“Boys Don’t Cry”: How Toxic Masculinity Affects the Ways Males

Communicate About Their Depression

Brian Fredrickson, Chandler Jensen, Hannah Oh, Emma Thurman

Communications, Utah Valley University

COMM 3020: Communication Research Methods

Dr. Jessica Pauly

April 20, 2022

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Introduction
Toxic masculinity has been a hot topic in our modern society for the past decade, and it

remains a highly controversial subject. While the term itself has a range of meanings dependent

on the user, Cambridge Dictionary and this paper define toxic masculinity as “ideas about the

way that men should behave that are seen as harmful (Cambridge, n.d.).”

Much of the conversation around toxic masculinity has been focused on its effects on

women. It is true that women suffer from toxic masculinity behaviors, such as a societal

tendency to excuse aggressive behaviors in men as normal or the “locker room talk” that

encourages derogatory speech about women. Entire books can and have been written about the

negative influences of toxic masculinity on the lives of women, and the topic remains

inexhaustible.

Yet, toxic masculinity is not just bad for women; it is just as harmful for men. From a

young age, men are trained to be manly and shun any feminine behaviors. This conditioning is

not performed exclusively by other men. One of our researchers recalled an impactful event

when he was a young teenager. While trying to express his feelings, he was shut down, not by

other boys or men, but by girls his age. The girls expressed that our researcher should man up,

implying that emotional expression was inappropriate in a boy. This reflects the societal

normalization of toxic masculinity: even those whom we most expect to be the victims are often

the perpetuators of it. Men are more likely to be rejected when they express feelings of

depression, especially by women (Guerrero & Anderson, 1998). Our researcher went on to

describe how difficult it was for him to talk about his feelings after that because he felt like it

was somehow wrong to communicate about those things.

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Common phrases that we often hear when men express vulnerabilities include: “boys

don’t cry”; “don’t be a sissy”; “man up” or “be a man”; or “toughen up”. When boys or men

show aggression, which is in line with perceived masculinity, we are more likely to hear

something along the lines of, “Boys will be boys!”, encouraging boys to continue engaging in

those negative behaviors.

Our team of researchers was interested in finding pattern in the ways toxic masculinity

affects how men communicate about their depression and, further, how we can change those

patterns to encourage men to communicate about and seek help for their depression.

In this paper, we will first explore the current literature surrounding the relationships

between toxic masculinity, depression, and communication, after which we will identify our

research questions. Then, we will describe our research methods, including our sampling,

processes, and analysis.

Literature Review
Most of the literature regarding the effects of toxic masculinity on men is found in

psychology journals. While there were some communications studies that give a peripheral view

on the matter, very little direct research directly pertaining to the research question was found in

communications journals. Psychological research, as shown in this review, does support

expectations that men are less likely to communicate about or seek help for their depression

symptoms and that toxic masculinity culture is a factor. It is noteworthy that much of the

literature regards mental health in general and is not specific to depression.

Effects of Toxic Masculinity on Males

Studies show that toxic masculinity has negative effects on males. A meta-analysis of

numerous studies on masculine norms and mental-health related outcomes also found that
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conformity to masculine norms was strongly associated with negative mental health (Wong, et.

al, 2017).

There is merit to the argument that toxic masculinity benefits men in some ways, but that

benefit is only in proportion to how well they perform in masculine roles. In an analysis of the

Netflix series Stranger Things, Driscoll and Grealy (2021) came to the conclusion, “that boys in

general benefit from their relation to male privilege, but…the benefits of patriarchy are returned

unevenly to boys precisely to the degree that their performances and practices conform to and

perpetuate traditional gender hierarchies.”

Depression vs Suicide Statistics

The CDC characterizes depression as, “the presence of feelings of sadness, emptiness, or

irritability, accompanied by bodily and cognitive changes lasting at least 2 weeks that

significantly affect the individual’s capacity to function” (Villarroel & Terlizzi, 2020). In 2019,

the Centers for Disease Control and Prevention (CDC) reported that 18.5% of adults reported

symptoms of depression (Villarroel & Terlizzi, 2020). The COVID-19 pandemic has

dramatically increased those rates, with approximately 42% of American adults reporting

symptoms of depression between August 2020 and January 2021 (Dunleavy, 2021).

