Defense Mechanisms

Men's mental health is a focus area for improving population health worldwide. Traditional masculine norms among men have been reported to make them more susceptible to mental health issues. This study aims to review existing literature on how traditional masculinity norms influence men's willingness to seek mental health support. This review followed stages of systematic review. The review search was initiated in February 2024. The search process was conducted on electronic databases such as PubMed, PsycINFO, Science Direct, and Google Scholar to identify relevant studies published in English between 2000 and 2024. The search terms included "traditional masculinity norms," "men's mental health," "help-seeking behavior," and "barriers to mental health care." Studies were selected based on their relevance to the topic. The inclusion criteria were studies focusing on adult men and examining the relationship between traditional masculinity norms and mental health help-seeking behaviors. Exclusion criteria included studies focusing on children, adolescents, or women and nonempirical articles. Data extraction covered study details, design, population characteristics, and key findings. This study included 47 relevant studies. Two key themes emerged, namely: masculinity and mental health (impact on mental health); and barriers to seeking help. Traditional masculinity norms significantly deter men from seeking mental health support, highlighting the need for culturally sensitive interventions that address these barriers.

BackgroundPrevious studies have found that Asians and men are more susceptible to the stigma and stereotypes associated with mental illness. This social perception makes it difficult for Korean men to seek professional psychological help even when they desperately need it. The primary objectives of this study were to investigate barriers to mental health help-seeking among Korean men and to identify the role of sociocultural factors.MethodsA total of 341 Korean men aged 19 to 59 years participated in an online survey, which included questionnaires on loss of face, self-stigma of seeking help, attitudes toward seeking professional psychological help, and conformity to masculine norms. Structural Equation Modeling was used to explore the relationships among these variables.ResultsThe results revealed that loss of face indirectly affected attitudes toward seeking professional psychological help (ATSPPH) through its mediating effect on self-stigma. Loss of face did not directly influence ATSPPH. Furthermore, conformity to masculine norms negatively affected ATSPPH, and self-stigma mediated this relationship.ConclusionThese findings highlight the importance of understanding the influence of sociocultural factors in encouraging Korean men to seek help. The ultimate goal is to foster a social environment that encourages open discussion about mental illness, masculinity, and Asian values.

When used as variables in biomedical research, sex and gender can be difficult to operationalize and measure. Questions have arisen about whether either category is stable or causally meaningful in a research context. Here, we discuss some of the limitations of using both or even one of these categories in correlational or experimental work. We argue that attempting to draw a distinction between sex and gender can reignite the nature/nurture debate, inadvertently bringing outdated metaphors and assumptions about innateness and causation into our research. Many researchers, including ourselves, have described sex and gender as separate collections of causal factors (which we describe as a "bucket" metaphor) or as entangled (a "knot" metaphor). Because they regard sex and gender as conceptually separable and internally consistent, such metaphors have limited value for understanding the drivers of diversity in our data. Rather than continuing to reify sex and gender as distinct buckets or threads of explanatory variables, we call for deconstruction of these categories by focusing instead on clearly operationalized, instantiating variables that researchers can manipulate or measure. Our proposed approach differs from recent, similar calls in that we are not suggesting the exclusion of a sex/gender category from statistical models; instead, we recommend keeping it-not as a representation of biological reality, but as a tool used under a careful set of assumptions. We provide example datasets to illustrate how a sex/gender category can, when thoughtfully operationalized, be used to improve statistical rigor and inferential precision. In addition, we advocate for attention to variation within sex/gender, which is more informative in investigations of mechanism than comparing means across sex/gender categories.

BackgroundGender-diverse individuals are at elevated risk for disordered eating, shaped by body dissatisfaction, gender dysphoria, and minority stress. The roles of gender identity and expression, however, remain underexplored in clinical samples. This study examined how self-perceived masculinity, femininity, and gender variance relate to eating behaviours in gender-diverse adults seeking gender-affirming care.MethodsEighty-four adults assigned female (n = 50) or male (n = 34) at birth were recruited from a regional gender incongruence clinic. Participants self-identified as male (n = 44), female (n = 30), or non-binary (n = 10); 36 were receiving gender-affirming hormone therapy (GAHT). They completed the Three-Factor Eating Questionnaire (TFEQ) and the Gender Variance Scale (GVS), assessing masculinity, femininity, and deviation from cisnormative expectations. Regression models tested associations between gender traits and eating behaviours.ResultsMasculinity was positively associated with cognitive restraint, while femininity correlated with emotional and uncontrolled eating. Gender variance was not significantly related to TFEQ; however, exploratory analyses suggested a modest quadratic trend with dysregulated eating. Eating behaviours did not differ by GAHT status.ConclusionsGender expression, more than gender variance, appears to influence eating behaviours in gender-diverse individuals. Clinicians should consider how masculinity- and femininity-linked eating patterns shape assessment and intervention.