Men's Mental Health Matters

To say that men and women are different is to state the obvious. It may even provoke a chuckle. But there is also a very serious aspect to gender differences for people living with a mental illness or a mental health problem.



It is time to re-emphasize gender differences when the evidence supports doing so because there are benefits to be gained.

Western culture has been heavily influenced during the past fifty years by the feminist movement which sought to minimize gender differences in an effort to achieve greater equality for women. The objective was correct, but there have been unintended consequences. It has not been politically correct to emphasize gender differences and the potential of a gender specific understanding of mental illness and mental health has not been realized.

Soon after conception, males and females embark on different developmental paths. There are significant hormonal differences with male development influenced by testosterone and female development influenced by estrogen-type hormones. But the chemical differences go further and include some which are more closely linked to mental health. Males and females have different levels of serotonin, dopamine and oxytocin. These physical differences drive behavioral differences which play out in every aspect of life.

Researchers are continuing to discover identifiable differences in male and female brain structure. Specific areas of the brain linked to how information is processed differ by gender. Males and females even differ in how they use their brains (no jokes please). Right-hemisphere preference is more common in males and left-hemisphere preference is more common in females.

The nature-nurture debate is also relevant, of course. Boys and girls are raised differently, but probably much less so than fifty years ago. The feminist movement emphasized nurture as it wisely sought to expand opportunities for women. But the direction of scientific research today appears to be shifting the focus to nature.

Yes, but…

There is immense overlap between the genders. Of course the individual is more important than the gender. But this does not mean that gender is not significant. All differences between men and women should be viewed in the same way as obvious physical differences. Some women are taller than some men. But on average, men are taller than women. Gender is significant.

Yet it was in this century that speaking about gender differences landed Larry Summers in deep trouble while still President of Harvard University. He dared to link lower rates of female enrollment in sciences and engineering to gender. One woman was so offended that she walked out of the conference at which he was speaking. But he did not say that women were not capable of becoming very good engineers. Hopefully no one will be offended by those advocating for a gender specific approach to mental health and mental illness in areas where this approach is useful.

So far this is merely pre-amble before stating that almost four times as many men as women die from suicide. Yet women are more often diagnosed with depression. Why? We must find the reasons for these strikingly different outcomes. And we must understand what role gender plays.

Do men suffer less from depression or are men simply more reluctant to admit it? Does depression manifest differently in men, perhaps as mis-diagnosed physical symptoms? Do the causes of stress in the workplace differ for men and women and, if so, what gender specific coping mechanisms are most helpful?

Being a male can be bad for your health. Men have higher rates of heart disease and cancer. In fact, men lead women in all of the top ten causes of death. The life expectancy of men is significantly less than women and along the way men live sicker. This is less surprising when seen in light of women visiting doctors almost twice as often as men. Behavior is strongly linked to health outcomes. When it comes to health, both physical and mental, men behave badly. Gender ranks high as a determinant of health.

My Masculinity

About fifteen years ago I bought my first purse. The traditional male wallet no longer met my needs, being too small to hold all the items I wanted to carry and too uncomfortable in a back pocket. I have no need to refer to my purse as a “man bag”.

I have long realized that I do not fit the profile of a typical man. Of course, that very concept is highly problematic. Fortunately for me the society I live in has made significant progress in understanding the complexity of true masculinity. So have I.

The Bem Sex-Role Inventory was developed by Sandra Bem in 1974 and was the first test designed to objectively assess an individual’s masculinity and femininity. The BSRI has been both widely used and widely criticized for decades. Gradually society is moving away from stereotyping but there is still considerable room for more progress.

On the BSRI I score 60 out of 100 masculine points and 55 out of 100 feminine points. I wonder how many men would be uncomfortable with such scores? Why can’t all of us, both men and women, be completely comfortable with the way we are? That is not as easy as it sounds because understanding the self takes much effort, much struggle. The family and societal expectations we internalize are major barriers, insurmountable for some.

I would describe myself as often being moody, loyal, sensitive to others’ needs, tactful and gentle. I am not often competitive, assertive or ambitious. And I like who I am.

More than once in my career I have received feedback during a workplace performance appraisal that I am not tough enough as a manager. In my experience, managerial toughness is overrated and too often used as justification for unnecessary insensitivity to employees, particularly those at lower levels in organizations. Also, not enough credit is given to the tender for the ability of the head to rule the heart. A tender individual can make tough decisions and I have made my fair share during my career.

Compared to many men, I am quite emotional. While on far too many days I battle to keep my emotions under control, I find my emotional reactions very helpful and usually vindicated by subsequent events. Often when something doesn’t feel right, as time passes specific reasons emerge that confirm my original gut reaction. This can be a powerful advantage for a manager and I sometimes marvel at how slow executives can be to see the “obvious”. Perhaps I have a healthy amount of what gets mislabeled as women’s intuition!

Gender also plays out in significant ways in mental health and mental illness and that will be the topic of my next post.