Interestingly, the CDC’s 2019 report also stated that women were more likely than men to have

symptoms of depression (Villarroel & Terlizzi, 2020). However, these reports only reflect the

amount of people who reported having depression. The numbers may suffer from both

respondent and nonresponse biases. People who feel that it is embarrassing or shameful to have

depression or to communicate about it are more likely to lie about their symptoms (respondent

bias) or refuse to respond all together (nonresponse bias).

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In fact, if suicide rates correlate positively with depression, there is evidence to suggest

that men may struggle more strongly with depression than women. As shown in Table 1, the

National Institute of Mental Health (NIMH) reported that in 2019 in the United States, men’s

suicide rates were significantly higher than women’s in every age category (National Institute of

Mental Health, n.d).

TABLE 1

(National Institute of Mental Health, n.d)

The juxtaposition of the CDC’s report on depression (Villarroel & Terlizzi, 2020) and the

NIMH’s report on suicide rates (National Institute of Mental Health, n.d) suggests that women

are more likely to report their symptoms of depression, and it challenges the claim that women

are more likely to have depressive symptoms.

Why Do Men Fail to Seek Help?

In a Swiss study on men and help-seeking, as cited by Howes (2017), the researchers

ended their research with a very blunt conclusion: “Women seek help—men die (p. 2).” The

following research contributes toward finding out why men are so resistant to seeking help.
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A study by Kesler, Brown, and Broman (1981) found no consistent sex differences in

recognizing when a given problem required psychological help; yet they also found that women

are as high as 82% more likely to report having psychological problems compared to men. This

begs the question of why men who can perceive the need for psychological help still will not

seek it.

Dr. Jim O’Neil (2016), a leading authority on the effects of toxic masculinity on males,

posits that one of the primary reasons for refusing or avoiding psychological help is because of

socialized gender roles. He has done an extensive study on what he calls Gender Roll Conflict

(GRC). Gender roll conflict is “a psychological state in which socialized gender roles have

negative consequences on the person or others (Hornigold, 2007).” GRC levels can be tested

using the GRCS-I test, where higher GRC levels indicate higher levels of gender role conflict

and fear of femininity (O’Neil, 2007). O’Neil’s research shows a strong negative correlation

between a high GRC and willingness to seek psychological help (O’Neil, 2016). Cole and

Ingram (2020) explain that men with higher GRC are less likely to disclose personal information

and emotions than those with a lower GRC. They argue that a man’s decision to seek help or not

varies depending on how strongly they endorse male norms that discourage or are otherwise

incongruent with help-seeking (Cole & Ingram, 2020). Some of these male norms include self-

reliance, toughness, and emotional restriction (Cole & Ingram). In short, they must control any

appearance of femininity (Iwamoto, Brady, Kaya, & Park, 2018).

Sadly, GRC also has a strong positive correlation with depression (O’Neil, 2007). This

presents a nasty Catch-22, in which the same factors that cause depression in men also prevent

them from seeking treatment for it.

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A qualitative study by Chuick, et al. (2009) on Caucasian men aged 18-75 who had been

diagnosed with depression found that societal messaging played a part in every single

participant’s choice to conceal symptoms from others. The study found a general belief within

the group of participants that depression is not socially acceptable within men and that seeking

help for depression implied weakness. There does seem to be one exception to this rule: when

there is “a clear external circumstance that led to the depression” (Cole & Ingram), such as a

family death, it is considered acceptable for a man to seek professional help (Cole & Ingram).

There may also be hesitation to seek help based on the societal belief that mental illness

prevents competitive success. Lavelle’s study on Kevin Love, a basketball player in the NBA

who disclosed his struggles with anxiety in 2018, showed that, while the media and general

public expressed admiration for Love for being outspoken about his mental illness, he faced

multiple inquiries about retirement, with people expressing that maybe the competitive world

was too stressful (Lavelle, 2021). The study also showed that players are more likely to stay

silent in order to remain competitive in the NBA drafts. Lavelle (2021) says that when

comparing players with equal ability, mental illness is a liability.

