Twelve Scholars Respond to the APA’s Guidance for Treating Men and Boys

Twelve Scholars Respond to the APA’s Guidance for Treating Men and Boys

18 min read

Introduction — John P. Wright, Ph.D.

John Paul Wright is a professor of criminal justice at the University of Cincinnati. He has published widely on the causes and correlates of human violence. His current work examines how ideology affects scholarship. Follow him on Twitter @cjprofman.

Thirteen years in the making, the American Psychological Association (APA) released the newly drafted “Guidelines for Psychological Practice for Boys and Men.” Backed by 40 years of science, the APA claims, the guidelines boldly pronounce that “traditional masculinity” is the cause and consequence of men’s mental health concerns. Masculine stoicism, the APA tells us, prevents men from seeking treatment when in need, while beliefs rooted in “masculine ideology” perpetuate men’s worst behaviors—including sexual harassment and rape. Masculine ideology, itself a byproduct of the “patriarchy,” benefits men and simultaneously victimizes them, the guidelines explain. Thus, the APA committee advises therapists that men need to become allies to feminism. “Change men,” an author of the report stated, “and we can change the world.”

But if the reaction to the APA’s guidelines is any indication, this change won’t happen anytime soon. Criticism was immediate and fierce. Few outside of a handful of departments within the academy had ever heard of “masculine ideology,” and fewer still understood how defining traditional masculinity by men’s most boorish—even criminal—behavior would serve the interests of men or entice them to seek professional help. Instead of passing quietly into the night, as most academic pronouncements do, the APA’s guidelines did what few such documents have ever done: They engendered a social media maelstrom, and likely not only lost professional credibility, but potentially created new barriers for men who need help.

It is tempting to excuse the APA’s guidelines as the byproduct of a select group of scholars whose intentions were good but whose delivery was tone-deaf. In today’s hyper-politicized environment, good intentions are often converted into the currency of ill-will. Yet the APA was forewarned by at least one psychologist that the guidelines would not be well received; that the document’s overtly partisan language and politically progressive narratives would not encourage men to receive services, but to keep them away.

When it became clear that those warnings should have been heeded, the APA found itself in an untenable position. Unfortunately, instead of calming the storm by acknowledging the validity of at least some criticism, the APA doubled-down, releasing a public statement asserting that the APA supports men, and the guidelines had been misunderstood and mischaracterized. In the same statement, they explained, “When a man believes that he must be successful no matter who is harmed or his masculinity is expressed by being sexually abusive, disrespectful, and harmful to others, that man is conforming to the negative aspects associated with traditional masculinity.” In other words, according to the APA, these selfish, violent, and abusive behaviors are not an issue of a person’s character, nor are they related to a person’s individual pathology. They are about “masculinity”—especially “traditional masculinity.” For added authority, the statement was signed by three presidents of the APA.

What should we make of not only the guidelines, but the APA’s inept handling of the criticism?  To better understand these dynamics, three of us, Quillette columnist and psychology professor Clay Routledge, along with criminology professor John Paul Wright, and Psychology Today contributor Pamela Paresky, sought commentary from a diverse range of voices, including therapists who focus on men’s issues, researchers whose work examines the complexity of men’s lives, and writers with diverse viewpoints. While we make no claim that the comments below are representative of the full range of views, we gave authors full editorial control over the content of their commentary and encouraged them to feel free to address both the positives and the negatives within the guidelines. Since we solicited many responses, we asked each contributor to limit her or his response to around 300 words.

We are heartened by the criticism that emerged from the APA’s guidelines. Why? Because we don’t believe that most of the backlash resulted from crass political motives. Instead, much of it was rooted in a deep concern about men and boys. The culture wars have not been kind to men, and data from an assortment of surveys tell us that boys and men are not thriving. Documents can be edited, but goodwill is a commodity no one should erase. If the APA is truly concerned about the mental and emotional health of men, it will recognize the goodwill and constructive intent underpinning much of the criticism, and consider the feedback as a starting point for a broader and more productive discussion of how to most effectively provide successful treatment for boys and men.

