Reflections on Patient Care
Men's Health and Gender Roles
by Olivia Arkell
Gender roles are deeply supported by and entrenched in the culture in which they reside. Basic psychology teaches us the mass majority of us have an innate craving to be a part of the in-group. In order to avoid feelings of discomfort and resentment, we often follow the framework society has laid out for us. We pick up on gender-appropriate and gender-inappropriate behaviors by developing gender schemas in relation to the cultural context we are placed in. From a very young age, we begin developing a highly engrained network of associations that guide our perceptions of what's acceptable and what's not in our culture based on our gender. Traditional male gender norms typically result in men believing they need to present themselves as strong, in control, and unburdened by vulnerability. However, it seems to be the case that society's expectations play a role in why men are less likely to openly speak up about their mental health.
The prevalence of any mental disorder is higher among females (25.8%) than males (15.8%) (NIMH). Additionally, 51.2% of females received mental health services whereas only 37.4% of men with a mental illness received services (NIMH). Although the prevalence of mental illness in females appears to be stronger, that doesn’t necessarily mean there are less men suffering from mental illness. My speculations lead me to believe the statistics that represent men as having less mental health diagnoses and encounters with mental illness services is due to the stigma attached to men's mental health and the prominent role that gender norms play in our society.
Adherence to these traditional male gender roles that consequently limit emotional expression in men have ramifications. Despite the lower prevalence of mental illness in men, four times as many men commit suicide than women (Johns Hopkins). If this isn’t a good enough basis for addressing the restrictive definitions of masculinity and the stigma attached to men's mental health, I don’t know what is.
I found it particularly compelling to shed light on the mere fact that long-established neuro-associations related to gender roles often lack critical reflection due to their deeply rooted nature. Because neuro-associations are utilized as a rapid process of calculation, they typically fall below our threshold of awareness. Men are expected to be dominant, strong, and in control. Although these aren’t inherently bad characteristics, they seem to make it harder for men to open up and seek help when needed. We often fail to critically reflect on why we believe and follow the things we do. It seems as if we’ve fallen victim to the cultural reinforcement and endorsement of gender roles without even questioning the foundational strength of them.
This has led me to be concerned about the misconceptions we may be nurturing as a society and the potential repercussions that come with it. Male gender role expectations appear to be associated with an increased endorsement of stigma around men's mental health.
Due to the socialization and conditioning that young men face regarding their gender role expectations, they feel the need to repress their emotional and psychological processes. From a young age, children begin learning gender-role behaviors over time through socialization, experience, and cognitive learning. These gender-role-consistent behaviors get reinforced throughout their adulthood. It seems to be the case that men and young boys aren’t properly taught how to identify, express, and deal with their emotions, especially ones that involve sadness, anxiety, distress, and vulnerability. This often leads males to express these emotions in the form of anger, contempt, and aggression, ones of which are more consistent with the societal gender roles that our culture has laid out for males.
The negative consequences of repressing emotions may pose danger to one's cognitive and emotional health. For example, inhibiting emotional expression and experience has been connected to certain mental health conditions. Internalizing negative emotions such as anxiety, sadness, and fear are involved in the etiology and description of various forms of anxiety and depression disorders. As mentioned previously, although men are less likely to get diagnosed and treated for these mental health conditions, they are much more likely to suffer the consequences such as suicidal thoughts and behaviors. All humans occasionally suppress their emotions as a strategy to regulate emotions. However, due to social and cultural expectations related to the male gender role, men are more likely to internalize their emotions which often leads them to be less likely to seek help in times when they may need it.
Men of Color
What’s more to be considered is that men of color and diverse ethnic and racial backgrounds face additional challenges. In addition to the social discrimination men of color face and their increased susceptibility of incarceration, they face road blocks when it comes to receiving treatment itself. In this case, there is a greater emphasis on increasing the contexts where they feel comfortable and understood when talking about their feelings and traumas. Previous research has told us that values, language, religion and other factors could create a gap in the understanding between a therapist and client. In order to minimize this gap, it seems to be effective to match up therapists with similar ethnic and racial backgrounds. However, there is a scarce amount of racially and culturally diverse professionals in the field of psychotherapy, especially racially and culturally diverse men. The difficulty in finding culturally responsive treatment for culturally and racially diverse men makes it even more less likely they will receive treatment.
“Add the stigmatization of help-seeking behavior by men of all races to the unique stressors faced by men and boys of color, and it’s no wonder men and boys of color are at higher risk for isolation and mental health problems. These challenges can manifest as substance use or acting out through violence and aggression — which can lead to more stigma and a continuation of the cycle.” - Hogg Foundation for Mental Health
The mere fact that men are significantly more at risk of suicide than women is a public health concern that begs for more attention. Is adherence to male gender role expectations more important than seeking professional help?
Changing the societal framework our culture and society has laid out for us is unlikely. However, we can change the idea that seeking mental health support is a “mark of weakness”. While putting an emphasis on mental health support and education in schools is an important step towards bridging this gap, I believe there are other approaches that may be effective. I find that it would be beneficial to provide a space where men can simply be human. Changing the landscape of care for mental health could also assist in changing the stigma attached to mental health in general. Providing a space that is gender-specific could create an environment for men to be vulnerable, express their weaknesses, receive support, listen and relate. Having a male figure model vulnerability and emotional expression also seems to be important in order to get men to open up. Focusing on community-based interventions could be a start in dismantling the stigma attached to men's mental health. Moreover, no mental health intervention is complete until it takes into account the culturally and racially diverse groups that face systematic marginalization.
Read More at: https://www.nimh.nih.gov/health/statistics/mental-illness
Olivia Arkell is a recent graduate from Hamline University who studied psychology, philosophy, neuroscience, and political science. She has a strong interest in biomedical ethics and the psychotherapeutic value of psychedelics. Olivia is always looking for ways she can expand her understanding on how we can transform the way we treat mental illness in the clinical setting. She demonstrates this passion through researching and interpreting literature then translating it into a short article/blog form that is easy, reliable, and comprehensible for the general public to read. Olivia joined the editorial team at Today’s Patient with the goal of initiating important conversations on topics related to wellness, mental health, neuroscience, and psychology and educating people on patient rights and advocacy.
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