For the first time ever, APA is releasing guidelines to help psychologists work with men and boys.
At first blush, this may seem unnecessary. For decades, psychology focused on men (particularly white men), to the exclusion of all others. And men still dominate professionally and politically: As of 2018, 95.2 percent of chief operating officers at Fortune 500 companies were men. According to a 2017 analysis by Fortune, in 16 of the top companies, 80 percent of all high-ranking executives were male. Meanwhile, the 115th Congress, which began in 2017, was 81 percent male.
But something is amiss for men as well. Men commit 90 percent of homicides in the United States and represent 77 percent of homicide victims. They’re the demographic group most at risk of being victimized by violent crime. They are 3.5 times more likely than women to die by suicide, and their life expectancy is 4.9 years shorter than women’s. Boys are far more likely to be diagnosed with attention-deficit hyperactivity disorder than girls, and they face harsher punishments in school—especially boys of color.
APA’s new Guidelines for Psychological Practice With Boys and Men strive to recognize and address these problems in boys and men while remaining sensitive to the field’s androcentric past. Thirteen years in the making, they draw on more than 40 years of research showing that traditional masculinity is psychologically harmful and that socializing boys to suppress their emotions causes damage that echoes both inwardly and outwardly.
“Men commit 90 percent of homicides in the United States and represent 77 percent of homicide victims. They’re the demographic group most at risk of being victimized by violent crime. They are 3.5 times more likely than women to die by suicide, and their life expectancy is 4.9 years shorter than women’s. ”
APA’s Guidelines for Psychological Practice With Girls and Women were issued in 2007 and, like the guidelines for men and boys, aim to help practitioners assist their patients despite social forces that can harm mental health. Many researchers who study femininity also work on masculinity: Several contributors to the guidelines for girls and women have also contributed to the new guidelines for boys and men.
“Though men benefit from patriarchy, they are also impinged upon by patriarchy,” says Ronald F. Levant, EdD, a professor emeritus of psychology at the University of Akron and co-editor of the APA volume “The Psychology of Men and Masculinities.” Levant was APA president in 2005 when the guideline-drafting process began and was instrumental in securing funding and support to get the process started.
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Gender and sexual minorities, too, must grapple with societal views of masculinity. This is an ever-shifting territory. When Levant and Rabinowitz launched the guideline-drafting process in 2005, only Massachusetts recognized same-sex marriage. Today, transgender issues are at the forefront of the cultural conversation, and there is increased awareness of the diversity of gender identity.
“What is gender in the 2010s?” asks Ryon McDermott, PhD, a psychologist at the University of South Alabama who also helped draft the men’s guidelines. “It’s no longer just this male-female binary.”
Though there is now more flexibility in gender norms than 30 years ago, according to Liang and McDermott, boys and men who identify as gay, bisexual or transgender still face higher-than-average levels of hostility and pressure to conform to masculine norms. The 2015 National School Climate Survey found that 85 percent of LGBTQ students reported verbal harassment at school over their sexual orientation or gender expression (GLSEN, 2015). Gender-nonconforming students reported worse treatment than did LGBTQ kids who conformed with traditional gender norms. These kinds of results indicate that gender policing still occurs, Liang says.
Sexual minorities or gender-nonconforming boys and men may face strained family bonds or even familial rejection. And family support can make all the difference in mental health. A 2016 study of a community sample of transgender children led by Kristina Olson, PhD, of the University of Washington in Seattle, found that those with supportive families were no more likely than nontransgender children to have depression, and were only slightly more likely to experience anxiety (Pediatrics, Vol. 137, No. 3, 2016).
Sexual and gender identity also intersect with other key life arenas, including military service (the guidelines suggest that therapists cultivate an awareness of military norms and common mental health concerns for veterans, such as post-traumatic stress disorder) and retirement.