Journal of American College Health

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Masculinity and Men's Mental Health

Gary R.BrooksPhD

To cite this article: Gary R.BrooksPhD (2001) Masculinity and Men's Mental Health, Journal of
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 JOURNAL OF AMERICAN COLLEGE HEALTH, VOL. 49, NO. 6
Masculinity and Men’s Mental Health
Gary R. Brooks, PhD
ow are men and women different from each other?
How do these differences affect their health? At the
most elementary level, these age-old questions
seem logical to ask and relatively simple to answer. The dif-
ferences between biologically determined categories of
male and female are apparent. To some, these structural dif-
ferences account for how the sexes become susceptible to
certain diseases and illnesses, as well as for the dramatic
differences in the longevity of men and women. However,
as has been demonstrated elsewhere, health is much more
complicated than biological processes. Physical health is
embedded in a complex system of interactions among bio-
logical factors and psychosocial processes that have been
shown to have enormous reciprocal effects.
As medicine has expanded its focus beyond exclusive
emphasis on physiological structure, it has been forced to
embrace a more complex conceptualization of the differ-
ences between women and men. Although it is frequently
useful to think of the differences in terms of biological sex,
it has recently become clear that the most productive
avenues of investigation are those that study women and
men in terms of gender. When people use the term sex, they
are limited to considerations of biological mechanisms.
When they use the term gender, however, they can broaden
their focus into analysis of social, cultural, and psychologi-
cal issues that pertain to the traits, norms, stereotypes, and
roles of women and men.
Articles on aspects of men’s health published in the May
2000 and subsequent issues of the Journal of American Col-
lege Health in the series Emerging Issues in College Health
exemplify this effort to understand how the male gender
~~ ~~
Gary R. Brooks is an associate professor in the Department of
Psychology and Neuroscience at Baylor University in Waco,
Texas.
285
role, or masculinity, intersects with male physiology to cre-
ate distinctive challenges for men’s healthcare. It seems log-
ical that this important work should not be limited to men’s
physical health but should also include men’s mental health.
In broadening the focus from physical health to include
mental health, it seems logical to initiate discussion by con-
sidering health as an absence of disease or pathology. This
perspective is briefly touched upon in the following section,
which considers differential rates of susceptibility to vari-
ous categories of mental illness.
But the discussion cannot stop there. Health is a far more
complex construct, and our discussion must include consid-
eration of many higher levels of emotional and psychologi-
cal functioning. Subsequent sections will elucidate the prin-
cipal thrust of this article-the process of being male that
makes men susceptible to certain formal categories of men-
tal illness but also leads to significant emotional dilemmas
and relational shortcomings that produce compromises in
men’s optimal mental health.
Men, Women, and DSM-IV
Over the past several decades, the field of psychiatry has
continually refined and systematized its procedures for
organizing the various mental disorders. As this process has
unfolded, there have been consistent trends in the relative
distribution of women and men within each of the evolving
diagnostic entities. The Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition (DSM-IV)is the latest
version of the American Psychiatric Association’s hand-
book of mental disorders. In reviewing this manual, one can
learn that although many mental disorders are relatively
evenly distributed among women and men (schizophrenia,
obsessive compulsive disorder, hypochondriasis, body dys-
morphic disorder, and avoidant personality disorder), men-
tal disorders seem particularly sensitive to gender. Most
BROOKS

mental health problems are disproportionately distributed, and humanistic approaches, calls for individuals to pursue
with many disorders much more common among women an idealized level of personal growth, self-development, or
and many others more common among men (see Table 1). self-actualization. Finally, the “normality as process” per-
spective considers mental health as a developmental and
Beyond the Medical Model interactional process whereby individuals are expected to
For some, the topic of women’s and men’s mental health negotiate their evolving needs successfully with those of
could be confined to the study “mental illness”-to explor- persons in their sociocultural environment.
ing the causes and cures for the standard diagnostic entities. In this article, I will expand beyond the absence of
For most mental health practitioners, however, mental pathology approach and look at men’s mental health from
health is a far broader concept that is related to the funda- the broader perspective suggested by Offer and Sabshin. In
mental issue of how one defines “normality.” Offer and Sab- writing this, I would have been justified in tying myself
shin’ reviewed this complicated issue, providing many per- quite closely to the formal and authorized diagnostic nosol-
spectives beyond the limited view of “normality as health.” ogy of the mental health field. One could, for example, seri-
This normality-as-health perspective is consistent with tra- ally address the various categories and describe what is
ditional medical and psychiatric approaches in terms of a known about gender contributions and manifestations (eg,
“negative” definition of pathology-health is the absence of how does male socialization contribute to the presence and
pathology; persons who are not in the diagnostic manual are absence of generalized anxiety disorder or phobic disor-
“healthy” by default. der?).
This perspective, although valuable, is certainly incom- In doing this, however, I would have reinforced the nor-
plete and must be supplemented by others. Offer and Sab- mality-as-health paradigm criticized by Offer and Sabshin.
shin noted three other paradigms of mental health. The Instead, I have elected to approach the matter from the
“normality as average” approach is nonnative, suggesting broader perspective of examining how “masculinity” pre-
that healthy persons are those that have about the same vents men from being as mentally healthy as they could
number of problems and psychological assets as most other possibly be. I will address how rigid adherence to very pow-
people. The “normality as utopia” perspective is an aspira- erful strictures of proper male conduct disposes men to
tional model that envisions an ideal or optimal level of men- adopt certain interpersonal stances and engage in certain
tal health. This model, consistent with the psychoanalytic behaviors that are not ultimately in their best interests (or
the best interests of their loved ones). But before doing that,
it seems important to provide context by providing a thor-
TABLE 1
ough review of some basic concerns about psychiatry’s tra-
Relative Frequencies of Women’s and Men’s ditional diagnostic system.
Mental Health Problems
The Feminist Critique of the Medical Model
and Psychiatry’s Diagnostic System
Disorder Ratio
Over the past 3 decades, feminist scholars and activists
WomedMen have taken serious issue with the way women have fared in
their contacts with the mental health establishment. With
Generalized anxiety 2: 1
Women and Madness, Cheder2 presented one of the earliest
Panic 2: 1
Agoraphobia 3: 1 and most influential indictments of “a century of psychi-
Eating 9: 1 atric theory and practice” that pathologized and stigmatized
Depression 3: 1 women. In succeeding years, other feminist voices have
Somatization (“rare in men”) identified other areas of concern about the treatment of
Conversion 2:1-10:1
women.
