Relationship between Conformity to Masculine Role Norms and Depression
among Vietnamese Male Students in College
T.Q.Nga

Abstract---College-bound males may experience considerable
maladjustment during the crucial developmental time between high
school and college. By participating in stereotypically male actions,
men may feel under pressure to "prove" their masculinity, which may
be harmful to their general well-being. Although adherence to
multidimensional male standards has been linked to worse mental
health, no research has considered the impact of these norms on
college men's potential depressive symptoms. A viable theoretical
framework to explain within-group variation in depression
symptomatology can be provided by longitudinally examining
college men's adherence to multidimensional masculine standards.
An overview of recent studies on the connection between masculine
norms and depression among Vietnamese men in college is given in
this article. 208 males from different Hanoi colleges were included in
the study. Male norms were evaluated at the start of their first
semester. Six months following the initial round of data collection,
depressive symptomatology was evaluated. Men who approved the
male norms of Self-Reliance, Playboy, and Power Over Women
showed a positive relationship between masculine norms and
depression scores. The impact of multidimensional masculine norms
on college men's depressive symptomatology was first examined in
this study. The findings imply that professionals who interact with
males should think about determining whether their clients conform
to particular masculine standards and investigating how these could
be affecting their present mental health.
Keywords---depression, masculinity, conformity to masculinity,
mental heath, college
Researchers have been working for decades to better
understand the complicated interplay between gender norms
and mental health (Read & Gorman, 2011). Traditional gender
norms have an influence on aid seeking, psychological
transformation processes, and health risk behaviours,
particularly in males (Brooks, 2010a; Brown, 1986;
Courtenay, 2009; Levant & Richmond, 2007). (Levant,
Wimer, & Williams, 2011). Health researchers have studied
the relationship between health outcomes and masculine and
feminine features (e.g., Bem, 1974; Spence, Helmreich, &
Stapp, 1975), gender role conflict (e.g., O'Neil, Helms, Gable,
David, & Wrightsman, 1986), and, most recently, compliance
to role norms (Mahalik et al., 2003). Volumes of research
articles and academic studies on these themes and their
contributions to mental health have been produced (e.g.,
Brooks, 2010a; O'Neil, 2008). Be that as it may, the genesis of
sexual orientation parts remains a matter which has been being
debated (Webster & Rashotte, 2009). In each age bunch, men
are at more noteworthy chance of genuine incessant infection
and death compared to ladies (Courtenay, 2003). Key
characteristics such as socioeconomic level, ethnicity, and
access to health care are insufficient to explain such gender
inequalities (Courtenay, 2009). The setting of manliness, in
 securing his children's education, job, and marriage; and look
any case, gives a uncovering focal point through which men’s
wellbeing issues regularly happen (Brooks, 2010a). In spite of
the fact that speculations of manliness are differing (Levant &
Richmond, 2007), common subjects develop within the
writing. Guys are mingled in ways that fortify standards of
stoicism, freedom, immunity, evasion of shows of negative
influence, and the concealment of enthusiastic torment
(Garfield, Isacco, & Rogers, 2008). Whereas such qualities
can incite social and financial benefits to men, this social
development of manliness too has negative results (Brooks,
2010b) and is related with a extend of interpersonal problems
(O’Neil, 2010) and psychopathology (Addis, Mansfield, &
Syzdek, 2010).
It was discovered that the majority of the published articles
were conducted in European or American nations. Even when
it is stated, gender equality research studies on Asian nations
only briefly touch upon this subject. As a result, it is crucial
and imperative that toxic masculinity studies be conducted in
Vietnam or other Asian nations, where patriarchal cultures are
prevalent. In order to gain a more elaborate understanding of
toxic masculinity among Vietnamese undergraduate students
and its relationship to participants' mental health, as well as to
be able to offer some recommendations based on our findings,
the author of this writing decided to conduct this research
topic.
Conformity to the Concept of Masculinity in Vietnam
Scholars investigated cultural narratives of manhood and how
concepts of Vietnamese masculinity have been affected by the
impact of Confucianism, the Âm - Dương ideology, and the
patrilineal ancestor worship tradition in the first body of study.
Early study in the 2000s concentrated on cultural concepts of
male and female bodies, masculinity and femininity, and how
these notions influenced men's and women's behavior in rural
Vietnam (Rydström, 2001, 2002, 2003, 2004, 2006). Local
