In January of this year, the American Psychological Association (APA) released a set of guidelines for the treatment of boys and men. In doing so, the organization appeared to offer a timely, direct response to the #MeToo movement and our culture’s recent examination of “toxic masculinity.” But even when putting #Metoo aside, the creation of standards and ethical boundaries around clinical men’s work was and is in fact much-needed. You see, for years now we’ve had such guidelines for clinical work with women, girls, as well as varied members of ethnic, sexual, and linguistic minorities, but not one for just plain men. And why not you may ask. Well, big surprise, apparently men have been somewhat inexplicably regarded, prior to now, as representing the psychological norm, with everyone else being the exception to this male-dominated view of normalcy.
The APA’s ten guidelines (shown below) suggest that boys and men are socialized, even before they are born, to a ‘traditional’ vision of masculinity, and their physical, emotional, and mental health is jeopardized as a result. The report also makes it clear that traditional concepts of masculinity vary across cultures, age groups, and ethnicities, though there are common negative themes like anti-femininity, violence, sexist thinking and behavior, along with the desire to avoid appearing weak/vulnerable.
Fredric Rabinowitz, a lead author of the guidelines, is quoted in the NY Times as saying, “Psychologists are encouraged to see men as being impacted by culture, by race, and by relationships, rather than just assuming that there is one sort of standardized set of behaviors. We want people to be aware that men are complex beings.”
The stated goal of the APA’s guidelines was to support psychotherapists helping men and boys to lead happy, healthy lives, a long overdue and seemingly admirable goal. However, the language used in the execution of this task leaves this therapist, one who has spent nearly three decades working with problematic masculine sexuality (and aggression), noting that the APA content feels much more tied to a political and nearly universal negative view of men. I couldn’t help but note when reading it that this culturally focused document lacks any basic awareness of the pure biology of masculinity (even simple references to how testosterone affects behavior/mood/desire), while at the same time missing the opportunity to demonstrate how typically masculine traits of, say, aggression or competitiveness can be seen as positive if channeled in a useful direction, rather than being seen as requiring elimination. Overall, it seems the APA has overshot its intended mark.
Here are the guidelines for the ethical clinical treatment of boys and men, per the APA:
- Psychologists strive to recognize that masculinities are constructed based on social, cultural, and contextual norms.
- Psychologists strive to recognize that boys and men integrate multiple aspects to their social identities across the lifespan.
- Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.
- Psychologists strive to develop a comprehensive understanding of the factors that influence the interpersonal relationships of boys and men.
- Psychologists strive to encourage positive father involvement and healthy family relationships.
- Psychologists strive to support educational efforts that are responsive to the needs of boys and men.
- Psychologists strive to reduce the high rates of problems boys and men face and act out in their lives such as aggression, violence, substance abuse, and suicide.
- Psychologists strive to help boys and men engage in health-related behaviors.
- Psychologists strive to build and promote gender-sensitive psychological services.
- Psychologists understand and strive to change institutional, cultural, and systemic problems that affect boys and men through advocacy, prevention, and education.
On first glance, most of this sounds relatively on-target. Certainly we need to understand that a societal version of men as rugged, entirely self-sufficient, and dominant in all aspects of life is undoubtedly harmful to men who do not inherently fit this supposed ideal (perhaps even more so to those who do). We also need to understand there are multiple dimensions to male identity, including age, ethnicity, gender, race, sexual orientation, etc., with each factor contributing to the male’s basic sense of self. But when we dig deeper into the rationale and application of the guidelines, we start to see an attack on human masculinity rather than an attempt to help men overcome any inner-conflict that prevents them from being their truest, healthiest, and happiest selves.
As a whole, the guidelines suggest that the social expectation and training of males to live out the elements of how our culture views masculinity, including “emotional stoicism, homophobia, not showing vulnerability, self-reliance, and competitiveness” leads men toward acts of aggression and violence, substance abuse, sexist behaviors, incarceration, psychological disorders, suicidality, and numerous other unpleasant outcomes. Sadly, it gives much less credence to the clear biological differences that evolve into the way men may think, act, and feel. And biology matters.
After reading the APA guidelines, it almost feels as if the organization thinks that masculinity, in and of itself, is inherently bad – automatically harmful to boys, men, and the people around them. But is that really the case? Are their not plenty of traditionally rugged, self-sufficient, square-jawed men who are never violent, not addicted, not sexist, not criminals, not psychologically disordered, not suicidal, and are just good people? You bet there are.
And guess what, there is nothing inherently wrong with traditional masculinity. Period. Now it’s not for everyone, sure. Some men have an overly feminine gender expression. So be it. Some men are more openly vulnerable than others. Good for them. Some men are willing to show their emotions. That’s great. Some men are openly affectionate with their wives and children, including their sons, while others are more reserved but no less loving. Both approaches are perfectly fine. Our job as therapists is not to necessarily challenge any person’s version of ‘being male,’ whether they’re gay, a shrinking violet, a wallflower, or a heterosexual lumberjack who eats nails for breakfast.
Our job is to help men be comfortable with who they are and to grow into the best possible version of themselves. In a New York Times opinion piece, columnist Thomas B. Edsall writes, “One could argue that what today’s men need is more encouragement to enhance one side of the masculine virtues – the dignity, responsibility, self-control, and self-reliance – while inhibiting others, such as machismo, violence, and the drive for dominance.” (Emphasis added.) To me, that kind of balanced, intuitive language gives most of us a lot more to work with than simply stating what is wrong with men in our culture today. And this kind of nuance is exactly what’s missing from the APA’s new guidelines, rendering them nearly unusable to the average clinician.
As currently written, the APA guidelines are filled with overkill and over-reach. As my friend and colleague Dan Griffin, an expert in masculinity, toxic masculinity, and the psychotherapeutic treatment of men, says, “The guidelines are an attack on traditional masculinity rather than its most harmful and disconnecting aspects.” He further states, “The challenge is what is always is – black and white all or nothing thinking rather than an ability to appreciate the nuances, the greys of being a man.” Adding fuel to my ire (along with others who generally view men in a more balanced manner), the APA report lacks any recognition that even those men who seem to act in very unhealthy and harmful ways are still people – deserving of our love, our compassion, and our acceptance.
To be fair, there is a lot of good in the APA guidelines. A lot. But there is also far too much in the report that is just plain judgmental and rigid, and as an expert on male biology and sexuality, it is very clear to me that the report is also blatantly underinformed. As psychotherapists, we need to understand and accept that every man is different, and some men do naturally and comfortably fall within the bounds of ‘traditional’ masculine thinking and behavior – without ever creating problems of aggression or misogyny for themselves or others. When working with such men, our job is not to judge or change them (and this is where the APA guidelines clearly miss the mark). And where many if not most men fall outside those bounds, it is not our job is not to judge or change them either. Our job is to listen to the person in situation. Our job is to engage with empathy and compassion (not pre-judgment) while observing closely in order to help any and all become comfortable with their own unique version of ‘being a man,’ all the while encouraging the client to gain empathy, compassion, and connection to himself and those close to him.