Personality
Multiple 3: 1-9: 1 Most research on differential rates of mental illness has
Borderline 3: 1 suggested that women are diagnosed and treated for mental
Histrionic - illness at a much higher rate than men are.3 Women have
Dependent -
been far more likely to receive intensive treatment that
includes psychotherapy and medication. Ashton4 found that
Men o m e n women are prescribed twice as many psychiatric medica-
Alcohol abuseldependence 5: 1 tions as men are. To many feminist critics, medications
Illicit substance abuse (except cocaine) 3: 1-4: 1 were one part of a larger effort to control and suppress
Antisocial personality 3: 1 women. For example, one critic noted:
Paraphilias (“almost never in women”)
Obsessive compulsive personality disorder 2: 1 Viewed from a feminist perspective, the history of the field
Combat PTSD (few women) - reveals a troubled-and troubling-relationship to women.
Diagnoses such as nymphomania, hysteria, neurasthenia,
Nore. F’TSD = posttraumatic stress disorder. erotomania, kleptomania, and masochism have served to
enforce conformity to norms of female domesticity, subordi-

286 JOURNAL OF AMERICAN COLLEGE HEALTH

 MASCULINITY 8 MENTAL HEALTH

nation, and subservience to men’s sexual needs. Moreover, if the proper sex role. Although androgyny (the incorporation
women’s anger, depression, and discontent come to be inter- of other gender characteristics) was thought to be benefi-
preted as medical or psychiatric symptoms, difficult and dis- cial, it was only so after a comfortable sense of gender iden-
tressing life experiences may be
tity had been achieved.
A core issue in feminist critiques of psychiatric practice The gender identity paradigm is rooted in essentialism,
has been the challenge to the effort to treat mental disorders an umbrella term commonly used to encompass the many
as if they were simply another version of physical disorders; theories that consider men and women to be fundamentally
that is, diseases of the brain or mind. When this is done, different because of genetic, physiological, or neu-
practitioners ignore the actual truth about psychiatric diag- roanatomic disparities or because of radical differences in
noses. As is reflected by the considerable changes and phe- their evolutionary challenges. Bohan] notes that “essential-
nomenal growth in the DSM since the first edition in 1952 ist views construe gender as resident within the individual.
(from 129 pages and 79 diagnostic categories to a current . . essentialist models, thus, portray gender in terms of fun-
886 pages and 374 diagnostic categories), diagnostic cate- damental attributes that are conceived as internal, persis-
gories are far more arbitrary and controversial than is gen- tent, and generally separate from the ongoing experience of
erally recognized. Although many important underlying interaction in the daily sociopolitical contexts of one’s life”
biological substrates to psychiatric conditions certainly (pp32-33). From this perspective, for example, one might
exist, most psychiatric diagnoses are neither “forged in the argue that women are more likely to have anxiety disorders
because
scientific laboratory” nor “medico-scientific ~ e r i t i e s ” ~ ( P ~ ~ ~ ) . of vagaries of women’s hormonal vacillations and
More frequently, they are convenient abstractions that pro- pressures. Men, on the other hand, might be considered as
vide a crude method of differentiating clusters of reactions predisposed to antisocial personality disorder because of
to human problems that are in themselves subject to the their testosterone or their evolutionary history as aggressors
idiosyncrasies of historical era, situational context, and and hunters.
changing moralities. The GRS paradigm takes a markedly different view of
Of greatest relevance for the present discussion is that mental health, one consistent with the social constructionist
feminist critics established that psychiatric diagnosis, and, perspective noted above. According to the GRS paradigm,
by implication, mental illness and mental health, cannot be gender roles are not only socially constructed, but are also
understood without a deep appreciation of women’s lives. highly problematic. Among the assumptions of the GRS
Before behaviors and emotional reactions are labeled as paradigm are (a) gender role norms are inconsistent and
pathological, their adaptive role must be understood. That contradictory; (b) a high proportion of these roles are vio-
is, psychiatric practices must be sensitive to the sociocul- lated frequently; (c) social condemnation and stressful psy-
tural influences of gender-they must be “gender sensi- chological consequences commonly follow role violations;
tive.” Feminist critics have pointed out that the mental and (d) many characteristics and behaviors prescribed by
health establishment, rather than limiting itself to the treat- gender role norms are psychologically dysfunctional.
ment of mental illness, should develop a broader agenda to The GRS paradigm has major implications for men’s
consider women’s well-being and should consider methods mental health. This model predicts that even when men do
of enhancing women’s lives. not develop formal psychiatric disorders, gender role strain
interferes with their optimal growth and self-actualization.
Feminism, Gender Studies, and Men’s Studies: Most critically, it predicts that men, in their efforts to be
New Perspectives faithful to the most powerful dictates of the male role, will
be subject to a wide range of emotional, psychological, and
How does the discussion of the feminist critique of the behavioral dysfunctions. These dysfunctions can be cata-
mental health establishment inform us about men’s mental logued under the rubric of the “dark side of masculinity.”’2
health? Primarily, feminism and women’s studies have
brought attention to the critical role of gender and have laid The Dark Side of Masculinity
the groundwork for the emerging field of men’s st~dies.’.~ In their exposition of the dark side of masculinity, Brooks
Men’s studies are an extension of women’s studies-an and Sil~erstein’~ posited that traditional masculine role
attempt to examine how masculinity is a social construction socialization produces a wide range of interpersonal pat-
and often has a negative effect on men’s lives and their men- terns and behaviors that are profoundly harmful to society
tal health. and to men themselves. Before outlining these features of
Joseph Pleck, a leading scholar of men’s studies, pro- the dark side of masculinity, some clarification is in order.
posed the “gender role strain” (GRS) paradigm of mas- These features (eg, violence, sexual assault, fathering
c ~ l i n i t y . ~Before
. ’ ~ Pleck and other social constructionists, problems) are not, in and of themselves, forms of mental ill-
most ideas about women and men were anchored in the ness. In some cases they may be a result of mental illness;
“gender identity” paradigm. According to this paradigm, in other cases they be a cause. For example, violence and
there are two “essential, distinct, and oppositional identities risk taking may be a partial result of mental illness, such as
of masculine and feminine,” with psychological health a DSM-IV Axis I1 personality disorder. On the other hand,
depending on incorporation of sufficient characteristics of certain dark-side behaviors (eg, violence, sexual assault)
VOL 49, MAY 2001 287
BROOKS
contribute to the development of other DSM-ZV categories,
such as posttraumatic stress disorder.
