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By Ray Williams

February, 2022


For as long as the United States has been a country, the straight white American male has ruled supreme. But as society changed and culture has evolved, traditional male masculinity is under siege. Economically, physically and emotionally, many American men are fighting to maintain a foothold. And it has brought the issue of male identity and toxic masculinity into focus.

 My forthcoming book, Macho Men: How Toxic Masculinity Harms Us All and What To Do About It examines the issue of traditional male identity in depth.

“What it means to be a man today is different than what it meant 20 years ago,” says James O’Neil, PhD, a psychologist at the University of Connecticut who studies gender role conflict. “There’s a paradigm shift occurring in our country regarding what it means to be masculine, and many men have had difficulty adjusting to that transition.”

That shift might have been a factor in the 2016 presidential race. President Donald J. Trump’s vow to “make America great again” seemed to resonate with the nation’s white male voters: Exit polls showed the widest gender gap among voters since exit polling began in the 1970s, with men favoring Trump over Hillary Clinton by 12 percentage points and women favoring Clinton over Trump by the same margin—for a total gender gap of 24 percentage points.

“In red states and blue states many men are struggling to figure out their place in 21st century America,” says Ronald F. Levant, EdD, a former APA president who studies men and masculinity as a professor of psychology at the University of Akron.

“With globalization, automation, the evolution of manufacturing, the increase in disparity of both income and wealth, there are all kinds of things going on that have had a devastating impact on white working-class men,” he says.


Distress and disconnection


Several analyses highlight the modern challenges for white, working-class men in America. In a working paper released in October, Princeton economist Alan Krueger,  reported that more than 11 percent of men age 25 to 54 were unemployed and not seeking work (Boston Federal Reserve Bank). That figure has been trudging upward for decades, but particularly during the last 20 years. Survey data suggest that nearly half of those men sitting on the sidelines of the workforce take pain medication on a daily basis, Krueger reported.

Indeed, the United States is in the midst of what the U.S. Centers for Disease Control and Prevention (CDC) has described as an “opioid epidemic.” Between 1999 and 2014, the number of opioid prescriptions in the United States nearly quadrupled, according to the CDC—and deaths related to opioid overdose, including prescription painkillers as well as illicit drugs such as heroin, also quadrupled during that period.

Other data suggest many of the nation’s white men—as well as women—are struggling with both physical and mental health problems. While other ethnic and racial groups have seen their health improve over the years, death rates have increased for middle-aged white Americans with no college education. Princeton economists Angus Deaton, PhD, and Anne Case, PhD, analyzed health data and found that increase can be explained by an epidemic of deaths related to alcoholism, substance abuse and suicide, a category sometimes referred to as “despair deaths” (PNAS, 2015).

At the height of New York’s coronavirus crisis, the number of deaths among men was nearly double that of women. Throughout the U.S., the statistics aren’t quite as startling, but men still make up the majority (54 percent) of all COVID-19 deaths, even though women account for a larger share of confirmed cases, according to data from the Centers for Disease Control and Prevention (CDC). And in certain age groups, the gap is even wider.

Among adults ages 40 to 49, men account for 69 percent of COVID-19 deaths; and in 50- to 64-year-olds, they make up 66 percent of deaths. Men of all ages are also more likely than women to require intensive care or mechanical ventilation once hospitalized for COVID-19, CDC data shows. For every 10 females admitted to the intensive care unit (ICU), there are 18 coronavirus-related ICU admissions for men, the nonprofit Global Health 50/50 reports.

While a biological component “is definitely there,” social and behavioral factors related to gender could also be tipping the trends in COVID-19 mortality, explains Derek M. Griffith, a professor of medicine and founding director for the Center for Research on Men’s Health at Vanderbilt University.

For example, men are more likely than women to engage in “high-risk behaviors” that make them vulnerable to a coronavirus infection, Griffith and his colleagues write in a July CDC report. They have lower rates of handwashing, mask wearing and social distancing than women. And according to a recent Gallup poll, they are less worried about getting COVID-19, despite the fact that many low-paid essential jobs that increase exposure to the virus (food processing, transportation, delivery, etc.) are often filled by men.

That mask-wearing has become such a gendered issue isn’t surprising for public health researchers. A 2016 paper by the Los Alamos National Laboratory also found that men are less likely than women to adopt protective behaviors, like washing hands, social distancing and wearing masks. More recently, three different studies — published this summer by Cambridge University Press — arrived at the same conclusions.

“Masculine toughness is consistently related to higher negative feelings and lower positive feelings about mask wearing,” noted the authors of one of those studies conducted in June.

