Addressing the invisibility of Black men in infertility care: A scoping review of cultural and structural barriers

BackgroundMale infertility remains critically underresearched, with Black men among the most overlooked populations in research and clinical care. Despite male factors comprising up to 50% of infertility cases, Black men face compounded barriers rooted in intersecting racial and gender marginalization.PurposeThis scoping review systematically examined structural and cultural barriers limiting Black men's access to infertility care in the United States, addressing a critical gap in reproductive health literature.Research DesignFollowing Arksey and O'Malley's framework, we identified peer-reviewed studies published between 2014 and 2024. Thematic analysis was conducted using deductive and inductive approaches guided by structural functionalism, symbolic interactionism, and empowerment theory.Study SampleThirty articles met the inclusion criteria, comprising studies examining Black men's infertility experiences, male fertility barriers, or reproductive health disparities.Data Collection and/or AnalysisStudies were identified through systematic searches across multiple electronic databases. Eligible articles underwent thematic analysis using deductive and inductive approaches guided by structural functionalism, symbolic interactionism, and empowerment theory.ResultsSix barrier categories emerged: cultural and social barriers (60% of studies), socioeconomic challenges (53%), knowledge gaps (30%), healthcare system barriers (17%), emotional burdens (17%), and environmental factors (13%). High costs of assisted reproductive technologies emerged as the primary obstacle, compounded by limited insurance coverage and income disparities. Cultural stigma surrounding masculinity, provider bias, and systemic marginalization of Black men in female-centric reproductive medicine represented additional barriers. Only 16.7% of studies focused primarily on Black men, highlighting systematic research neglect.ConclusionsBlack men face complex, multilevel barriers to infertility care rooted in compounding racial and gender marginalization. Addressing these disparities requires interventions spanning clinical practice reform, policy advocacy, and culturally responsive research. This represents the first scoping review of barriers to Black men's fertility care access and calls for transformative action.