If these dark-side behaviors are not actually formal cate-
gories of mental disorder, why am I focusing on them? As
noted earlier in this article, I have a broader focus than that
of narrowly dissecting the formal diagnostic categories. I
am making a special effort to transcend the sharp distinc-
tions between men who are pathological and men who are
healthy. (In addition, I am attempting to overcome the
sometimes unnecessarily polarized view of men exclusive-
ly as victimizers and ignoring them as victims.)
It is critical, of course, that clinicians recognize the line
between pathological and normal. At the same time, how-
ever, it is a mistake to assume that all persons who do not
meet formal criteria of mental illness are therefore free of
problems. Certain conflicts and distress are inherent in the
lives of all men, as Pleck noted in the GRS paradigm. Most
men manage well enough; few acquire a formal diagnostic
label, although this sometimes necessitates a high degree of
avoidance and covering up. The point is that even when men
do rather well, their optimal mental health is often compro-
mised by many of the more problematic demands of rigid
male socialization. In worst case scenarios, these demands
contribute to the behaviors of the dark side of masculinity.
Violence
Male violence represents both the most celebrated and
the most censured features of masculinity. It is also one of
the most paradoxical. When displayed for noble, righteous,
or patriotic causes, male violence is exalted, as in the form
of the “warrior male” or “epic male.”I4 Nevertheless,
because of its immense destructiveness, it clearly represents
one of the greatest impediments to the physical health of
women and men. Somewhat less recognized has been the
immense damage it does to the emotional health and well-
being of both women and men.
Although most violent men are more likely to be seen in
institutions of the criminal justice system than in psychi-
atric institutions (that is, “bad’ versus “mad”), violence
poses major dilemmas for men. In poorly understood ways,
violence also jeopardizes men’s emotional health. Even
though women are far too frequently victimized by men’s
violence, men themselves are more likely to suffer at the
hands (or weapons) of other men. Male violence against
other males is by far the most common type of violent crime
in the United States, where 77% of all murder victims are
males and where male assailants kill 88% of male murder
victims.ls Males in the United States are eight times more
likely to suffer a firearm-related injury and six times more
likely to suffer a firearms-related death.16
Male violence against young males is only recently
beginning to receive the attention it deserves. Estimates of
childhood physical abuse among men suggest rates between
10% and 2O%.I7 When the focus is shifted to “minor vio-
lence,” rates escalate to as much as 65%.17(pp197-212) Lisak18
points to the chronic problem of underreporting physical
abuse by men. He finds that men consistently downplay the
288
severity of the abuse they experienced and think of it with-
in the context of “normal” discipline. LisakI8 argues that
physical abuse is nevertheless likely to create many long-
term problems for young men: developmental delays, neu-
rological dysfunction, difficulties with emotional attach-
ment, lowered self-esteem, cognitive delays, poor school
performance, discipline problems, problems with peer rela-
tionships, and a greater likelihood of physical aggression
and substance abuse.
Data on male violence against other males does not
diminish the enormous problems of male violence against
women. Straus and Gelles,I9 using probability sampling
techniques, estimated that from 2 to 3 million women in the
United States are assaulted by their male partners each year.
Most of the assaults involve “minor” violence (eg, pushing,
slapping, shoving, or throwing things). However, assaults
take the form of severe beatings in 3 out of every 100 cases.
A recent analysis of prevalence studies suggests that
between 21% and 34% of women in this country will be
physically assaulted by an intimate adult partner, and that
between 14% and 25% of adult women have been raped.20
Hart2’(p18)quoted C. Everett Koop, former US surgeon gen-
eral, as identifying domestic violence as “the number one
health problem for women in the United States, causing
more injuries to women than automobile accidents, mug-
gings, and rapes combined.”
The foregoing material should make it abundantly clear
that male violence is far too frequently destructive to
women, children, and certain male victims. Far less appre-
ciated has been damage done to the emotional health of all
men by the common messages about the need for “real”
men to be tough, physically aggressive, and violent when
“necessary.” From the recognition of Fasteau22that violence
is the “crucible of manhood,” to the more recent insights of
many men’s studies authors,2”2s to the appearance of the
troubling video Tough Guise,26violence has begun to be
recognized as a sword that cuts both ways. Increasingly, the
focus has shifted to consideration of the ways that men’s
capacity for intimate relationships, emotional comfort, and
general mental health are compromised by the convention-
al association of violence with true manhood.
Rape and Sexual Assault
Kaplan and associates27characterized sexual assault of
women as a critical problem in contemporary US society.
They reported that research studies vary widely in their esti-
mates of the prevalence of rape, but that between 5% and
44% of women are raped at some time in their lives. A simi-
lar range is found in estimates of the prevalence of assault on
college campuses, from a low of 15% to a high of 78%.28*29
Koss30 reported that the Uniform Crime Reports, a com-
pilation of crimes reported to local authorities, found that
102,555 crimes qualified as rapes in 1990. However, she
notes that national samples of adolescents, college women,
and adult women suggest that rape incidence is 6 to 15
times higher than reported.
When women are sexually assaulted, their intimate male
JOURNAL OF AMERICAN COLLEGE HEALTH

partners are most frequently responsible for the attack.
Using a random sample of 930 women, Russell3’found that
14% of women who had ever been married reported being
raped by a husband or ex-husband. This figure was more
than twice as many as were assaulted by strangers. Rape
and sexual assault are more common in relationships in
which other forms of physical aggression are ongoing.32
Violent episodes seem to include sexual as well as nonsex-
ual physical attacks.
In a study of the sexual behavior of 518 college men,
34% reported that they had engaged women in unwanted
sexual contact (kissing and fondling), 20% reported that
they had attempted unwanted intercourse, and 10% report-
ed that they had completed unwanted i nte rc our~ e.Similar
~~
findings were reflected in a study of 196 college men.29
Forty-nine percent of the primarily White, Catholic, subur-
ban men surveyed reported that they had engaged in some
form of sexual aggression toward women since the age of
14 years. Although 54% of the men had attended a rape
awareness workshop, 30% reported sexually aggressive
behavior in the past year, and 16% reported at least one inci-
dent of the more serious form of sexual assault (attempted
rape, coercive intercourse, or rape) in the past year. Only
2.5% of the young men viewed themselves as “very likely
to rape,” but 46% reported some likelihood to force sex if
they would not get caught or punished. These data on the
likelihood of forcing sex are comparable to data reported in
earlier ~ t u d i e s . ~ ~ , ~ ~
The data on rape and sexual assault are most distressing
because they suggest that sexual aggression and coercive
sexual practices seem to be more common that previously
recognized. Once again the question arises: Why is this
material included in an article about men’s mental health?