It is important to note that these studies can only gather data from men who have

obtained help, either by choice or by requirement, and so these studies do not necessarily reflect

the thoughts of men who have not obtained help for their depression.

When, How, and Why Do Men Talk About Depression?

Identifying when, how, and why men do finally communicate about their depression is

critical in finding how to encourage more men to do so.

A study using data collected from several large epidemiological surveys showed that

white people in general are more likely to enter psychotherapy once the initial mental health
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appointment was set (Vessy & Howard, 1993). While this is encouraging, the person must first

be willing to make the appointment and must also be willing to communicate openly in the

appointment. It may also be noted that this is a pre-Internet and texting era study, and so the

results may be different now. A study with newer technology (including an easier appointment

setting and cancelling system) may be required to legitimize this claim.

A study by Berger, et al., (2013) identified situations in which men were more likely to

seek or accept psychological help. First, participants tended to prefer talk-therapy, as opposed to

other forms of psychotherapy treatments. Second, men, especially those who meet masculine

norms, are more likely to be opposed to taking medication for mental health. Third, men are

more likely to accept advice about seeking help when the advice-giver is a psychotherapist than

when the advice-giver is a significant other or a medical doctor. (Berger, et al., 2013).

Media has also been identified as a possible influence in helping men make the decision

to seek help. Another study on NBA player Kevin Love, conducted by Parrot, et al. (2021),

found that media stories were overall positive in their depictions of Love and his transparency.

They emphasized the overall idea that mental illness is common and that those who struggle with

it are not alone.

Diane Francis conducted two studies regarding hip hop artist Kid Cudi’s disclosure about

his own depression. One study on Twitter conversations between black men suggests that Twitter

can act as a form of therapy, where black men are more likely discuss their own experiences. The

use of a hashtag (#YouGoodMan) helped the conversation to gain traction while the original

subject, Cudi, served as a celebrity role model (Francis, 2019). Francis also found that young

black men were more likely to seek information after Cudi’s disclosure and found a positive

relation between celebrity health disclosures and proactive health behaviors among young black
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men (Francis, 2018). These were limited to the black community, so it is not generalizable to

other populations, but more research on similar situations may help us identify how celebrity

transparency can be used to help more groups of men.

In another study on difficulties families faced in talking with U.S. Military Service

members about seeking help for mental health, families identified four strategies: 1) Time: Being

mindful of the timeliness of the discussion; 2) Speech: Using a relational tone and style of talk,

while emphasizing unconditional caring and commitment to the service member, remaining

polite and respectful, and acknowledging the service members autonomy; and listening

nonjudgmentally when the service member talks; 3) Framing: Emphasize positive rather than

negative meanings, including framing the act of seeking help as a means of becoming healthy,

happy, and productive, rather than as a means of fixing them; and 4) Utilizing a social network to

discuss the matter with the service member, rather than using direct conversation, such as others

that have experienced miliary deployment (Wilson, et. al, 2014). This study was specific to

miliary family and service members and is not generalizable to all men, but these strategies may

be studied further as a means of encouraging men to seek help for mental health.

Gaps in the Literature

Research has primarily been conducted on men who have already been diagnosed with

depression, and so it largely excludes those who choose not to seek help and successfully mask

their depression.

There is also a gap in the literature from a communication perspective. While psychology

journals have provided a significant amount of research on the matter and have addressed

communication as an issue, they have not defined specific solutions on how to get individual

men to talk about their depression. In the grand scheme of things, it is important to identify toxic
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masculinity norms that society as a whole can irradicate to encourage more open discussion on

mental health. However, in the present time, it is also important to identify ways to help those

males that have already been affected by those norms and who need encouragement to seek help.

More research from a communication perspective on how toxic masculinity affects how men

communicate about depression or other mental illness may help the psychology world discover

the best ways to encourage men to communicate about their depression.

These gaps lead to the questions at the heart of this study. First, how does toxic

masculinity affect the ways that males communicate about their depression? Second, how can we

encourage men who live with depression to communicate about and seek help for their

depression?

