Seeking medical help early is critical for recovery, yet evidence indicates that men do not utilise general practitioner services as often as women. This paper draws on Connell's (1995) theory of hegemonic masculinity to critically examine how men's under-utilisation of medical services may be influenced by the social construction of masculine identities. Interviews with seven older rural men about their help-seeking behaviour, used a movie extract and hypothetical scenarios to stimulate discussion. Transcribed data were analysed using discourse analysis, which showed that in this particular social context, the men faced a dilemma when identifying with two conflicting subject positions: the virtuous regular health care user, and the masculine infrequent user of health care services. They solved this dilemma by positioning women as frequent and trivial users of health care and themselves as legitimate users of health care. By using biomedical and morality discourses in this way the men could maintain a masculine identity whilst also identifying as virtuous users of health care services. These results support the utility of hegemonic masculinity as a theoretical basis for examining the construction and maintenance of gendered identities by highlighting the complexity of multiple masculine identities.