As was the case in the earlier discussion about masculinity
and violence, no effort is being made to diminish the culpa-
bility or responsibility of men who rape or commit sexual
assault. Neither is there any effort to suggest that all men
are rapists, because most men reject sexual coercion as an
interpersonal strategy.
My central point is that men are raised in a culture that
teaches men to be sexually preoccupied, assigns sexual
“gatekeeping” to women, endorses rape mythology, and
provides mixed messages about how far a man should go to
acquire sex.35*36 As a result, in their efforts to navigate the
path to mental and emotional health, men must overcome a
number of powerful messages that encourage them to adopt
dysfunctional sexual attitudes and behaviors.
Sexual Misconduct and Sexual Excesses
In the decade of the 1990s, male sexual misconduct was
repeatedly in the national spotlight. Highly visible and for-
merly esteemed male public figures, from US senators, con-
gressmen, Supreme Court nominees, and even the presi-
dent, were charged with promiscuous and irresponsible
sexual behavior. During the Tailhook Affair, charges of
high-level support and encouragement of sexual miscon-
duct rocked the US Navy. Some men’s studies authors1’.37
VOL 49, MAY 2001
MASCULINITY & MENTAL HEALTH
challenged the notion that these events should be dismissed
as aberrations and argued that they represent fundamental
problems with normative male sexuality. In essence, these
scholars argue that contemporary men are taught to
approach sexuality from a “nonrelational” perspective in
which they are encouraged to experience sex primarily as
lust, without any consideration of relational intimacy or
emotional attachment.
This approach to sexuality, they argue, profoundly inter-
feres with men’s capacity to integrate their emotional and
sexual selves. According to this conceptualization, young
males are given the message that sexual activity is a way to
validate one’s own masculinity. An integral feature of this
masculinity validation is the presentation of sexual behav-
ior as a contest with women, in which men use a variety of
means to obtain intercourse, whereas women are expected
to resist. Sexual activity, thereby, becomes a form of “con-
quest” and evidence of masculine prowess. Greater mas-
culinity is bestowed upon young males who have frequent
sex with multiple partners, with minimal regard for intima-
cy, tenderness, or compassion.
Whether nonrelational sexuality and sexual promiscuity
are viewed as an inevitable aspect of male behavior or as a
product of traditional male role socialization, the picture is
relatively clear: Within patriarchal cultures, men are far
more likely than women to engage in casual or nonrelation-
a1 sex. In reporting on gender differences in sexuality, Shi-
bley-Hyde3*identified attitudes toward casual sexual activ-
ity as a principal difference between men and women. The
data on sexual activity of heterosexual men and women out-
side of marriage also support this contention. Both men and
women are sexually active outside of marriage, but men are
far more likely to report their sexual activities as “solely
physical” in nature. Men have many more outside partners,
but “what they do not have are many emotional attach-
ments ,”39(~279)
Alcohol and Drug Abuse
Alcoholism and drug abuse can easily be recognized as
major mental health problems that are intricately connected
to masculinity. Alcoholism and masculinity seem to go
hand in hand. Although exact figures may vary, all studies
indicate that men are far more likely than women to abuse
alcohol. Conservative estimates suggest that men are twice
as likely to experience alcohol problem^,^.^' whereas other
authors cite a rate of 4 or 5 alcoholic men for each woman
who abuses a l ~ o h o l .Many
~ ~ - ~male
~ settings, from military
units to college fraternities, encourage men to abuse alcohol
as a common male rite of passage.- Other prevalence
data indicate that while only 1 in 50 women becomes alco-
holics, 1 in 10 men do.47Cirrhosis of the liver, a medical
condition highly associated with chronic alcohol abuse, is
twice as likely to take the lives of men.I4
Drug addiction, in the form of use of illicit drugs, is com-
monly viewed as one of the most pressing contemporary
social problems. There have been estimates that more than
6 million Americans are either selling or using drugs, and
289
BROOKS
that 1 in every 5 inner city babies is born addicted to
drugs.48Prevalence rates vary greatly according to specific
drug and sociocultural group, but one pattern is quite clear:
Like alcohol abuse, illicit drug addiction is largely a male
problem. “Although addiction does not discriminate against
women, it does seem to be a disease that is closely associ-
ated with men.” 49(PP332-342) According to Department of Jus-
tice figures, more than 85% of drug offenders are male.48
Although the etiology of substance abuse is a complicat-
ed matter that requires consideration of genetic as well as
environmental factors, there can be little doubt that the
social construction of masculinity plays a significant role.
Isenhartso has noted that men use alcohol to play out the
expectations of the male role and to deal with stresses of
perceived role failures. Lemle and Mishkinds’ have argued
that alcohol use has been considered symbolic of being
male and have noted that “Alcohol is the only drug which is
part of the male sex role, the only mood altering drug which
society promotes as manly” (p217).
Depression and Suicide
Although the idea that women express far greater inci-
dences of depressive conditions than men has long been
accepted, this view has recently become more clouded. Part
of the complication is recognition that men are four times
more likely to take their own lives.14This dramatic dispari-
ty has typically been attributed to the knowledge that men,
when contemplating suicide, tend to consider far more
lethal method^.'^ But the matter is now receiving additional
attention as many scholars in the field of men’s studies are
suggesting that the prevalence of male depression is far
greater than previously ~uspe c te d.’~~’~ Most of these
researchers suggest that male depression is generally sup-
pressed and manifested through more “acceptable” male
outlets, such as alcohol abuse and aggressive behavior.
Risk Taking, Abuse, and Neglect
of Personal Needs
There is no standard diagnostic category for risk taking
and neglecting one’s personal needs. Persons with certain
personality disorders may take more risks or make life
choices that are not in their long-term best interests. But this
behavior pattern is not generally recognized as a mental
health problem. Nevertheless, when one examines this pat-
tern closely, it is possible to see that it is so closely tied to
masculinity that it makes sense to consider the pattern in the
context of men’s mental health problems.
Research in gender studies has revealed that although
adolescent girls are likely to internalize distress and experi-
ence higher rates of depression, adolescent males external-
ize distress through a wide range of “acting out” behav-
i o r ~ . ~ In
’ , ~the
~ past few years, a wealth of data have
accumulated suggesting that males are risking their lives
and safety at alarming rates. The recent Department of
Health and Human Services “blueprint for healthcare initia-
t i v e ~ ”notes
’ ~ multiple areas of concern. For example, men
are twice as likely to be hospitalized for nonfatal head and
290
spinal cord injuries. They experience an eightfold greater
risk for firearm-related injuries and a sixfold greater risk for
firearm-related deaths. Men are twice as likely as women to
die from falls, and men, especially African American men,
are four times more likely that women to be homicide vic-
tims. Men are at a four times greater risk than women of
drowning deaths.
