In the last 20 years, adolescents’ heavy drinking in many western countries has declined. Simultaneously, researchers have identified an increased interest in health among young people. The paper compares adolescents’ gendered discourses and practices on intoxication and health in order to clarify the role gender plays in their current low alcohol consumption. The data consists of semi-structured interviews about alcohol, health and leisure activities among adolescents aged between 15 and 19 (N = 56). In the coding of the material, we have singled out two approaches to health and well-being among the participants, which we name the ‘social’ and ‘physical health’ approaches. By drawing on Butler’s work on ‘gender as performativity’, Connell’s understanding of gendered identities as ‘multidimensional’ and Bourdieu’s concept of ‘habitus’, we analyse how the participants align with, negotiate or oppose the hegemonic masculinities and femininities in these approaches, and examine the everyday practices that the two approaches are embedded in. Our analysis shows that the participants’ gendered performances in the ‘physical health’ approach are more variable, reflective and critical than those in the ‘social health’ approach. Moreover, the physical health approach modifies young people’s risk-taking practices of heavy drinking and helps to reinforce practices that favour young people’s low alcohol consumption. We propose that the move from doing gender in relation to risk-taking by heavy drinking towards doing it more through health- and physical appearance-related activities may generate processes that narrow the gender gap between masculinities and femininities and encourage new kinds of interaction and gender blending between them.