curiosity and care. We need to treat it as an integral part of our well-being. Instead of focusing on individual sperm counts, let’s look at how our lifestyle and environmental changes impact reproductive health. Remember, taking charge of your health isn’t just about sperm count — it’s about overall vitality and our collective well-being.
Declining birth rates are a symptom of a male malaise
This article was originally published in The Financial Times on 26 February 2024.
I was struck by the FT’s separate coverage of two recent news stories: the emergence of a new political gender divide (Data Points, January 27) and falling birth rates in the progressive Nordics (The Henry Mance Interview, January 29). As a demographic researcher interested in men’s health behaviours, I have a strong sense that these are related and a sign of what’s to come.
In her interview, demographer Anna Rotkirch points out that nearly 40 per cent of Finnish men with low education are now childless by the age of 45, and most have no partners. While my colleagues at the Leverhulme Centre for Demographic Science recently showed that early-life diseases play a significant role, others have linked male childlessness to lifestyle factors like alcoholism.
But I believe there is a missing piece to this puzzle: culture. Specifically, stereotypes around masculinity continue to encourage young men to view care work and taking equal parental leave as feminist and unmanly.
Recent polling is showing that boys and men from Gen Z are now more likely than older baby boomers to believe that feminism has done more harm than good. Young women think the opposite. The result, as John Burn-Murdoch explains in his piece, is that young men and young women’s world views are pulling apart. While the consequences could be far-reaching, I believe decreasing birth rates are already one of the symptoms of this male malaise.
When studies ask women who want to have children why they’re not having any, one of the most common replies is: they don’t have the support. Finland is showing that family-friendly government policies aren’t enough. Male partners are simply not embodying the support women need to have children.
Regardless of whether we want to increase birth rates or not, a culture that fails to teach boys and men to be more caring and nurturing and to ask for help — including from each other — ultimately also leaves them worse off. Self-reliant, conservative ideals of masculinity can lead to loneliness and exacerbate risky health behaviours like alcohol abuse.
So where do we go from here? A first step is to take the limelight away from the likes of Andrew Tate and start a new conversation about men; one that shows images of a caring, vulnerable and nurturing masculinity as more healthy. Those who will benefit are men themselves and society as a whole.