Angier,“I(P1)in a New York Times article titled “Why men
don’t last: Self-destruction as a way of life,” noted that
between 1977 and 1995, three and a half times more male
drivers than female drivers were involved in fatal car crash-
es. She also noted that men have an eightfold greater chance
of ending up in prison (once again, African American men
suffer disproportionately).
Boys are much more likely than girls to be thrown out of
school for a conduct or antisocial personality disorder, or to
drop out on their own surly initiative. Men gamble them-
selves into a devastating economic and emotional pit two to
three times more often than women ~ o . ~ ’ ( P ~ )
Courtenays7 recently documented a range of ways that
males do not take care of themselves and do not seek needed
help. Research consistently indicates that for most health
problems, men are less likely than women to perceive them-
selves as being at risk, even for risks that men are more like-
ly to experience.s8Psychosocial factors are particularly rele-
vant to address in working with men because a growing body
of research provides evidence that loyalty to traditional ideas
about masculinity is negatively associated with men’s health.
Traditional men have greater health risks than nontraditional
men do, and they not only engage in riskier behaviors, but
their diets are less healthy and they get less sleep.59
In his analysis of men’s problems with the healthcare sys-
tem, Courtenaym notes that men commonly miss opportu-
nities to get help and medical advice. He cites research indi-
cating that men represent 65% of those who have not visited
a physician in 2 to 5 years and 70% of those who have not
had such a visit in more than 5 years. Courtenay further
notes that even when men, regardless of income or ethnici-
ty, have serious health problems, they are significantly more
likely than women not to have had any recent physician
contacts. He points to research that indicates that men
receive significantly less physician time than women do in
their health visits and generally receive fewer services and
dispositions than women.
Fathering Problems
Emotionally uninvolved and physically absent fathers are
now seen as representative of another aspect of the dark side
of masculinity. Before industrialization, when work was
intertwined with family life, fathers interacted closely with
their children, training boys, and sometimes girls, in work
skills.61,62
Fathers were usually in charge of discipline and
of imparting religious and moral traditions. Since the late
19th century, by contrast, mothers have come to be regard-
ed as the primary parenting figure.
The transformation of parenthood into motherhood
occurred at the moment that industrialization separated the
JOURNAL OF AMERICAN COLLEGE HEALTH

location of paid work from the household. Thus, fathering, a
role for men within the family, became defined as something
that occurred outside the family. This limitation of fathering
to the provision of material resources has had dramatic neg-
ative consequences in terms of men’s relationships with their
children and has increasingly been recognized as a signifi-
cant impediment to men’s optimal mental health.
For poor, ethnic and other minority men, racial discrimi-
nation in the arena of paid work leads to high rates of unem-
ployment or underemployment. These men are therefore
unable to fulfill the traditional role of provider. For them,
the definition of fathering often does not extend beyond
procreation. Working and middle-class fathers who define
their fathering role in terms of providing financial security
to the family often become preoccupied with work. As a
consequence, these men often have little intimate contact
with their children.
One study reported that, on average, men living at home
spend 12 minutes a day with their children.63Gottfried and
Gottfried@ found that fathers spent, on average, 26 minutes
per day in direct interaction with children below the age of 6
years. As children got older, that time period decreased to 16
minutes per day. US data suggest that fathers tend to spend
more time with younger children and more time with sons.
Although the publicity given to minority fathers creates
an image of ethnic differences in fathering behavior,
research findings suggest that nonpayment of child support
by White, middle-class fathers parallels the lack of paternal
investment of poor, minority fathers. In 1985, although
nearly 90% of custodial mothers were awarded child sup-
port, only 54% received any money at all. The exception to
this trend is among fathers earning more than $50,000
annually. Among those fathers who excel at the provider
role, 90% do comply with child support orders.65
In the last 2 decades, new cultural expectations have cre-
ated the “modern father role” that includes caretaking and
nurturing, as well as providing resources. This new defini-
tion of fathering places far greater emphasis on how well a
man attends to the emotional needs of his children. Men’s
capacity for nurturing has been well d o ~ u m e n t e d . ~ ~ . ~ . ~ ~this trend may reflect more positive attitudes toward
Articles in the popular press suggest that a dramatic
change has occurred in fathering behavior. Supposedly, the
“new” father or the “nurturant” father has become the main-
stay of the nontraditional, or role-sharing family in Western,
industrialized countries. Unfortunately, the available data
suggest that the changes are not yet of dramatic proportions.
DeLarossa@ distinguished between the “culture” (changing
norms) and the “conduct” (what is actually done) of father-
hood, noting that the conduct has been far slower to change
than the culture.
Fathers are now routinely present during childbirth,
whereas they were excluded from the delivery room 30
years ago.69 This is not an insignificant change. Many
fathers report that the emotional bonding achieved in these
first hours with their infants substantially affects their self-
evaluations as fathers and as How much this sub-
jective experience has been translated into specific behav-
VOL 49, MAY 2001
MASCULINITY & MENTAL HEALTH
ioral changes after the mother returns from the hospital is
the subject of a great deal of scholarly debate.
Conclusions vary, depending on the research methods
used to collect the data. If a study relies on fathers’ self-
reports, their participation in childcare tends to be overstat-
ed. If mothers’ reports are used, role-sharing behavior is
only slightly overstated. If independent raters use observa-
tional data measures, the data suggest that the proportional
relation between the work done by mothers and fathers has
changed very little over the past 20 years.
Although fathers did more in the 1990s than they did in
the 1970s, mothers have also increased their workloads.
Thus, mothers generally do two thirds of the total amount of
housework and childcare, and fathers shoulder only one
third of the b ~ r d e n . ~ ~ . ~ ’
In summary, it can be said that the enormous shifts in
men’s fathering roles have provided many men with rich
opportunities for greater involvement with their children
and higher levels of personal gratification in the relational
world. Yet, these new opportunities are embedded in a cul-
ture whose dominant institutions place barriers in the way
of men who want to change. In addition, although men gen-
erally desire higher levels of participation with their chil-
dren, many feel emotionally unprepared in terms of basic
skills of nurturance and communication. Finally, even when
they make efforts to change, they are prone to insecurity
over their not being able to live up to the traditional roles of
breadwinner and protector.