inhabitants in rural places, according to Rydström, felt that
male corpses were connected with the powers of Dương. Men
have "hot" blood under the influence of the Duong energy in
their bodies, allowing them to have physical strength and "hot"
character, which correlates to being "naughty," "mischievous,"
"active," aggressive, difficult to "control," and violent
(Rydström, 2003, 2004). Rydström further claimed that "in
both biological and socio-symbolic dimensions, a male body
was built as superior to a female body" (Rydström, 2002).
Men maintained a more prominent role in a family, as "trụ cột
gia đình" (the family pillar) and as the primary decision-maker
in a home, responsible for training young male members of his
clan. As the pillar of the house, a man should have a stable job
to secure economic status; be an alcoholic who can manage
his alcohol consumption; be a good-mannered representative
of his family; have a large social network; be capable of
after his siblings and male friends (An et al., 2012; Horton &
Rydström, 2011; Le, 2012; Lê et al., 2012; Vũ, 2008). Le
(2012) suggested that being the family's backbone was not a
function that men could take for granted. Rather, it was
symbolic wealth that men had to labor hard to acquire, lest
their wife take over the position (Le, 2012; Martin, 2013).
Such men would be viewed as failures if this occurred.
Traditional gender standards in Vietnam are linked in family
discourses and gender interactions (Rydström, 2010). Within
family systems, males and boys are regarded to have more
status and more privilege than women (Rydström, 2001, 2002,
2010). Men are supposed to be the leader of the household, the
primary decision-maker, the giver of material and moral care
to his family, a role model for his children, and a responsible
alcoholic (An et al., 2012; Phan, 2008; Rydström, 2003; Vu,
2015). Men are required to conduct "major" labor and have a
paid position as the breadwinner of the family, such as a
construction worker, teacher, or government officer, among
other vocations (Bergstedt, 2016). Meanwhile, women are
assumed to be subordinate to their husband as the primary
caregiver and reproducer of the family, performing "small"
tasks such as housework, childbearing, caring for other family
members, maintaining family harmony, and, for rural women,
the majority of farming work (Bergstedt, 2016; Khuat et al.,
2009; Knodel et al., 2005; Luong, 1989; Rydström, 2010).
Scholars such as Hoang and Yeoh (2011), Vu (2015), and
Horat (2017) have noted that, despite tremendous changes in
gendered relationships, both husbands and wives have
maintained conventional masculinity and gender norms rather
than addressing them. Breadwinner-wives have acted as a
subservient wife in public to safeguard their husband's
masculinity as the patriarchal hierarchy role model for their
children and to create an image of a happy, conventional
household (Vu, 2015). The research also identifies many
techniques for guys to protect their feeling of masculinity. To
maintain their well-respected status within the community,
some have built their image as a responsible kinship member
and a good father (Hoang & Yeoh, 2011; Horat, 2017), while
one study reported how some men affirm their decision-maker
role in the family by purchasing expensive goods despite
objections from their wife.
According to qualitative research, Vietnamese males are
innately aggressive and violent, which justifies harsh physical
treatment of female partners (Jame-Hawkins et al., 2016;
Phan, 2008; Rydström, 2003). Krause et al. (2016) discovered
that younger men with fewer social and economic resources
are more likely to affirm their masculinity by hitting their wife
than well-respected and wealthy older men, highlighting a link
between economic resources and engagement in maltreatment
of women (Krause et al., 2016). According to research
undertaken in rural Vietnam, violence aimed against children
is also widely tolerated, with physical punishment being used
to discipline young males (Rydström, 2006). Men's drinking
behaviors, particularly family violence and men's bonding
rituals, have also been studied. The ability to consume
significant amounts of alcohol is commonly viewed as a sign
of masculinity, possibly best stated by the widespread
Vietnamese attitude, "a man without alcohol is like a flag
without wind" [Nam vô tửu như kỳ vô phong] (Lincoln, 2016;
Vu, 2008). Men drink alcohol not just to establish their
manliness, but also to broaden and reinforce male connections
(Nguyen et al., 2019; Vu, 2008). Drinking alcohol may be
viewed as a way to strengthen social networks, which can be a
successful technique for men from rural regions who lack
economic resources but can still preserve their status as
leaders of their households by other evident kinds of male
conduct (An et al., 2012).
Additionally, men's sexuality is viewed as a "natural basic
desire" among Vietnamese people (Horton & Rydström, 2011,
p. 543). According to Horton and Rydström (2011), men with
"hot" blood and temperaments require women with "cool"