While the latter data apply to both men and women, experts say that some cultural changes appear to be affecting men in uniquely troubling ways. “Society is changing, but we don’t talk to white men and ask them what they are struggling with,” says William Liu, a professor of counseling psychology at the University of Iowa who studies masculinity. “There’s a tendency to minimize it, yet the distress and disconnection are very real.”

Over the last several decades, working-class men have seen jobs in manufacturing and mining grow scarcer. Meanwhile, the economic disparity between the haves and have-nots has only gotten wider. “Working-class men look into the future and see that their options are limited. They’re not sure what their role in society is,” says Liu.

Many men feel their masculinity ideology is under attack, Levant adds. That ideology is built on a set of gender norms that endorses features such as toughness, dominance, self-reliance, heterosexual behaviors, restriction of emotional expression and the avoidance of traditionally feminine attitudes and behaviors. “These gender roles come through our parents, male relatives, teachers and peers, and we’re socialized into these roles starting in infancy,” Levant says.

Men who strive to meet these masculine “ideals” might feel threatened, consciously or otherwise, by societal shifts, including the increasingly powerful role of women in the workplace or the growing acceptance of same-sex relationships. “The culture is changing, and it no longer privileges [the stereotypical male] point of view,” says Liu.

Unfortunately, that viewpoint can be self-defeating, say experts who study gender role conformity. In a new meta-analysis, Y. Joel Wong, PhD, a professor of counseling psychology at Indiana University Bloomington, and colleagues found that overall, men who conformed to traditional masculine norms had higher rates of mental health problems such as depression, anxiety and stress, and lower rates of positive mental health outcomes, such as life satisfaction, self-esteem and psychological well-being (Journal of Counseling Psychology, 2016).

In particular, Wong found conformity to three masculine norms—playboy behavior, power over women and self-reliance—were significantly linked to psychological maladjustment. That suggests that sexist attitudes might have detrimental effects on men’s mental health, Wong says. And men who assign a great deal of value to self-reliance are less likely to seek help when they need it, he explains. “Self-reliance may have been helpful in the past, but it is becoming increasingly outdated in our interdependent world,” Wong says.

The traditionally male trait of “restrictive emotionality” also works against men’s well-being, adds O’Neil. Many men haven’t been given the tools to discuss their feelings in healthy ways. “Men are experiencing the loss of [traditional male] stereotypes but they don’t have the capacity to process the loss emotionally. Men don’t know what to put in place of what they’re giving up,” he says.

Gender role conflict doesn’t just damage the way a man sees himself, Liu adds. It can also strain the relationships a man has with male family members and friends. If a man starts to challenge traditional “locker-room talk,” for example, he might find he doesn’t know how to connect with his father or his brother as easily as he once did. “A lot of men are socialized into messages and mottos and identities that have been passed down. That allows them to relate to important people in their lives,” he says. “As society changes, individual narratives start to change, and that puts stress on the inter-generational connections men have.”


Masculinity gets in the way


Endorsement of traditional gender role norms can be a challenging issue to address, says Levant. “In many ways, masculinity is the problem—and it also gets in the way of the solutions.”

One traditional male norm, for example, is to avoid all things feminine. Yet some of the fastest-growing occupations in the United States are in fields traditionally embraced by women, such as child care, health care, education and food preparation, Levant says. “Men who strongly endorse these masculine norms probably wouldn’t consider a ‘pink-collar’ occupation,” he says—a catch-22 for men who are unemployed and struggling to find a place in modern society.

But while traditional gender roles are deeply entrenched, they aren’t immutable. One of the best ways to chip away at old-fashioned gender norms, Levant says, is with education. “Working-class, less-educated men tend to believe it’s very important for men to meet these standards. More educated men have more occasions to challenge these ideas,” Levant says.

He proposes targeted campaigns to challenge gender roles, such as public service announcements that encourage men to pursue careers traditionally thought of as feminine. He points to projects such as the Man Up Campaign, which engages youth to promote gender equality and end violence against women.

Levant also encourages men in positions of power to violate outdated male norms. A politician crying during a press conference, or a popular pro athlete talking openly about his depression, can go a long way toward breaking down those barriers, he says.

In addition, the psychology field has to get creative to reach the men who are struggling. One example isBoys Don’t Cry,” a YouTube video produced by APA’s Public Interest Directorate, which was designed to let boys know it’s OK to show emotions.

“Therapy should always be there, and we should always advocate for it. But we know masculine norms that are correlated with mental health problems also prevent men from seeking psychological help,” Wong says. “We need to look beyond therapy to find other ways to reach men.”

It’s clear there’s a male identity crisis in America, and toxic masculinity may actually be on the rise, as witnessed in politics, entertainment and business.