Evidence is presented supporting the view that serious illness is often interpreted by men as an opportunity for emotional expressivity, contrasting with language and gender ideologies that stress men’s deficiencies in this realm. Comparative analysis of a large matched corpus of male and female interviews concerning the experience of a wide range of illnesses is reported. Illness experience prompts a process of biographical disruption for men resulting in a highly varied verbal repertoire. Compared with women discussing the same kind of experience, some men employ direct ‘on the record’ styles such as swearing, while others employ indirect ‘off the record’ distancing strategies, such as metaphor and generalisation that reify illness experience by externalising it as a problem. Some men express high levels of frustration, while others use a more self-conscious ‘women’s language’ of feelings that enables them to construct new identities. Such men associate this with the capacity for new and, paradoxically, more powerful performances of masculine identity.