Flipping the APA on its Head — W. Keith Campbell, Ph.D.

W. Keith Campbell is a professor of psychology at the University of Georgia. He has authored and co-authored several books including The Narcissism Epidemic. Follow him on Twitter @wkeithcampbell. 

I ran a little thought experiment with the APA traditional masculinity model: What kind of society do you get when masculine values are centered on emotional self-focus rather than stoicism; cooperativeness rather than competitiveness; submissiveness rather than dominance; and kindness rather than aggression? Would men be happier and healthier in such a society? Well, given how bad traditional masculinity is, reversed masculinity should be flourishing in other cultures. Oddly, the APA doesn’t offer any examples. The closest example I found was this hot take on Asian men (birthplace of Genghis Khan—literally the most badass male ancestor of all time). The APA notes that “at least among white college students, Asian-American men are viewed as less manly than white or black American men.” We aren’t told if that is good or bad. If you look at the massively underpowered and poorly sampled study, it turns out that 250 psych undergrads think masculinity lines up with physical strength and athleticism, and place men’s masculinity in the order of black men being most masculine, Asian men the least, and white men in the middle. The closest you find to the flipped masculinity script are peace-focused masculine cultures that exist as protected subcultures in larger liberal cultures (e.g., India currently protects Tibetan spiritual culture—explicitly nonviolent groups like the Jains, etc.). Without this protection, peaceful groups get killed off. When there isn’t war, cultural aggression is celebrated in ceremony and sport, like this proud masculine display at the India-Pakistan border. No traditionally masculine men at the border means no men of peace in the nation.

My Warning to the APA About the Draft Guidelines — Chris Ferguson, Ph.D.

Chris J. Ferguson is a professor of psychology at Stetson University. He has published one book on video game science, Moral Combat: Why the War on Violent Video Games is Wrong as well as a murder mystery, Suicide Kings. Follow him on Twitter @CJFerguson1111.

In August, 2018 before the APA’s Council of Representatives (of which I am a member) voted on the controversial practice guidelines for boys and men, I shared with them a review I conducted of the proposed guidelines. Unfortunately, I was unsuccessful in interesting the Council in discussing the scientific merits and shortcomings of the guidelines. The version finally announced publicly has some superficial changes, but fundamental problems remain. Specifically, the guidelines lack a broad scientific base, particularly an understanding of biological contributors to gender identity, tend to use terms such as “traditional masculinity” in ways that lack conceptual integrity and are often stereotyped, and tend to read too often as a sociopolitical ideology than a balanced and nuanced scientific review.

I don’t doubt the need for practice guidelines for men. Men do struggle with many issues, such as lower school success, higher suicide and violence. A data-based, objective and compassionate document could have been useful. However, the APA’s practice guidelines’ obsession with “traditional masculinity” ultimately failed to help practitioners find compassion and understanding of those with values different from their own, and have probably offended and turned away many men who might most have benefited from psychotherapy.

Unfortunately, from my view the APA has a poor track record of biased and scientifically misleading policy statements including practice guidelines. Usually such statements exaggerate the consistency, quality, and policy applications of a field of study. The APA’s statement on violent video games, my own field, does not resemble the actual science, which has not provided good evidence for links with aggression. Other statements on issues ranging from abortion to a divisional review of spanking have, likewise, stoked scientific controversy. In many cases, statements are developed by scholars reviewing their own work and declaring it beyond debate, a clear conflict of interest. At present, the APA’s policy statements often read like marketing tools rather than objective reviews. Fixing this will require significant change in how APA policy statements and practice guidelines are developed and reviewed. Until then, they should be regarded with skepticism.   

Who Will Mount Up and Ride to the Sound of the Guns? — B. Christopher Frueh, Ph.D.