blood and temperaments to balance male quintessence via sex.
If a man's sexual urge goes unsatisfied, heat builds up in his
body, creating the possibility of "explosion" (Horton &
Rydström, 2011). Not only is it often assumed that males are
unable to control their sex desire (Paula-Frances, 2003), but
being sexually active is regarded as vital for men in order to
maintain balance and health (Khuat et al., 2009). As a result, if
a man participates in extramarital sex, his wife, rather than
himself, will be blamed for failing to fulfill her sexual
obligations. The male is said to be obliged to locate another
woman in order to release the "heat" and prevent the chance of
an explosion (Horton & Rydström, 2011; Khuat et al., 2009;
Nguyen & Harris, 2009).
Masculine Norms Conformity
It may be seen in the context of masculinity because males
frequently demonstrate their conformance to masculine
standards by suppressing their genuine feelings and proving
their manhood in order to prevent perceived weakness and the
impression of being "feminine" (Rice et al., 2013). While
gender norm conformance theory offers additional clarity
regarding the extent to which adherence to dominant
masculine norms might subsequently damage mental health
outcomes, dysfunction strain helps explain the psychological
strain caused by upholding masculine standards (Mahalik et
al., 2003). Because these avoidant coping mechanisms may be
in accordance with how men who uphold masculine ideals,
such as self-reliance and managing emotions, conceptualize
what it is to be a man, they may utilize them to regulate their
negative affect.
According to the gender role strain model (Pleck, 1981, 1995),
men who uphold such masculine ideals are socialized to strive
for unrealistic and occasionally harmful cultural norms. The
subjective effects of a guy's self-concept and male role
standards differing, according to theory, depending on whether
or not he endorses masculine norms (Pleck, Sonenstein, & Ku,
1993). The proportion of men who violate (i.e., fail to conform
to) masculine norms is high due to the unachievable and
precarious nature of conformity to masculine norms
(Vandello, Bosson, Cohen, Burnaford, & Weaver, 2008). This
leads to social condemnation (Courtenay, 2003) and negative
psychological consequences, including reductions in self-
esteem, wellbeing, and internalized negative self-judgements
(Pleck, 1995). This internal and perceived (or actual) external University of Education, Foreign Trade University, VNU
unfavorable appraisal, also known as discrepancy strain, is University of Science... The first wave of data was collected
likely to have a detrimental effect on men's mental health during the beginning of the participants’ Freshman year, and
through a variety of risk factors, such as problems coping, the Wave 2, 6-month follow-up was collected in the second
hindered assistance seeking, or externalizing behaviors. semester of their Freshman year. Data was collected by
sending Google forms. 
In addition, internalized guilt and other maladaptive self-
conscious emotions may be sparked by men's apparent Categories Frequency Percent
inability to meet internalized normative masculine ideals
(Axelrod, 2001; Springer & Mouzon, 2011). Shame is a Age 18 201 96.6
feeling of inadequacy and helplessness that develops when
one perceives they have unfavorable characteristics 19 5 2.4
(Tangney, Miller, Flicker, & Barlow, 1996). Clinical
research and theory have linked men's experiences of shame 20 2 1.0
to depressive and suicidal symptoms, interpersonal issues,
anger and aggression, substance abuse, and difficulty Total 208 100
engaging in psychotherapy (Dearing & Tangney, 2011;
Wexler, 2013). Adaptive aid seeking for depression is Relationship In a 61 29.3
known to be hampered by interpersonal avoidance and status relationship
disconnectedness, which are behavioral indicators of shame
Not in a 147 70.7
(Dorahy, 2010). Adhering to masculine ideals may be a way
relationship
for men to escape the humiliation that comes with being
seen as a weak man (Kimmel, 1994; Reigeluth & Addis,
Total 208 100
2016). But in terms of epidemiology and help-seeking,
shame is still a subject that hasn't received much attention in
Sexual Heterosexual 200 96.2
relation to the mental health of males (Kim, Thibodeau, &
orientation
Jorgensen, 2011). According to the theory of discrepancy Homosexual 5 2.4
strain, males who follow traditional male standards will face
psychological stress, which will show up as feelings of Bisexual 2 1.0
failure and diminished wellbeing. Studies have shown that
compliance to male standards and depression are positively Not specified 1 0.5
correlated (Rice, Fallon, & Bambling, 2011; Rice, Fallon,
Aucote, & Möller-Leimkühler, 2013). However, men's Total 208 100
awareness of a discrepancy between an idealized self—
seeking high conformity—and an actual self—unable to Area Urban 136 65.4
achieve conformity—would likely result in a perceived
failure to enact normative ideals, which may trigger Rural 72 34.6
experiences of shame and subsequent depression (Bryant &
Garnham, 2015). Total 208 100

