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  • Society of Bioethics and Medicine

The Modern Man and Mental Health: Breaking from Traditional and Toxic Masculinity

Written by: Lok-Yee Lam

Edited by: Laila Gad

In recognition of National Men’s Health Awareness Month, it is important that we draw attention to men’s mental health which is too often overlooked in our modern-day society. As the mental health community continues to raise awareness and prioritize the issue, people are learning to speak up against stigmas and acknowledge that it is okay to not be okay. Despite the ongoing efforts to normalize mental health, the conversation around this issue is often perceived as controversial and is widely avoided when it comes to males. Mental health, substance abuse, and eating disorders affect males equally as much or sometimes more than their female counterparts. And yet, men are less likely to seek treatment compared to women and are more often underdiagnosed for depression. This is especially concerning because of the high rates of suicide and substance abuse experienced among men. Thus, there is an increasing urgency to break this silence and address the mental health crisis afflicting men, especially during this month.

The present problem primarily stems from the traditional norms of masculinity and the associated stigma, which pose both an immediate threat to psychological well-being and a long-standing perpetuation of poor health outcomes in boys and men. The conversations around “toxic masculinity” often focus on the harmful effects on women and society, but it is seldom discussed within the isolated context of being toxic to the men themselves. According to the American Psychological Association’s Guidelines for Psychological Practice with Boys and Men (2019), “many characteristics of masculinity--such as courage, strength, compassion, leadership, and assertiveness--are often associated with positive psychological and behavioral health.” On the other hand, some traditional masculine social norms can result in negative consequences that perpetuate poor mental health outcomes.

According to Psychology Today, “there are four common areas of [traditional] masculinity in American society: “no sissy stuff” (i.e., men should avoid anything feminine or associated with females), “the big wheel” (i.e., men should strive for success and achievement), “the sturdy oak” (i.e., men should not show weakness and handle their problems independently), and “give ‘em hell” (i.e., men should seek adventure, be risk-takers, and use violence if necessary)”. Emphasizing these traditional norms, boys are from an early age that vulnerability and expression of emotions is a weakness. As they get older, they are taught that “big boys don’t cry” which further reinforces the toxic notion that boys aren’t allowed to express themselves which leads to suppression. Rather than being able to release through communication, the traditional norms of masculinity champion that emotions be released in the form of physical exertion or anger.

It is also important to note that, boys and men of color are further restricted by these rules because their expression of emotion is divided between perceptions of being weak or being a threat in our society due to the long history of discrimination and oppression against colored men. Hence, most men of color tend to be even more reluctant to talk about their emotions. This positions boys and men of color, particularly Black and Hispanics, at an even greater disadvantage and consequently greater risk of poor mental health outcomes and overall well-being, considering how these social constructs of masculinity norms further exacerbate issues with health disparities.

Such emotional restrictions have been linked to increased negative risk-taking behavior, aggression, and violence which concur with the common themes of masculinity. These factors have been associated with greater risk for psychological problems such as depression, anxiety, and substance abuse disorders. Stressing the need for independence and self-reliance, males are often left to their own devices and fail to address these problems openly with others, and especially with mental health professionals. Furthermore, masculine norms also contribute to the underdiagnosis of depression in men because they encourage minimization and ignoring of signs and symptoms of mental illness. For example, men who may be depressed and are experiencing symptoms might think that their problem will go away on its own rather than seeking for meaningful help from someone close or even a professional. This is closely tied with the failure to recognize the symptoms of depression because the condition is often associated with feelings of sadness or being emotional, but this may not be how men experience and show depression. It has been suggested that depression in men often results in irritability, anger, hostility, risk-taking, and escaping behavior—all which are closely associated with traditional masculine attributes and ideology. Thus, it isn’t surprising that depression is severely underdiagnosed and yet affects almost 1 in 3 men in the United States.

In addition to the barrier that masculinity poses to men’s mental health, having a mental illness is still stigmatized which further perpetuates the silent suffering cycle of boys and men not being diagnosed and properly treated for their symptoms. It can be further argued that because so many go undiagnosed and untreated for their mental health disorders, their condition worsens over time and can lead up to suicide death, which affects men four times more than women.

It is unfortunate that these traditional characteristics that are ascribed to manhood and masculine gender roles remain one of the greatest barriers to targeting the issue of mental health in boys and men. Rather than teaching boys at a young age that being vulnerable makes you less of a man, we should establish a new tone that empowers all youth to develop communication skills to better express their emotions and accept that it is okay to not be okay. Both boys and girls should be taught to be comfortable speaking openly about mental health with an emphasis that physical and mental illness have equal importance. It is also important to keep in mind that as society moves towards a more inclusive culture, gender neutrality and appreciation for diversity of gender identity and roles is essential.

Certainly, the present discussion has not explored the nuances beyond this binary perspective of men vs women, but the parting message here is that mental health awareness is important to everyone in society because mental illnesses can affect anyone. Putting gender aside, there are some characteristics that don’t need to be classified as masculine or feminine. They simply are qualities that promote positive psychological outcomes such as bravery, resilience, strength, and persistence -- all of which are necessary in fighting the stigma that mental illnesses are faced with.

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