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In January 2019, the American Psychological Association, the country’s largest professional organization of psychologists, did something for men that it’s done for many other demographic groups in the past: It introduced a set of detailed guidelines for clinicians who treat men and boys. The 10 guidelines make suggestions on how to encourage fathers to engage with their kids, how to address problems that disproportionately affect men, like suicide and substance abuse, and how to steer men toward healthy behaviors. The guidelines’ development began in 2005, and has included input from more than 200 physicians and researchers.
This emphasis on understanding the issues men face comes at a crucial time, according to Ryon McDermott, a psychologist who helped the APA craft its new standards. Although people of all genders face no shortage of obstacles in America, “men are struggling,” he says. “The recession has hit men harder than women, men are less likely to graduate from college, men are more likely to complete suicide than women.” To help patients, the guidelines assert, psychologists need to understand what’s making their lives untenable. For a lot of men, it might be the harsh cultural expectations that can come along with manhood itself.
In providing standards for men in the same way that it previously has for women, LGBTQ people, and other demographic groups, the APA attempts to right an enduring wrong in a field that has long glossed over how being a man might impact a person’s experiences and well-being. But by making treatment more accepting of men while also critiquing the way many of them see themselves, the group is trying to thread a difficult needle in taking on the nature of masculinity.
In popular culture, meanwhile, “traditional masculinity” has a fuzzier, broader meaning, which generally encapsulates whatever the person reading or saying it associates with being a man. If McDermott sounds like he’s being careful in his distinctions, it’s because the APA’s efforts to critique masculinity’s most harmful norms have not been universally well received. When an article in the APA’s Monitor magazine characterized traditional masculinity as “on the whole, harmful,” writers for conservative media outlets including National Review and Fox News saw it as an attack on a population that’s suffering exactly the ills the APA hoped to address: elevated levels of depression and anxiety, and higher suicide and overdose rates.
“As we survey a culture that is rapidly attempting to enforce norms hostile to traditional masculinity, are men flourishing?” asks the columnist David French. “And if men are struggling more the farther we move from those traditional norms, is the answer to continue denying and suppressing a boy’s essential nature?”
Joseph Vandello, a social psychologist and professor at the University of South Florida who was not involved in crafting the APA guidelines, can understand why some people aren’t open to the new rules’ point of view. “It’s positioning traditional masculinity as a problem to be solved,” he says. “If you’re a man who holds traditional values, why would you go see a psychologist when the starting point is that traditional masculinity is the problem?” That conflict, he says, might exacerbate an issue the guidelines seek to manage. “Part of the problem among men is that one of the markers of traditional masculinity is independence and rejection of help.”
The guidelines’ authors say that their goal isn’t to directly change how men think about themselves, but to help psychologists more deeply understand whom they’re treating. “There are some principles by which masculinity has been defined—being strong, being powerful, being courageous—and we’re not taking any of that away,” says Fredric Rabinowitz, a psychology professor at the University of Redlands who stewarded the 13-year process of creating the APA’s guidelines.
McDermott says that the guidelines are “meant to protect men, because studies indicate that men receive quite a lot of gender bias in therapy. These are stereotypes that men experience, and when therapists buy into them, that can cause serious problems.” For example, if a male patient wants to address problems with violence or aggression, seeing a therapist who believes men are resigned to those traits probably won’t get him the help he needs.
Vandello believes that a more effective way to understand masculinity and its modern problems, rather than as “traditional” or “toxic,” is to emphasize the sense of insecurity that a lot of men feel about their status as masculine, a phenomenon known as “precarious masculinity.” In American culture, Vandello points out, manhood generally has to be earned and maintained through actions in a way that womanhood doesn’t. That constant test is where harm can fester, he says: “Proving your manhood can be done through risky, aggressive, and violent behavior. And another response is the shaming and bullying of men who don’t fit the masculine mold.”
No matter where the turmoil in modern men’s lives comes from, it seems like there would be a clear benefit to men feeling confident in seeking help to cope with mental illness and change the behaviors that harm their health—and that risk hurting others. “We’re not anti-male. It’s all about helping men be more healthy, helping them be more successful, helping them navigate the difficult situations of life,” says Rabinowitz.
McDermott hopes that the guidelines help doctors see their male patients as a little more human. “We have a chance here to understand men as multidimensional individuals,” he says. “There are many different ways of being masculine.”