Method
Participants and Procedure
Method Participants and Procedure Survey data were obtained
from a larger data set, which aimed to longitudinally
investigate health outcomes and behaviors among incoming
college freshmen between the age of 18 and 20. Participants
were recruited by emailing a random sample of freshmen
through universities in Hanoi and through recruitment fliers.
In order to participate in the study, participants had to be
freshmen between the age of 18 and 20. Before participating
in the study, participants had to click a checkbox indicating
that they read and agreed to the conditions in the informed
consent form. The survey was divided into 2 waves: Wave 1
was to investigate the conformity to masculine norms in first-
year men, and Wave 2 aimed at studying the level of
depression among those research projects. Participants were
included if they completed both Wave 1 and Wave 2, which
resulted in a sample size of 208 adult freshman men from
universities in Hanoi: Trade Union University, Hanoi National
Table 1.1. Demographic statistics of the sample (N=208)
Conformity to Masculine Norms Inventory (CMNI-22)
The Conformity to Masculine Norms Inventory (CMNI-22;
Owen, J. (2011)) was used to assess support for
multidimensional male norms. This measure, which was
examined during Wave 1 (first semester of freshman year),
assesses the extent to which an individual embraces particular
subcategories of masculinity as they correspond to Vietnamese
male role norms. The CMNI-22 is a condensed version of the
CMNI-46 (Parent & Moradi, 2009), which is a more
condensed version of Mahalik and colleagues' (2003) original
94-item CMNI. The CMNI-22 assesses adherence to male
standards using a continuous variable, with higher scores
indicating greater conformance. It assesses 11 distinct Components Conformity to masculine norms
dimensions: (1) Winning, (2) Emotional control, (3) Risk- levels
taking, (4) Pursuit of Status, (5) Primacy of Work, (6)
Low Moderate High
Violence, (7) Power over women, (8) Dominance, (9)
Playboy, (10) Self-reliance, and (11) Homophobia. Each
1. Primacy of Frequency 25 148 35
question is assessed on a Likert scale, with responses ranging work
from 0 to 3 (strongly disagree). The CMNI-22 has been
employed as a continuous variable in several research, with Percentages 12.0 71.2 16.8
low scores suggesting non-compliance and higher scores
indicating increasing conformance. Frequency 44 136 28
2. Dominance
Beck Depression Inventory II (BDI-II)
One of the most well-liked and often used tools for assessing Percentages 21.2 65.4 13.4
depression is the Beck Depression Inventory-II (BDI-II; Beck,
Steer, & Brown, 1996) (Whisman & Richardson, 2015). In 3. Risk - taking Frequency 34 144 30
addition to having strong internal consistency estimates
Percentages 16.3 69.2 14.4
(internal consistency estimates over.90; Dozois, Dobson, &
Ahnberg, 1998) and being well-validated with college 4. Homophobia Frequency 20 121 67
students, the BDI-II is a highly effective tool for screening for
severe depressive disorders (Arnau, Meagher, Norris, & Percentages 9.6 58.2 32.2
Bramson, 2001). The BDI-II is a 21-item self-report
questionnaire that assesses how severe depression has been in 5. Power over Frequency 79 117 12
the preceding two weeks. An estimated total depression women
severity score is calculated by adding together all of the
categories. Scores range from 0 to 69, with 0–13 suggesting Percentages 38.0 56.3 5.8
minor depression, 14–19 indicating mild depression, 20–28
indicating moderate depression, and 29 and above indicating 6. Emotional Frequency 24 148 36
control
severe depression. The BDI-II was assessed during Wave 2 of
the study (6 months after Wave 1 data were collected in the Percentages 11.5 71.2 17.3
second semester of Freshman year).
7. Pursuit of Frequency 13 156 39
Data Analysis status
Data was gathered with Google Form and transferred to IBM
