Masculinity Mental Illness

For the first time, the American Psychological Association (APA) has published guidelines on the mental health of boys and men. It features in the most recent issue of the APA’s Monitor on Psychology magazine. The 36-page APA Guidelines for the Psychological Practice with Boys and Men has stirred up some controversy, however. Authors have targeted “traditional masculinity ideology” is a cause of serious harm to boys’ and men’s well-being. Here’s why.

Masculinity and Mental Illness

The APA has been around for 127 years. But the organization has never devised guidelines that apply specifically to boys and men. Given the current crisis in men’s mental health, it seems that the APA can no longer ignore the ways in which masculinity is related to men’s mental health issues. The organization claims that traditional masculinity ideology includes aspects such as “anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence.” And the authors of these guidelines believes:

“Socialization for conforming to traditional masculinity ideology has been shown to limit males’ psychological development, constrain their behavior, result in gender role strain and gender role conflict, and negatively influence mental health and physical health.”

The organization admits that masculine identity can benefit men in terms of their “relational, psychological, and behavioral health outcomes” but what is particularly important for the authors to note is how “constricted notions of masculinity” worsens boys’ and men’s mental health. They say that boys and men believe masculinity is tied to aggression, homophobia, and misogyny, and that these ideas:

“may influence boys to direct a great deal of their energy into disruptive behaviors such as bullying, homosexual taunting, and sexual harassment rather than healthy academic and extracurricular activities.”

These harmful aspects of masculinity, otherwise known as ‘toxic masculinity’, seem to impact not just other people but men themselves. ThriveTalk has identified seven reasons why masculinity is causing a crisis in men’s mental health:

  • Men attach strong importance to – and are insistent on being – self-reliant.
  • Men believe it is strongly important to be stoic and hold back when it comes to express their emotions.
  • Compassion isn’t viewed as manly.
  • The only acceptable emotion men feel they can express is anger.
  • Men boost their masculine identity through risky behavior.
  • Men have an unhealthy attitude towards relationships and women.
  • Men’s self-esteem is tightly wrapped up with certain ideas about success, such as job status and earning power.

It is these elements of masculinity that stop men from opening up, as well as cause them to refuse help, engage in heavy drinking, and judge themselves negatively. A lot of men’s poor self-esteem is intimately tied to narrow notions of masculinity. And expectations for men to ‘toughen up’ in difficult situations – and keep their mental suffering to themselves – are certainly contributing to the male suicide epidemic.

The APA makes some important points in these guidelines. For example, the organization also adds how the pressure on boys and men to be hypercompetitive gets in the way of them forming close, same-sex friendships. This is important, as intimate male bonds play an important role in protecting boys’ and men’s mental health. But the authors also include a political narrative in the guidelines, which may receive some backlash.

Male Privilege and Power

The authors allude to men’s “power” and “privilege” in comparison to their female counterparts and say how this not only oppresses others but men too. The authors highlight:

“Men who benefit from their social power are also confined by system-level policies and practices as well as individual-level psychological resources necessary to maintain male privilege. Thus, male privilege often comes with a cost in the form of adherence to sexist ideologies designed to maintain male power that also restrict men’s ability to function adaptively.”

This fits in with the idea that ‘patriarchy harms men too’. This notion is often used by feminist commentators to help convince all of us why patriarchy is bad for everyone in society. But this does seem to raise a certain paradox. If the patriarchy is designed to benefit men by virtue of being men, then why would powerful men uphold such a system if it harmed them too? There could be a number of reasons for this, including blind conformity to gender norms.

Other psychologists and commentators believe that the variety of harms suffered by boys and men contradicts the existence of patriarchy, at least in a Westernized country like the US. For instance, the feminist author Christina Hoff Sommers has made the case against privilege enjoyed by boys in her book The War Against Boys (2000). 

It may be questionable how impactful power, privilege, and sexism are in terms of men’s mental health. For example, previous research has shown that, out of the 11 masculine norms (many of which seem to reinforce power and sexism), only one was seen as being strongly linked to the risk of self-harm and suicide in boys and men. And that’s self-reliance. Nonetheless, other studies have found links between misogynistic and ‘playboy’ behavior and poorer mental health outcomes for men. The APA recommends that:

“Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.”

It adds:

“Although privilege has not applied to all boys and men in equal measure, in the aggregate, males experience a greater degree of social and economic power than girls and women in a patriarchal society (Flood & Pease, 2005).”

Again, many commentators challenge the assumption that we actually live in a patriarchal society. The journalist Hanna Rosin asserts in her book The End of Men: And the Rise of Women (2012) that the patriarchy is coming to an end in the US. There is obviously a strong division of opinion on issues relating to feminism and gender. But many experts may take issue with the APA’s stance in its guidelines.

What Does It Mean to be a Man?

With these guidelines, the organization may add to a narrative that pathologizes manhood. Many men feel alienated and lost when it comes to their sense of identity. We hear a lot about toxic masculinity but not so much about the positive aspects of masculinity. A lot of men may, therefore, feel ashamed that they possess masculinity, and not really know what it means to be psychologically healthy as a man. Is traditional masculinity always harmful? Can stoicism and competitiveness not sometimes benefit men (and others)?

Nevertheless, it is clear that certain aspects of gender norms – be they masculine or feminine – are harmful both to the individual and others. So it’s important for the APA to highlight this in its guidelines on boys and men. The link between notions of masculinity and mental health needs to be emphasized. We know that boys and men face high rates of problems such as aggression, violence, substance abuse, and suicide. So psychologists should understand how masculinity can lead to such issues and find ways to help their male patients develop a healthier perspective on their masculine identity.

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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