A man sits in a doctor’s office after months of his wife’s increasingly desperate pleas for him to seek professional help for his constant coughing. In the end, she was the one who booked his appointment and even drove him there.
Another man is meeting with his manager, anticipating derision and mockery when he mentions he needs to reduce his workload to accommodate the birth of his first child.
A third man has a violent encounter in a street outside a pub, fuelled by binge drinking and machismo. He cops a blow to the head and crumples, hitting his head against the pavement.
These aren’t just stereotypes of men. They are the types of experiences and outcomes that reliably differ between men and women. We know from the research that men are 32% less likely to visit a health professional compared to women. Men are also less likely to seek therapy for psychological complaints, like feeling down or anxious.
Men also experience higher rates of suicide and motor accidents, are more likely to drink excessively and smoke, and are more prone to serious health conditions like heart, stroke, and vascular disease.
Similarly, men are more likely to both perpetrate and experience violent behaviours, and to adopt beliefs and behaviours that increase the risk of violence.
It is no surprise then that men exhibit higher mortality rates than women. There is a four-year gap in average lifetime expectancy between the genders – a woman can expect to live to just over 84, while a man can expect to live to just over 80.
In a bid to improve men’s health and wellbeing, the American Psychological Association (APA) recently released a set of guidelines for psychological practitioners when working with boys and men. These guidelines complement the APA’s guidelines for working with girls and women, released in 2007.
Both sets of guidelines share commonalities, like focusing on gender-appropriate therapeutic practices and education. Through these new guidelines, the APA is engaging in a shift towards seeing gender issues as being relevant to everyone, rather than just relevant to women. It recognises that the lived experiences of men may differ qualitatively to those of women. However, despite the positive intentions of the guidelines, their release was met by backlash and unfounded criticisms in some parts of the media.
What do the guidelines actually say?
The core concept of the guidelines is to challenge some of the aspects of traditional masculinity that might be causing problems in men’s lives. Traditional masculinity encompasses a set of norms around the ideas and beliefs that we hold, as a society, about what it means to be a man. For example, these beliefs identify men as self-reliant, emotionally reticent, focused on work over family, and oversexed.
When these beliefs are taken to an extreme level, they can result in poor outcomes for men like being dissatisfied in romantic relationships, having mental health problems, and engaging in more risky behaviours.
To illustrate the impact of these traditional ideas of masculinity on men’s health and wellbeing, let’s look at three of the ten APA recommendations in detail.
First, the guidelines urge psychologists to address the high rates of problems like violence, substance abuse, and suicide, which are more commonly experienced by men. For example, the guidelines highlight the link between beliefs about traditional forms of masculinity and the encouragement of aggressive behaviour in boys by family, peers and the media. As a result, men are more likely to engage in violent behaviours, and to experience violent victimisation themselves.
The guidelines also highlight the extraordinarily negative links between childhood abuse and victimisation, and later aggressive behaviour, suicidality and substance abuse in men. Recognising these patterns offers an opportunity for therapists to engage in gender-appropriate conversations and tailor behaviour change problems to the problems that plague men.
Second, the guidelines highlight the need to encourage men’s positive involvement in families. Despite increasing numbers of dual-income households, there is still strong social pressure for men to be the providers and breadwinners rather than taking on nurturing and caring roles. This expectation can come at the expense of men’s relationships with their partners, children, and extended family.
Encouraging men’s positive involvement with their families has been shown to improve health and wellbeing outcomes for both men and their children, and may also be beneficial for their romantic relationships. Further, it may have spill-over benefits in making work practices more progressive, with better balance between paid work and time spent with loved ones.
Third, the guidelines highlight the need for boys and men to more willingly engage in help-seeking and health promotion behaviours. Research suggests that men are more likely than women to die from easily preventable diseases, like colorectal cancer. Furthermore, high rates of self-harm and suicide may be tied to a reluctance to express emotions and seek help through therapy.
Traditional masculinity also encourages risky and competitive actions in men, resulting in unintentional injuries being the leading cause of death in men under age 45.
The guidelines suggest that to encourage men to better engage with healthcare and improve their health and wellbeing, we need to shift beliefs around self-reliance so that men feel more comfortable in looking after themselves and seeking professional help and services when needed.
Taken together, the APA has provided a promising set of guidelines that has the potential to improve the lived experiences of men. The guidelines squarely focus on the disparities in outcomes experienced by men compared to women, and provide clear suggestions on improving men’s wellbeing through strategies like strengthening family engagement and changing attitudes towards embracing healthy behaviours.
Many non-profit organisations and advocacy groups are already taking on this challenge to encourage healthy masculinities among boys and men. For instance, Our Watch, Australia’s national foundation to prevent violence against women and their children, provide numerous resources and articles for young people on masculinity and what it means to be a man via their campaign – The Line.
By recognising the importance of gender not just as something that affects women but as something also affecting men, we can move towards improving the way that clinicians, practitioners, and society at large provide support to our boys and men.
A version of this article appears in The Conversation.
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