B. Christopher Frueh is a professor of psychology at the University of Hawaii, Hilo. Under the pen name “Christopher Bartley,” he is author of They Die Alone and other hardboiled novels. Follow him on Twitter @christobartley.

The APA’s latest manifesto is an embarrassment to the discipline of psychology. It is an abdication of scientific responsibility, denying biological and evolutionary realities in favor of a progressive fantasy pushed by “social justice” and “feminist” ideologies. It is harmful to all members of our society and dangerous to our national security. Masculine qualities like rugged individualism, courage, stoicism, ambition, and a willingness to protect and sacrifice for others helped secure the freedom and prosperity that so many now take for granted.  

At a time when many academics are virtue-signaling by whining about “toxic masculinity,” taking offense at every imagined “microaggression,” and listing their “pronouns” in their email signature blocks, we should ask where does this line of absurdity end? Perhaps the next APA manifesto will seek to abolish religion, athletics, heterosexual marriage, eating meat, etc. Whatever happened to common sense? And where does this take us? Will we next ban books, movies, and podcasts by people named Ernest Hemingway, Clint Eastwood, or Jocko Willink?

How will this affect our armed forces, police and fire departments, and all the other dangerous but important jobs that must be done? Who will volunteer to mount up and ride to the sound of the guns to protect our nation and its founding principles when masculinity has been smothered in our society?

“We make men without chests and expect from them virtue and enterprise. We laugh at honor and are shocked to find traitors in our midst.”

—C.S. Lewis, The Abolition of Man (1943)

The APA Guidelines for Working with Male Clients: Ambitious but Severely Flawed — Roy Wayne Meredith III

Roy Wayne Meredith III is a graduate student of social work at Columbia University. Follow him on Twitter @thoreausquad.

Practitioners should treat the new APA guidelines with caution. For starters, the document itself is poorly written. It frequently employs passive sentence constructions and modal verbs, such as “may,” “can,” or “it has been suggested that.” This strongly implies that the authors lack confidence in the robustness of the research they cite.

In some cases, this hesitation is clearly warranted. Psychologists such as Scott O. Lilienfeld have demonstrated that microaggression theory, for example, lacks construct validity. Seeing that its proponents classify offenses that range from calling on students too often to outright racist slurs as microaggressions, it is hard to imagine how Lilienfeld could be wrong. However, the authors fail to mention this and other glaring problems.

Some statements are so obvious that I wonder why the authors even bothered to include them, such as “inconsistent and contradictory messages can make the identity formation process complicated for some populations of boys and men.” No kidding.

Nevertheless, the APA deserves praise for emphasizing the importance of fatherhood in childhood development, the gendered bias that therapists often have against male clients, and the pitfalls boys and men face in educational settings. Furthermore, the authors correctly assert that racial disparities in criminal sentencing, health outcomes, and other measures of welfare are significant enough to compel therapists towards social activism. That these are still pressing issues, however, is even more reason to ground our solutions in research that utilizes rigorous methodology.

The APA Guidelines Are Unethical — Pamela Paresky, Ph.D.

Pamela Paresky writes for Psychology Today and is a senior scholar in human development and psychology at the Foundation for Individual Rights in Education (FIRE). Dr. Paresky’s opinions are her own and should not be considered official positions of FIRE or any other organization with which she is affiliated. Follow her on Twitter @PamelaParesky.

The APA’s code of professional ethics requires that psychologists respect clients’ “dignity and worth” and their “rights to self-determination.” It urges them to “take precautions” about “potential biases,” to refrain from taking on a clinical role when “other interests” could impair their objectivity, and reminds psychologists that they must “establish relationships of trust” with clients. The new guidelines violate these ethical standards. The guidelines’ basic premises are rooted in a set of ideological biases that are likely to impair psychologists’ objectivity, ability to respect the dignity and worth of certain clients, and make it difficult if not impossible to establish a therapeutic relationship based on trust.