Methodology
Data collection for our research project took place using focus groups. Focus groups are

facilitator led conversations (Keyton, 2019, p. 292). These encounters were guided to get insights

from the various participants related to our research topic. With focus groups we were able to not

only study the spoken words but also examine the nonverbal cues from our participants. Our

focus groups were recorded both audio and video and then later transcribed. We read and reread

each transcript and compiled the data to determine our findings.

Participants

Our sample consisted of 45 American-born, biological males. Biological males are more

likely to have been conditioned from a young age to follow masculine norms than transgender

men. We chose to focus on American-born men as toxic masculinity varies culturally and

geographically. We decided to include males from different cultural backgrounds because they

can still be affected by American masculine norms from a young age.

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Our population was recruited from Utah county in Utah, USA. To recruit participants for

our focus groups we used a two-step process. First, we used a Qualtrics survey to recruit and

screen our first participants, sort them into groups, and collect demographic data. The link to the

survey was posted on the Utah Valley University research opportunities boards with both a link

and a QR code and was also listed on the Brigham Young University research opportunity

database. We chose to use both schools in order to widen our demographic pool. After our first

participants were selected, we used a snowball sampling method (Keyton, 2019, p. 107), where

we asked them for referrals for others that may benefit from the study. We did this so that we

would be able to a wider variety of men in the geographic area, rather than having it largely

constrained to student participants. After contacting those referrals and screening them with the

Qualtrics survey, we selected our participants based on primary criteria (biological, American-

born males) and then based on variation needs.

We used maximum variation sampling to seek out a holistic understanding of toxic

masculinity and its effect on men whose lifestyles are different from one another. By seeking out

this maximum variation in our sampling, we could analyze both large and small differences

between age groups, socioeconomic status, marital status, and many other factors. Because we

used an iterative approach, maximum variation sampling allowed us access to a larger

understanding of how toxic masculinity affects men and their communication with others.

We successfully achieved the criteria of a maximum variation sample through the use of

the demographic questions on the Qualtrics questionnaire. Our sample included men from a

variety of employment backgrounds, age groups, socioeconomic status, experiences with mental

health, and ethnicities. Given the propensity for snowball sampling to result in participants who

are similar, extra attention was given to the formation of focus groups to ensure that participants
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were grouped together with a diverse group of individuals, so that the discussions in the focus

group would highlight these differences between individual participants. This allowed us to

maintain reliability and validity with our participants and in the study overall. We knew we

achieved maximum variation sampling as respondent’s answers began to match previously

gathered data and were not providing new concepts or answers to our research question.

We briefed each participant on the purpose of the study. We chose not to use the word

“toxic masculinity” to avoid language bias, as the term is polarizing. Instead, we used the phrase

“expectations of masculinity”. Once participants agreed to participate, they were assigned to one

of 9 focus groups, with five participants in each group.

Process

The focus groups were held at Utah Valley University in a conference room in the

Browning building. We selected this environment because it is a quiet space with few

distractions. The room was set with six chairs in a circle, which included the five participants and

the moderator. Each focus group discussion met on average for 60-minutes. Focus groups were

conducted over three months in Spring 2022. The lead author served as focus group moderator.

A trained undergraduate assistant was present at all focus groups to welcome participants, collect

consent forms, and take notes inconspicuously during the discussion. Focus groups and

interviews were audio recorded for later transcription and coding.

The group moderator asked each focus group the same set of nondirective open-ended

questions in an effort to elicit detailed participant responses. The questions were carefully

worded for neutrality and to avoid any language bias. First, the moderator asked an ice breaker

question to create an environment of comfort and trust. The question was, “What was the coolest

thing you did this year?” After a brief discussion on that question, the moderator proceeded with
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our research-related questions. Questions used in the focus groups included: (1) If you have ever

felt depressed, did you tell anyone about it, and who did you tell? (2) Do you feel that it is

acceptable for you as a man to express feelings of depression and in what ways is it acceptable?

(3) How have you been treated when you have expressed your emotions? (4) Do you think it is

easier for a man or a woman to admit they are feeling depressed, and why do you think that? (5)

In your own words, describe what it means to be masculine. For example, what traits should a

masculine person have? (6) How have societal rules or expectations for you as a man impacted

how you talk about depression? (7) What expectations of being a man have impacted you most?

