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Mental Health Among Boys and Men: When Is Masculinity Toxic?

Psychologists offer tips on navigating masculinity norms.

Kevin Dodge/Masterfile
Source: Kevin Dodge/Masterfile

According to research, men are less likely to seek mental health services compared to their female counterparts. One of the factors that contribute to this underuse of seeking professional help is masculinity norms. It is often viewed that it is not okay for boys and men to express or discuss their emotions. In recent months, there has been a lot of debate about “toxic masculinity” and manhood. This was partially due to the release of guidelines published by the American Psychological Association, Guidelines for Psychological Practice with Boys and Men. Although this topic is nothing new, conversations about masculinity have been more frequent given the #MeToo movement and discussions focused on sexual assault.

What’s in the Guidelines for Psychological Practice with Boys and Men?

According to the APA (2019), the guidelines are “designed to summarize the current research to help psychologists provide their patients with the most effective, evidence-based care.” For mental health providers that specialize in working with boys and men, these guidelines are developed to aid providers in their work. One of my issues with the controversy with the guidelines is that many people in the public such as media sources are discussing them outside of the context. To fully appreciate the usefulness of the document, you must read them from front to back.

The guidelines offer 10 principles for psychological practice with boys and men – discussing concepts such as awareness of biases and stereotypes (especially towards males of color), understanding power, privilege, and sexism, risky sexual behavior, and promoting positive fatherhood. The American Psychological Association notes that “many characteristics of masculinity—such as courage, strength, compassion, leadership, and assertiveness—are often associated with positive psychological and behavioral health.”

On the contrary, the APA Guidelines are an identity that hegemonic or rigid adherence to masculinity norms can be detrimental to the health and wellness of boys and men. For example, males are often taught that showing emotions is a sign of weakness. Based on decades of research, emotional restriction—or not expressing emotions—is linked to increased negative risk-taking and inappropriate aggression. These factors also males at greater risk for psychological and physical health problems (APA, 2019).

In my opinion, the controversy about the guidelines has primarily focused on the misrepresentation of the document. In a recent discussion on The Breakdown Podcast with Dr. Earl, a mental health podcast, I had a conversation with psychologist Bedford Palmer, Ph.D., about the guidelines and how society can change our rigid views towards males and manhood. These conversations need to occur and it’s important to give males the space to have this dialogue.

Defining Traditional and Toxic Masculinity

There is a range of masculinity ideologies but most people have often used traditional and toxic masculinity to mean the same things, which are not. According to some researchers (Silver, Levant, & Gonzalez, 2018), there are four common areas of masculinity in American society:

  1. “no sissy stuff” (i.e., men should avoid anything feminine or associated with females
  2. “the big wheel” (i.e., men should strive for success and achievement)
  3. “the sturdy oak” (i.e., men should not show weakness and handle their problems independently)
  4. “give ’em hell” (i.e., men should seek adventure, be risk-takers, and use violence if necessary).

It has been discussed that this traditional masculinity ideology reflects the dominant view of the male role prior to the feminist deconstruction of gender roles. Hegemonic or toxic masculinity is a manifestation of masculinities that is characterized by the enforcement of restrictions in behavior based on gender roles that serve to reinforce existing power structures that favor the dominance of men (Parent, Gobble, & Rochlen, 2018). Although there are only slight differences in the definitions of traditional versus toxic masculinity, we need to understand how the APA Guidelines help improve the lives of males.

Effects of Toxic Masculinity

Displaying traits of toxic masculinity can lead to numerous negative outcomes. As noted in a previous blog post, adherence to rigid masculine norms may lead to:

  • problems with dating and interpersonal intimacy
  • greater depression and anxiety
  • abuse of substances
  • problems with interpersonal violence (e.g., sexual assault, spousal abuse)
  • greater health risk (e.g., high blood pressure)
  • greater overall psychological distress

The APA Guidelines on the Psychological Practice with Boys and Men is one resource to help mental health providers explore the complexity of masculinity and work with males to become their best selves.

Copyright 2019 Erlanger A. Turner, Ph.D.

Resources for finding a provider:

  1. The APA ( and Find a Psychologist ( provide resources for locating a therapist in your area.
  2. SAMHSA’s Treatment Referral Routing Service Helpline provides 24-hour free and confidential treatment referral and information about mental and/or substance use disorders, prevention, and recovery in English and Spanish. SAMHSA's National Helpline 1-800-662-HELP (4357) Website:
  3. Henry Health—mental health care for Black men
  4. Psychology Today’s Therapist Directory


American Psychological Association, Boys and Men Guidelines Group. (2018). APA guidelines for psychological practice with boys and men. Retrieved from

Parent, M. C., Gobble, T. D., & Rochlen, A. (2018). Social media behavior, toxic masculinity, and depression. Psychology of Men & Masculinity. Advance online publication.

Silver, K. E., Levant, R. F., & Gonzalez, A. (2018). What does the psychology of men and masculinities offer the practitioner? Practical guidance for the feminist, culturally sensitive treatment of traditional men. Practice Innovations, 3(2), 94-106.

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