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Why Gender Matters

By Comments off By the Numbers: Why Gender Matters

Following is the first in a series of forthcoming blogs that address the impact of gender on behavioral health care.

The very first question posed to an expectant mother is usually, “A boy or a girl?” An avalanche of assumptions begins to develop based on the answer to this question. The process of gender socialization literally begins in utero as parents and other family members begin to plot out the life of the baby.

If it’s a boy the room will be blue; there will be stuffed lions, toy soldiers, and building blocks. No trace of frilly pink pillows, butterfly mobiles, or rainbow unicorns. When he’s born he will be held and comforted less than a female infant. As a toddler he will be rewarded for displays of strength and coordination; he will be encouraged to be adventurous and take risks.

He will also experience a gradual but inexorable constriction in the range of emotions and behaviors he is allowed to display.

Gender roles in society

We are taught what it means to be a boy or a man, a girl or a woman. And we learn from our parents, siblings, other relatives and family friends, teachers, and coaches.

We also learn from various media – the books we read, the TV shows and movies we watch, the music we listen to. These messages about masculinity and femininity may vary somewhat based on geography, culture, or socio-economic class. They also evolve over time.

However, there tend to be some universal “rules” that shape the way most of us understand what it means to be a man or a woman. Even children who are exposed to countervailing messages within their families are subject to the pressures of the mass culture.

We adopt these rules because it is critical that we gain approval from our family and acceptance from our peers. Eventually the rules become an integral part of who we are and how we interact with the world.

Society’s expectations of males

Let’s think for a moment about the rules that most men have learned to follow:

  • Don’t acknowledge or express emotions—except anger.
  • Don’t acknowledge physical, emotional or spiritual pain.
  • Don’t ask for help.
  • Be strong.
  • Be a provider and protector.
  • Don’t be vulnerable.
  • Be logical and practical.
  • Have lots of sexual experiences (with women), but don’t invest too much in relationships.

The overarching message is: “Don’t be weak!”

Now imagine that a man who has been living by these rules for decades decides to initiate therapy or treatment. In most settings he is immediately confronted with the expectation that he begins to practice a new set of behaviors. We could call these the principles of recovery:

    • Allow yourself to be vulnerable.
    • Share your deepest feelings.
    • Recognize that you need the support of others.
    • Be compassionate and empathetic.
    • Let go of the need to be in control.
    • Success and happiness are the product of investing in relationships.
    • The overarching message is: “You need to admit that you are weak!”

All too often, men are unwilling to step outside of the rules and shed the skin that has been keeping them safe. Treatment and therapy are the antithesis of what a “real man” does when he’s having trouble. Far too many therapists interpret such reluctance as a lack of serious motivation. If this dynamic is not effectively addressed, therapy is less likely to be successful.

Helping men recover

In talking with men, I found that the tension between the rules of being a man and the principles of recovery opens up rich areas of insight and connection. Three insights bear mentioning:

  1. Revealing a social context for many problematic and self-defeating behaviors serves to diminish feelings of alienation and shame for men.
  2. Patience is necessary. We can’t expect a man to immediately abandon everything that has kept him safe. In fact, he may at first feel threatened by the experience of treatment or therapy to the extent that he holds on even more tenaciously to his notions of masculinity.
  3. Therapists must be aware of what we bring to the table with respect to our own beliefs about masculinity.

This blog has focused on how gender messages affect the men that come into our systems of care. Next time we will explore women’s services. Smile! Spring is almost here.

Interested in a gender-focused approach to recovery? We can help. Email us at or schedule a consultation today.