Homelessness,Vagrancy, and Dropping Out
Not all men participate in the dominant cultural institu-
tions of work and family life. Those who remain outside
these social structures pose a challenge to mainstream cul-
ture. Many of these nonparticipants are dismissed as asocial
or antisocial, and their problems are relegated to the criminal
justice system. Recently, a somewhat more compassionate
tone seems to be entering the discussions of this issue. For
example, the term homeless has become more popular than
earlier pejorative terms such as bums or vagrants. Although
“dropout” men, it may only be a response to the recent
increase of women and children in the homeless population.
Marin74argued that sympathy for the homeless is gener-
ally reserved for the “innocent victims” - women and chil-
dren. For example, although men make up more than 70%
of the homeless populati~n,’~ The American P~ychologist’~
devoted several articles in a special issue to the special
problems of homeless women and children. By contrast, the
authors in that issue discussed none of the special problems
of homeless men. Perhaps this is a result of the long-stand-
ing tradition of viewing the unattached male as a romantic
figure-the “hobo” or the “dropout.” In addition, however,
this may be the result of a general lack of compassion for a
population of men who are poorly understood.
To date, the psychological community has not examined
how male socialization may contribute to the problem of
men’s social alienation and familial estrangement or aban-
29 1
donment. Clearly, alcohol plays a role because a large per-
centage of this population abuses alcohol. Mental illness, as
well, plays a significant role, especially in a culture that
provides minimal care for those who are chronically men-
tally ill. These formal mental illness issues are extremely
important, and all interventions must place great emphasis
on their remediation. At the same time, however, we would
do well to take a closer look at the masculinity aspect of this
problem-the way that male socialization contributes to
men’s likelihood of becoming homeless and unattached
from their families. We must consider men’s poor control of
violent impulses, emotional inexpressiveness, difficulties in
seeking help, and preoccupation with work rather than fam-
ily roles in devising broad models of corrective interven-
tion. For example, we must understand that in some cases a
man may be more likely to leave his family if he cannot ful-
fill the provider role and may be highly reluctant to reen-
gage with estranged family members if he is burdened with
extreme shame for his failures.
The Interactive Systems Model of Gender Role
Strain: A New Perspective on Men’s Mental Health
When we approach men’s mental health from an essen-
tialist perspective, we are more likely to view the dark side
of masculinity as an unfortunate, but relatively inevitable,
outcome of male heritage. However, when we approach the
matter from a social constructionist perspective, we are
more likely to offer ambitious programs to change our cul-
ture and enhance men’s psychological well-being. An illus-
tration of a social constructionist approach is that of the
“interactive systems model of gender role strain” proposed
by Brooks and Silverstein.” This model addresses cultural,
social, psychological, and political contexts and offers a
more sanguine view of change and a more diverse set of
possible interventions. According to its developers, the
interactive systems model
reflects a synthesis of several theoretical approaches: the
gender role strain paradigm; an ecological perspective on the
origins of gender roles; the Bowen family systems theory of
the impact of chronic anxiety on behavior; and the social
constructionist analysis of gender-linked power differentials
with patriarchal society.”(P3”’)
The interactive systems model is theoretically grounded
in the aforementioned gender role strain paradigm of Pleck.
It also draws from Bowen family systems theory77by adopt-
ing Bowen’s belief that anxiety results when persons “give
up self.” In this formulation, Brooks and Silverstein’I con-
sider men and women to have been resolutely socialized to
limit themselves to narrow and stereotyped roles, to view-
ing men as providers and protectors but not nurturers and
emotional communicators. This narrow socialization
requires that men and women deny aspects of self, a process
that generates overwhelming anxiety. The resultant anxiety
perpetuates rigid definitions of acceptable marital roles and
further alienation from one’s full human potential.
The interactive systems model enriches the psychological
perspectives of the gender role strain paradigm and the
292
Bowen theory by embracing the broader sociopolitical per-
spectives of feminism and the ecological perspective of
anthropologist David G i l m ~ r eFeminist
.~~ theory holds that
the behaviors of husbands and wives cannot be fully under-
stood without attention to the considerable power inequities
between marital partners. Miller79noted that membership in
a group holding power over others generates personality
characteristics that are associated with the use and abuse of
power. On the other hand, membership in a disempowered
group produces personality characteristics that reflect this
powerlessness and dependence upon the dominant group. In
this analysis, women, like members of other subordinate
groups, have needed to develop interpersonal empathy and
emotional sensitivity. Men, on the other hand, have been
free to develop entitlement and exercise their power.
The ecological insights of anthropologist David
G i l m ~ r add
e ~ ~further complexity to this analysis. Gilmore
studied a wide array of contemporary cultures and found
that most societies have a “manhood cult” that is based on
the ideas of competition, risk-taking, stoic emotional
reserve, and rejection of “feminine” aspects of self. But
Gilmore also found that a manhood cult was not present in
all societies. The degree to which a society adopts strict
ideas of manhood (and, by implication, of womanhood), is
closely related to two critical ecological variables: (a) the
availability of natural resources and (b) the degree of exter-
nal threat. Within the ecological context of plentiful
resources, relative ease in the production of food, and the
absence of external threat, role pressures are less intense.
Therefore, according to Gilmore’s research, rigid standards
of manhood are not inevitable, but they depend upon eco-
logical context.
In summary, the interactive systems model can be viewed
as an effort to examine men’s mental health through inte-
gration of several perspectives. First, it incorporates the
social constructionist idea that mental health problems are
an outgrowth of the gendered experiences of women and
men. Further, because it identifies the role of psychological,
cultural, and political variables, it offers much broader
potential for intervention and change.
Practical and Clinical Implications:
Enhancing Men’s Lives and Becoming Better
Counselors With Men
To this point, I have offered theoretical perspectives on
the ways that the dominant social constructions of mas-
culinity affect men’s mental health. Because it seems quite
reasonable to ask “So what?’ I will now focus more direct-
ly on practical implications of the findings I have discussed.
First, I present some general ideas about needed cultural
changes, then turn more specifically to general recommen-
dations for mental health clinicians.
Cultural Changes to Enhance Men’s Lives
The interactive systems model I have described is
immensely useful because it provides a critical new way to
understand men’s mental health. This model advances the
JOURNAL OF AMERICAN COLLEGE HEALTH

view that gender, because it is a product of culture, can, and
must, be altered to accommodate to changing times and sit-
uations. Although this may not always be a simple process,
it is possible with insight and dedication to a few practical
objectives.