SPSS 22.0 software. Some of the tests used during the process Percentages 6.2 75.0 18.8
of data analysis were: descriptive statistics (Frequency, M,...)
and inferential statistics. Using M points from each component 8. Self-reliance Frequency 37 141 30
and SD points of each subscale of CMNI-22 items version, the
range for each level: Low, Moderate, High of the conformity Percentages 17.8 67.8 14.4
to masculine norms have been measured. Whereby, if the level
9. Winning Frequency 25 153 30
reaches High, it means that the person has toxic masculinity.
Pearson's correlation test was used to figure out the correlation Percentages 12.0 73.6 14.4
among the components of CMNI-22 items version and BDI-II.
For errors in the investigation process, measures to limit errors 10. Playboy Frequency 68 119 21
were applied: consult experts, and standardize the
questionnaire through the trial survey. With errors in the data Percentages 32.7 57.2 10.1
entry process, the dataset re-entered 10% of the votes to check
the information entered and minimize errors in the most 11. Violence Frequency 36 145 27
thorough way.
Percentages 17.3 69.7 13.0
Findings conformity to masculine norms is “Homophobia”, with 32.2%
Level of masculine norms conformity among freshmen in of total participants expressing toxic masculinity. It can be
college inferred that approximately in every 3 male undergraduate
The Table 2 beside provides an intimate glimpse of the level students, there is 1 student who has a strong belief in binary
of toxic masculinity expression in first-year students. genders theory in which gender only consists of men and
Generally, every determinant in CMNI - 31 items version has women and negative opinions about homosexuality, non-
about 10% - 32% of participants that are at a high level of binary gender. “Pursuit of status” also has high proportions of
conformity to masculine norms. This means that more than participants that are at a high level of conformity to masculine
30% of freshmen in college always express toxic masculinity. norms. 18.8% of participants are in the pursuit of being
The component that has the highest percentage of high level of prominent and recognized in the community. Other
noteworthy components are “Emotional Control” and 8. -.0 -.0 -.0 .1 -. .1 .0 -
“Primacy of Work” with respectively 17.3% and 16.8% of Pursu 41 95 80 4 1 70 7
participants that are at a high level of conformity to masculine it of 3 7 6
norms. These participants that are in the 17.3% proportion status 1
have a powerful urge to prove their manliness by controlling
the sentimental emotions and repressing them into the 9. .3 .2 .2 .2 .3 .2 .2 -.3 -
unconscious mind. With the data we received, it can be noted Self- 33 39 69 4 3 98 4 54
that 16.8% of participants have a strong desire to prioritize relian * 9 6 * 4 **
work over the other things. The component “Power Over ce *
Women” can be referred as the component that have the
10. .1 .4 .3 .3 -. .1 .1 .1 .3 -
lowest percentage of high level of conformity to masculine Winn 42 24 98 0 0 37 0 62 70
norms (5.8%). 3 components “Winning”, “Self-reliance”, ing ** ** 0 7 4 **
“Risk-taking” are at the same level: 14.4%. The other 3 * 6
remaining components – “Dominance”, “Playboy” and
“Violence” - are the components that have the lowest 11. .4 -.2 .2 .0 .0 .2 .0 -.0 .1 -. -
percentage of high level of conformity to masculine norms, Playb 04 30 33 2 3 86 9 75 70 0
respectively 13.4%, 10.1%, and 13.0%. oy ** 2 1 * 0 3
8

Varia 1 2 3 4 5 6 7 8 9 1 11 1 12. .0 -.2 .3 .0 -. .3 .0 -.0 -.0 .0 .3 -

ble 0 2 Viole 67 60 18 6 0 57 2 45 71 3 71
nce * 2 3 ** 9 6 **
1. - 9
Depr
essio
n
(Wav
e 2)

2. -.0 -
Prim 70
acy
of
work

3. .0 -.1 -
Domi 93 58
nanc
e

4. .1 -.0 .0 -
Risk 13 14 97
-
takin
g

5. .0 .1 .1 -. -
Hom 36 47 06 0
opho 0
bia 7

6. .2 -.0 .2 .2 -. -
Powe 97 76 84 0 0
r * * 0 1
over 7
wom
en

7. .1 .0 -.0 .2 .1 .1 -
Emot 04 67 56 3 8 62
ional 0 7
contr
ol