The guidelines include, “Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others,” and “When working with boys and men, psychologists can address issues of privilege and power related to sexism.” Regardless of what a given male client brings to therapy, it appears that “issues of privilege and power related to sexism” can be addressed.

Some of the guidelines are positive. But psychologist Ryon McDermott, who was among those who drafted the APA guidelines, admitted in the APA’s own publication that they contain an overarching ulterior motive: “If we can change men,” he explained, “we can change the world.” 

Changing men starts with the premise that there is something wrong with men. If these guidelines are followed, how will men who see themselves as “traditionally masculine” trust that their sessions will be used for their own goals of psychotherapy rather than to address their masculinity?

Any guidelines issued by the APA should be for the purpose of more effectively treating the problems that clients bring to psychotherapy. Ulterior motives are countertherapeutic and undermine trust. These guidelines subvert the purpose of clinical psychology and will jeopardize the public’s trust in the profession.

The Passive War of Attrition on Masculinity — Natalie Ritchie, M.A.

Natalie Ritchie writes for Child Magazine and is the author of Roar Like a Woman: How Feminists Think Women Suck and Men Rock (2018). Follow her on Twitter @womendontsuck.

For years, feminism has fought a passive war of attrition on masculinity, starving it of honor. With its 2018 guidelines, the inherently feminist APA has gone on the offensive. This assault is not as simple as misandrist pay-back by feminism for a history’s-load of oppression. It has its roots in the feminist need to be man-identical. When your idea of gender equality is a 50/50 breakdown of men and women in any given situation—that is, when you think that 100 percent of women should do what 100 percent of men do—masculinity poses a threat. Making men less like men (and more like women) becomes a backdoor route to making women more like men. Such gender denial is the new Aryanism; unscientific, unprofessional, immoral. Insisting that each gender is “wrong” and must be more like the other to be “right” cripples both, and shrivels the human footprint to only what the genders have in common.

“Traditional masculinity” is a sorry litany of criminality, suicide, violence, and “sexism,” the APA claims. Yet it seems that the APA’s real target is the core male trait of taking responsibility. It was responsibility that channeled the male spirit of efficiency into the industrial and digital revolutions’ sensational wealth; that deployed the male instinct for combat to highlight both sides’ viewpoints to the max in the superb Western legal system; that kick-started democracy when the nobles heavied bad King John into signing the Magna Carta; that met Messerschmitts with Mustangs and Spitfires; that turned up to work (or risked livelihood and life to strike for the 40-hour week); that made good fathers.

Many of the male problems the APA laments vanish with taking responsibility. Yet “responsibility” only appears twice in the guidelines’ 36 pages, “responsibilities” once.

A Case Study of Traditional Masculinity — Clay Routledge, Ph.D.

Clay Routledge is a professor of psychology at North Dakota State University. He authored the 2018 book Supernatural: Death, Meaning, and the Power of the Invisible World. He writes a monthly column for Quillette. Follow him on Twitter @clayroutledge.

Instead of focusing on the cherry-picked research, over-reliance on blank slate thinking, or the general progressive ideological bias observable throughout the guidelines, I would like to share a personal, but I hope helpful, anecdote.

The rule in our house when I was a kid was we had to participate in at least one sport or related physical activity. I wasn’t very interested in typical sports so I decided to give martial arts a shot. I was just a scrawny kid with glasses who was regularly picked on by bigger boys so learning how to fight seemed like a good idea. I learned so much more.

For the first few years of training, I was still just a skinny kid but I was developing a variety of psychological, social, and physical skills that would prove very helpful as I got older. Our martial arts gym was old-school, run with military-like structure. Workouts and sparring were intense. The training disciplined my mind and body, gave me the opportunity to work my way through a hierarchical system that rewarded hard work and dedication, and helped me become a strong and focused young man.

The training involved a healthy dose of traditional masculinity—aggression, stoicism, confidence, and competitiveness. Critically, using a traditional martial arts philosophy and traditional military-style teaching methods, this training took advantage of traditional masculinity to build positive characteristics such as dignity, restraint, personal responsibility, and a sense of duty to others.

