Why APA’s new guidelines for boys and men may do more harm than good.
Posted Jan 18, 2019
I find it ironic that a field which has proven the dangers of labeling people, seems the most ready to do just that. Many studies show that the people we label as black, white, rich, poor, smart or simple, appear blacker, whiter, richer, poorer, smarter, or more simple wholly because we’ve labeled them so. Why is that we seem to have fallen into the same trap regarding gender?
As a burgeoning clinician who works predominantly with male veterans, I am deeply concerned about the impact the APA's new guidelines, released earlier this month, might have on the men I see in treatment and the men who need treatment. We know that men who identify as highly masculine are also highly unlikely to present for services. This holds especially true for a large portion of the veteran population where concerns of stigma prevent many from seeking out care.
While to some this might prove the APA’s point that traditional masculinity is harmful, the reality is far more complex. Stigma is not rooted in any one thing. If it was, it would not remain a monolith and eradicating it would not be such a challenge.
The APA’s poor rolling out of the guidelines and the resulting sensationalistic headlines may farther stigmatize a group that feels increasingly isolated, misunderstood, and abandoned. It seems possible, if not probable, that this effort may prove to be more detrimental than helpful.
Take a minute to search “APA traditional masculinity.” What you will find is those already entrenched in their own beliefs regarding masculinity, for better or worse, are utilizing this moment to dig themselves in deeper. Those who identify as highly masculine feel attacked and those who feel attacked by traditional masculinity are calling all masculinities dangerous and toxic. We are all on the same carousel going no where.
Sadly, in my view, this is not a moment of repair but of greater rupture. As anyone who works with a highly masculine population understands, the confronting of the shadow side of masculine traits and their subsequent integration is tenuous work. Trust and rapport must be well-established. It does not happen overnight or in short-term therapy. In addition, therapists must remain cautious about bringing their own goals and ideologies into the therapy. Our job is not to overtly tell someone how to live their life or what to believe, as tempting as it might be.
For post 9/11 veterans, many already experience significant levels of transition stress as they reintegrate back into civilian society post-service after 17 years of war. Part of that challenge appears to be reconciling their deeply held beliefs with a society that does not seem to value the same convictions. Condemning the very traits that kept them alive in combat, feels like a betrayal by the society they sacrificed so much for. Men and women that exhibit many of the traditional masculine traits (i.e. assertiveness, dominance, stoicism, aggression, protectiveness, and sexual appetites) have fought in many of our nation’s wars.
Moreover, those who have seen the most intense combat and been exposed to the most potentially traumatic events are predominantly men—men who self-selected into an all-volunteer force after September 11, 2001, into jobs that all but guaranteed combat exposure. We cannot on the one hand demand their service and sacrifice by virtue of our elected officials and our distaste of the draft (which currently does not require women to register) and then sweepingly denounce the characteristics which propelled them to stand in harm’s way, so others didn’t have to. As the global wars on terror enter their twilight, so seems to go a large portion of our society that believes in the necessity of traditional masculinity.
Anything taken to the extreme can be negative; masculine traits are no different. These are issues that need addressing and the greater tragedy is that the APA guidelines do not do a good job of providing clinicians with application recommendations. It acknowledges that while privileged in some areas, men are marginalized in others.
This population deserves our care and attention. They deserve guidelines so we can deliver effective treatment. They don’t deserve labels. In labeling traditional masculinity as harmful we begin to see traditionally masculine men as harmful. Societally, that appears to translate to menacing and we seem intent on diminishing that “threat.” The irony is in mitigating it, we might be opening ourselves up to greater peril. The truth that we seem loathe to admit is that we need men, and women, capable of enacting harm on others in times of war. So maybe a better place to begin is by shaming any and all toxic behavior, and not the gender in which it originates.