Broadening Gender Socialization
The single most significant implication of the interactive
systems perspective is that women and men must be
allowed greater access to their full human potential. Rather
than being coerced to behave according to narrow ideas of
proper conduct, they should be encouraged to develop skills
that make them more adaptive to a changing culture. For
example, the male gender role must be redefined so that
men are not valued exclusively by their roles as protectors
and providers. Their abilities to function as caretakers and
nurturers must be given far greater emphasis. If men were
expected to nurture, then attachment, intimacy, and emo-
tional connection would become central in masculine as
well as feminine role socialization.
In a corollary fashion, women should be encouraged to
expand their capacity to function as providers, leaders. and
protectors. If cultural norms for women included the respon-
sibility for providing economic resources for themselves and
their families and for protecting themselves, little girls
would be encouraged to develop personality characteristics
that emphasize autonomy, achievement, and mastery.
New Family Roles
Cultural change in the definition of gender roles would
lead to a restructuring of family relationships and to new
ideas about how men and women might behave. A necessary
precondition for transforming gender roles would be chang-
ing the traditional sexual division of labor in family life. To
some extent, this process has begun in that the recent trend
of mothers’ working has forced greater movement toward
mutual commitment in providing and nurturing. With
greater acceptance of the ultimate need to share roles, par-
ents would not be so preoccupied with “toughening up” lit-
tle boys or “softening and sensitizing” little girls. Both men
and women would be socializing both boys and girls to
develop a wide range of personality characteristics related to
expanded, rather than restricted, gender possibilities.
Changes in the socialization process and in family rela-
tionships would markedly decrease gender role strain-the
psychological stress associated with strict conformation to
gender roles. Thus, the pressure to give up self would lessen
as a cultural context would be created without the need for
such radically different behaviors by women and men.
Based primarily on their idiosyncratic situation and person-
al taste, individuals of both sexes could choose from a wide
range of culturally sanctioned behaviors without fear of
recrimination. Without the psychological stress associated
with giving up self to conform to restrictive gender roles,
levels of chronic anxiety would be reduced. The need for
dysfunctional psychological defenses would be similarly
reduced.
VOL 49, MAY 2001
MASCULINITY 81MENTAL HEALTH
Reshaping Patriarchal Culture
Even though the rigid constraints of traditional gender
roles produce gender role strain, they cannot be changed
without attention to the political system of patriarchy. Over
the past 4 decades, feminists have raised consciousness
about cultural and political limitations placed upon women.
Of late, many men have recognized similar needs for
changes in their lives and have called for a “reconstruction
of ma~culinity.”~~ In large part, many women and men have
recognized how interconnected their causes are; they have
pushed for political changes that could enhance the mental
health of women and men.
Becoming Better Counselors for Men
Space permits only a brief overview of the many new
ideas that have recently appeared regarding new models of
counseling and counseling for men (see Brooks and Good,80
for a more thorough elaboration of some of the newer con-
ceptualizations). In the past few years, I have described a
gender-sensitive model of counseling with traditional
men.so-s7For convenience, I have used the acronym MAS-
TERY to represent the core components of the model.
Monitor Personal Reactions to Men
and Male Behavior Styles
Empathy, the capacity to understand the world from the
perspective of a client, has long been accepted as a critical
component of successful counseling and psychotherapy.
One of the most respected principles of counseling is that
clients are more likely to consider change when they feel
they are understood, appreciated, valued, or esteemed. In
the case of counseling with traditional men, this is especial-
ly true because of the many ways that these men make
themselves difficult to value or understand. As I have previ-
ously indicated, the dark side of masculinity includes a
wide range of negative behaviors that frequently appear in
populations of traditional men-violence, alcohol and drug
abuse, sexual excess, emotional flight or withdrawal, sex-
ism, and inadequate behavior as partners in a relationship.
Counselors working with the victims of men’s dark-side
behavior are quite likely to have strong negative reactions to
the perpetrators. This is fully understandable and, to the
extent that it alerts counselors to the need to protect vulner-
able parties, it is functional. However, in some extreme
cases of dark-side behavior, men are likely to evoke unnec-
essarily strong reactions to being labeled as wife-beaters,
winos, deadbeat dads, or male chauvinist pigs. At other
times, counselors must struggle to avoid generalizing their
negative reactions to some male perpetrators onto all men,
that is, to the entire male gender.
Already angry or defensive about entering the counseling
situation, many of these men can be expected to be quite
sensitive to counselor disapproval. If they sense it, they may
quickly exit. Some men may adopt a supplicant and self-
condemning stance, heaping blame and guilt upon them-
selves while idealizing loved ones that they have mistreat-
ed. Others may present to the clinician as overwhelmed,
293
BROOKS
confused, or emotionally anesthetized. Regardless of the
type of client presentation, the counselor faces a significant
challenge.
To establish therapeutic rapport, the counselor must find
a way to get behind aversive features of the male client’s
precounseling behavior and highlight the client’s more pos-
itive, or ennobling, characteristics. In brief, the capacity to
monitor personal reactivity and to value traditional men is
one of the core elements of treatment.
Assume That the Male Client Is Feeling Pain
When one reviews the newly emerging men’s studies lit-
erature, he or she finds that a critical realization emerges
about the lives of contemporary men: Although there are
many benefits of the traditional model of manhood, there
are also many penalties. This, of course, is the heart of the
gender role strain model described above. Although many
men are leading very fulfilling lives, most men suffer in
many areas. They are plagued with a degree of anxiety
about whether they are “man enough” (ie, do they measure
up to the next guy or to unrealistic public images of male
heroes?). Most men are susceptible to a range of health
problems that are related to the way they are taught to treat
their bodies. Many men will die prematurely. Many men
have satisfying sex lives, but many others will be dissatis-
fied with the quantity or quality of their sexual activity or
the physical appearance of their partners. Finally, many will
feel emotionally isolated and will yearn for closer connec-
tions with others.
See the Male Client’s Problems
in Gender Context
Culturally sensitive counseling adjusts its diagnostic for-
mulations and intervention style to the dominant value sys-
tem of clients. When it comes to counseling for traditional
men, it follows that “masculinity” should come under the
microscope. Solomons4 proposed that most men benefit
from “gender role psychotherapy” in which gender role
issues are explicitly agreed upon as a major focus of thera-
py. Many others have argued for “gender sensitive” or “gen-
der-aware” therapies, that is, those that make gender an
integral aspect of counseling/therapy and view client prob-
lems within their social c o n t e ~ t . ~ ~ - ~ ~
At heart, these context-aware therapies urge men to see
themselves in social context; that is, as products of, and
sometimes victims of, their upbringing in a “gendered” cul-
ture. This challenge to men’s usual attribution system usu-
ally provides immense subjective relief. Men often benefit
when they see their failures as less personal and more as the
product of a severe and unforgiving socialization process.