Mental illness is a real problem that haunts even some of the strongest of men. And all of us, men and women alike, grapple with psychological vulnerabilities and life stressors. But I would argue that traditional masculinity is not the problem. Instead, it can be part of the solution to the problems that plague many modern boys and men. With proper guidance from positive male role models and institutions that give males a code to live by and connect them to a purpose-providing moral system, traditional masculinity plays a vital role in creating healthy men as well as building and preserving safe and prosperous societies.

Psychotherapy Is Meant to Be Personalized Medicine — Sally Satel, M.D.

Sally Satel is a practicing psychiatrist, a lecturer at the Yale University School of Medicine, and a resident scholar at the American Enterprise Institute. Follow her on Twitter @slsatel. 

The APA guidelines risk subverting the therapeutic enterprise altogether because they emphasize group identity over the individuality of the patient.  

Psychotherapy is the ultimate personalized medicine. The meanings patients assign to events are a thoroughly unique product of their histories, anxieties, desires, frustrations, losses, and traumatic experiences.

“Gender-sensitive” psychological practice, as the APA calls it, is questionable because it encourages clinicians to assume, before a patient even walks in the door, that gender is a cause or a major determinant of the patient’s troubles.

To be fair, the APA does emphasize that it does not intend to mandate changes in practice. But therapy is a delicate business not readily amenable to guidelines tailored to gender—or to any group affiliation, for that matter. So when the APA encourages practitioners to engage in vaguely defined activities—“address issues of privilege and power related to sexism” or “help boys and men, and those who have contact with them become aware of how masculinity is defined in the context of their life circumstances”—it seems more focused on a political agenda than on the patient.

Leading with an ideological agenda risks alienating the patient and thereby compromises a critically important phenomenon called the therapeutic alliance. In his classic book Persuasion and Healing (1961), psychiatrist Jerome D. Frank describes the alliance as “the therapist’s acceptance of the sufferer, if not for what he or she is, then for what he or she can become.”

Through that therapeutic relationship, the patient gains insight, a degree of mastery over himself and alternative ways of thinking about his problems. Frank believed, as do many therapists today, that the power of a clinician’s dedication to the patient is not only essential, but may also be the most active ingredient in the therapy itself.

People seeking help are in a state of suggestibility. Therapists need to be careful about imposing their “gender-sensitive” worldview on them.

The New APA Guidelines Are Predatory — Shawn T. Smith, Psy.D.

Shawn T. Smith is a licensed, clinical psychologist. He is the author of several books, including The Practical Guide to Men: How to Spot the Hidden Traits of Good Men and Great Relationships. Follow him on Twitter @ironshrink. 

The APA, not known for its high testosterone level, seems to view masculinity with the same distaste a Disney princess has for manual labor. They speak of masculine traits with deep suspicion, despite the fact that their safe world rests on the backs of men who possess those traits.

I won’t spend these few paragraphs repeating the efforts of those defending masculinity. Instead, I hope to persuade other clinicians to take a stand against the APA’s ideologically-driven guidelines for working with men and boys.

If the APA were truly concerned about males, they would strive to help those who are suffering by building on the time-tested virtues of masculinity. Instead, they frame the “patriarchy”—that nebulous bête noire of radical feminism—as the root of all suffering. Seeing the world through that tainted lens, their response to men and boys can only be that of the radical feminist: tear men down. Denigrate noble traits. Advance feminist ideology at all costs.

Under this APA policy, any man unwise enough to trust a psychologist is to be chastised for his alleged privilege and sexism, and he is to be re-educated into something far more docile and apologetic than a full-blooded man.

If the predatory nature of the APA’s new guidelines isn’t immediately apparent, consider the inverse: psychologists organizing en masse to dismantle femininity, treating each female patient as an opportunity to reshape women as the APA sees fit.