The moderator also asked follow-up questions as warranted. At the end of each session, the lead

author offered all participants an opportunity to ask questions before ending the session.

Analysis

Our analysis was a multi-step process based on grounded theory, wherein units of data

are constantly compared with each other and where themes, codes, and categories change and

evolve with the addition of new data until the data is exhausted (Keyton, 2019, p. 312). This was

an iterative process, requiring us to go over the data several times until we concluded that every

possible category and relationship within the data was identified.

After each focus group session concluded, the researchers would individually read over

the transcripts of the meeting. Then, they would repeat their reading while coding the data. This

involved marking data that was considered relevant to our research questions. We did this

through simple open coding, meaning that we were not looking for specific categories or types of

information (Keton, 2019, p. 313). We would then read through a third time to identify

categories. Finally, we would use axial coding to connect the relationships between categories
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(Keton, 2019, p. 313). This individual analysis allowed us to read and interpret the data

independently of any influence from other researchers, reducing groupthink bias.

After our independent reading, we would discuss our observations as a group, comparing

categories. This group analysis allowed new categories to emerge as new information and

interpretations were introduced through our discussions.

After our last focus group and our initial analyses were concluded, we compared our

findings from the various focus groups. We identified patterns in the categories and threw out

categories that no longer fit the data. This process of constant-comparative analysis allowed the

data to direct the categories, allowing for a more dynamic analysis. We met multiple times as a

group to discuss the data until we felt that all relevant categories had been identified.

Finally, our analysis was divided into themes, categories, and subcategories. The themes

we focused on were Expectations of Masculinity; Expressing Emotions; and Experiences with

Depression. Some of the categories within those themes included: how the participants were

affected by expectations of masculinity; participants’ relationship with their own masculine

identity; how participants felt about the state of living with depression; how participants felt

about communicating about the emotions; how participants have communicated about their

emotions and depression; who participants communicate to about their emotions and depression;

and participants’ methods of dealing with depression.

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Appendix
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Qualtrix Survey

https://uvu.qualtrics.com/jfe/form/SV_4IQPgX88gIVLmWG
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Survey Instrument

Hello everyone and thank you for participating in this focus group today. My name is ______.
(Everyone in research team introduces themselves).
I have a question before we get started: What is the coolest thing you did this year?
(Allow a 3-5 minute discussion)
Each of you here has completed a pre-screening survey which indicated that you have dealt with
depression. Each of our questions today will be aimed at answering our question. Our research
team is interested in finding out how expectations of masculinity have affected the ways men
communicate about depression. We will be asking several open-ended questions and you will
have the opportunity to discuss. This is a closed environment. While we do plan on using your
answers for our research, your names and identifiable information will not be released, so we ask
you to be open and honest in your discussion.
Do you have any questions before we get started?
Let’s get started.

1. How do you define depression?

2. Have you ever told anyone about your feelings of depression?

• Who did you tell and why did you choose to tell that person or those persons?

3. In what ways do you think it is acceptable for a man to express feelings of depression?

4. How have you been treated when you have expressed your emotions?

5. Do you think it is easier for a man or a woman to admit they are feeling depressed and

why do you think that is?

6. In your own words, describe what it means to be masculine. For example, what traits

should a masculine person have?

7. How have societal rules or expectations for you as a man impacted how you talk about

depression?

• What expectations of being a man have impacted you most?

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That concludes our questions for you. Is there anything else that anyone would like to share?

Thank you all for being so honest and open with us today. We will be using your answers to
further research on toxic masculinity and its effects on men’s communication about depression.
Our hope is that this research will help us to identify ways to help men to be more open to
seeking help for their depression, as well as other mental health needs.

As a thank you for your time, you will each be receiving a $75 digital Visa gift card, which will
be delivered to the e-mail we have on file within 5 business days.

Does anybody have any questions?

If that is all for today, you are free to exit. If you think of any other questions or concerns, you
may e-mail sdjkfsalkjf@uvu.edu, and we will be happy to discuss it with you. Again, thank you
for participating today.
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(Supplemental)