When they recognize that they have suffered because they
have been loyalists to an anachronistic masculine code, they
cannot help experiencing a dramatic decrease in excessive
self-blame. This process not only provides substantial com-
fort for many anguished men, but also may generate enough
energy for them to begin the corollary investigation of how
socialization pressures have limited women.
294
Transmit Empathy and Understanding
If hidden emotional pain is the shameful secret of tradi-
tional men, then it is especially critical that counselors
establish a therapeutic connection by recognizing and vali-
dating their male client’s psychic pain. When not translating
their vulnerable emotions into rage, men typically experi-
ence any psychic pain as humiliating weakness. Psychic
pain can be so terrifying that men will go to great lengths to
hide from it. Rage and frustration, because they are “manly”
emotions, are the primary affective states men allow them-
selves. McLeans7 stated that
the process of turning boys into men has, historically, been
one of systematic abuse, both physical and emotional,
designed to teach boys not to show most emotions, except in
certain ritually prescribed situations, and if possible, not to
feel them (p21).
For growth to occur, men’s pain cannot remain hidden or
misunderstood. For that pain to come into the open, an envi-
ronment of empathy and acceptance must be established.
Before significant therapeutic change can take place, coun-
selors must understand the dimensions of men’s psychic pain
and they must convince men that it is safe to encounter it.
Often, this cannot take place unless a man realizes that he is
not alone, that other men also hide similar emotional burdens.
As a result, counseling must be conducted in a fashion that
maximizes the possibility of men’s becoming more self-dis-
closing. In my experience, this is most likely to occur in the
relative safety of a men’s group, although it can certainly
occur with a skillful counselor in other counseling formats.
I have previously noted that men’s groups help men reveal
their pain because “participative self-disclosure” allows
them to feel a sense of “universality” with other men.s2-s3
Many times I have heard a troubled man say, “These men
can understand me because they have been there, they have
walked in my shoes.” This process is also helpful because it
frequently instills hope in a troubled man. Group members
can bear witness and offer testimony about the benefits of
counseling and the potential for therapeutic growth.
Even when groups are not feasible, this critical step of
“transmitting compassion and understanding” can be
accomplished. A counselor who has worked extensively
with men can reach a troubled man by describing his or her
past encounters with men in similar straits. A male coun-
selor can, to some extent, describe his own struggles and
fears. A female counselor can describe her experiences with
important men in her life and demonstrate her empathic
connection with these struggles.
Empower Men to Change
As I noted earlier, men are likely to experience consider-
able subjective relief and gain substantial self-respect as
they recognize the universality of these struggles among
men, that is, “I am not alone in this.” They may realize ten-
sion reduction through their cathartic expression of intense
negative feelings. But, although these accomplishments are
quite important, they are not sufficient. This is the point at
which my approach to men differs markedly from that of
certain others. Let me elaborate.
JOURNAL OF AMERICAN COLLEGE HEALTH

From Robert Bly’s Iron John88and John Gray’s Men are
from Mars, Women are from VenusE9to the controversial work
of sociobiologists and evolutionary psychologists, many
authors have recently called for greater understanding of
men’s behavior and more acceptance of male modes of being.
Their works are helpful, yet they are highly disappointing,
even counterproductive, when they espouse essentialist
philosophies and call for nothing more than improved under-
standing of men’s behavior. It is my fervent belief that coun-
selors cannot settle for mere understanding of men. We must
also have complete commitment to helping men change.
The subjective relief our male clients experience is a crit-
ical first step, but counseling cannot stop there. Men must
be challenged to initiate a major re-evaluation of their gen-
der role values and assumptions in an effort to bring them-
selves into greater harmony with a changing world.
Respect Resistance and Yield Some Control
to the Larger System
Many metaphors from which to choose are available-
“Rome was not built in a day,” “The longest journey begins
with the first step,” “You can only eat an elephant one bite
at a time.” I believe that the first counseling contact,
whether in a men’s group or in gender-sensitive individual
counseling, is only one step in the therapy journey of tradi-
tional men. As a systems therapist, I believe that families
and larger social systems are “rule-governed.” Therefore,
any attempt to change the beliefs, attitudes, and behaviors
of one person will be met with a “change-back” reaction,
homeostatic pressures to return to more customary patterns.
Therefore, I commonly envision the initial contacts as a
critical step that prepares the way for more systemic change
in the form of eventual family counseling and, for some,
men’s movement activism. Men are shaped by their families
and by the larger culture. At the same time, they themselves
contribute to creating that culture. Change needs to occur at
both the individual and the societal level.
Despite my belief in the ultimate convergence of coun-
seling and social action, I recognize that many men will
take only small steps. All traditional men will not take on
the larger project of reforming the culture. Most will
approach counseling in a tentative and cautious fashion. If
they feel understood and the overall experience is positive,
they will return. For this reason, I consider it essential that
counselors develop a high degree of respect for men’s reluc-
tance to embrace change and a high level of patience with
their ambivalence.
Conclusion
Gender studies provides a new and vital perspective to
the student of men’s mental health. Rigid gender socializa-
tion into narrow roles is not in the best interests of individ-
uals or of enhancing their emotional well-being. To function
successfully in a complex and changing culture, women and
men must have full access to the widest range of social,
emotional, and psychological skills. Counselors and psy-
chotherapists can play a pivotal role in furthering this mis-
VOL 49, MAY 2001
MASCULINITY & MENTAL HEALTH
sion because gender sensitive interventions may offer men
critical insights into their emotional distress and fresh
incentives to initiate needed change.
AUTHOR’S NOTE
Over the past 2 decades, men’s studies research has begun to
uncover variations among men and “masculinity” that depend on
race, ethnicity, social class, sexual orientation, and other charac-
teristics. In some ways, it would be more appropriate to speak of
masculinities. However, once this problem has been identified,
there is value in speaking of masculinity as a relatively unitary
construct. First, this practice recognizes that despite the occasion-
al variations, there is considerable overlap in all masculinity ide-
ologies. Second, most men expect to conform to a dominant
‘‘hegemonic”gO masculinity and consider themselves inadequate or
unworthy when they fail to meet that standard. For a review of
masculinity ideologies, one might consult Thompson and Pleck.y’
For further information, please address correspondence to Gary
R. Brooks, PhD, 902 South 31st Street, Temple, TX (e-mail:
Gary-Brooks@Baylor.edu).
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