People generally seek psychologists in moments of vulnerability. It is plain vicious to seize on that vulnerability for the sake of advancing an ideology. Ironically, the APA’s mercenary approach to the culture war—a war in which they have no business taking sides—exemplifies the destructive and ruthless qualities they wrongly attribute to honorable men everywhere.

Professional Best Practices Are Not Ideological — Debra W. Soh, Ph.D.

Debra W. Soh is a Canadian science columnist, political commentator, and the co-host of Wrongspeak. Follow her on Twitter @DrDebraSoh.

I have several concerns regarding the APA guidelines for practice with men and boys. Perhaps a good starting point would be the belief that masculinity is an “ideology,” “socially constructed,” and “learned during socialization,” as opposed to biological and the result of hormonal influence. Secondly, the guidelines portray abusive behavior as a natural extension of being male-typical, as opposed to being due to anti-sociality and negative views about women.

If we were to follow this suggested line of thinking, masculinity should be something that can be corrected and unlearned. As someone who has worked clinically with incarcerated male sexual offenders and violent offenders, I can tell you that therapeutic interventions informed by intersectional feminism and its ideas about “power and privilege” will have zero effect when working with these populations. 

Progressive talking points, like calling gender a “non-binary construct” and openly advocating for “participation in social justice activities,” have no place in a document detailing professional best practices. They foreshadow a future in which psychologists must alter their therapeutic approach, not in the best interest of their client, but because this new orthodoxy is trendy and they are afraid of having their licenses revoked. Psychological services should be scientifically-informed and cater to an individual’s needs and history, instead of being based on sweeping, politically motivated assumptions about their sex.

In Defense of the APA Guidelines — Christina Hoff Sommers, Ph.D.

Christina Hoff Sommers is a resident scholar at the AEI where she studies the politics of gender and feminism, as well as free expression, due process, and the preservation of liberty in the academy. Follow her on Twitter @Chsommers.

Yes, the new APA “Guidelines for Psychological Practice with Boys and Men” are saturated with gender studies rhetoric. But buried under the blather about “hegemonic masculinity” are suggestions that are both contrarian and sensible.

Consider this sentiment: “For boys and adolescents, shorter sessions, informal settings outside the office (e.g., playground), instrumental activities, using humor and self-disclosure…may provide more congruent environments than traditional psychotherapy.” That may not sound revolutionary, but the authors are conceding that conventional talk therapy may work less well for young men than for young women. They are suggesting the need for male-specific mental health protocols. That goes against decades of theory denying the relevance or legitimacy of anything male-specific. Unfortunately, the authors offer very little advice beyond the passage quoted above. But it’s a start.

There is more hidden wisdom: “Psychologists are encouraged to advocate for public policy that supports and enhances teenage boys’ career prospects.” That is a revolutionary call-to-arms! Almost no one is advocating for the vocational well-being of young men. Politically mainstream organizations avoid it, knowing that it would be dismissed as a backlash against women. But men need help.

As my colleague at the American Enterprise Institute, Nicholas Eberstadt, documents, the U.S. is in the midst of a “quiet catastrophe—the collapse of work for men.” America, says Eberstadt, “is now home to an ever-growing army of jobless men no longer even looking for work—over seven million between ages 25 and 55, the traditional prime of working life.” Economist Lawrence Summers projects that one third of working-age men will to be out of the workforce by 2050. The social and psychological toll of such a dislocation is incalculable. Boys and young men desperately need advocates. So, I commend the report for suggesting the nation’s psychologists take up their cause. 

There is much that is good and important in the APA guidelines. The authors stress the importance of fathers and present dozens of statistics that belie the idea of “male privilege.” So why did they bury their message in distracting passages about “Eurocentric masculine ideals of restrictive emotionality?” Here is my best guess: In our current male-averse environment, the only way to help men and boys is to pay homage to the gender dogmas—then quietly insert some sound and critical advice and hope no one notices. Even the authors themselves.

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