Male centred therapy: Male psychology and masculinty

After completing my postgraduate training in counselling and spending countless hours giving therapy, I found myself captivated by a recurring theme: certain questions seemed to hold real power in helping male clients move forward.

The following research is based on systematic reviews, which gather and analyse all relevant studies using strict methods to reduce bias and identify clear patterns. This approach is the most reliable form of research because it combines large amounts of data to provide balanced and trustworthy conclusions.

Understanding the term toxic masculinity

The term toxic masculinity has become a common phrase in everyday conversations, but what does it mean? How does the idea of toxic masculinity affect men’s mental health, and is this label truly fair or helpful?

As a male-centred therapist with postgraduate training in male psychology, I’ve witnessed many reactions to this topic, some supportive, others critical. One particularly eye-opening experience was watching the fictional Netflix program Adolescence, which sparked diverse responses from men and women alike. It helped me see how societal expectations, emotional expression, and the stigma around mental health all intersect for men.

This insight motivated me to research more with the only university in the world that has dedicated a module on male mental health in their psychology degree and to think deeply about how I, as a therapist, could better support men navigating these challenges.

The research behind masculinity and male psychology

To understand masculinity more clearly, I dove into systematic research, the most reliable form of study that combines and reviews many different research projects. This approach, called a systematic review or meta-analysis, offers the strongest evidence on complex topics.

One incredible piece of work I found was from Lee Ellis and his research team. Over 11 years, they reviewed over 18,000 studies focused on sex differences around the world. Their monumental book, Sex Differences, summarises more than a century of scientific research across seven global regions, including Europe, North America, Africa, Asia, the Middle East, Latin America, and Oceania.

What makes this research truly exceptional is its scale and consistency. Across different cultures and historical periods, the patterns they found about male and female traits appeared repeatedly, suggesting that many differences are not just cultural but also biological and evolutionary.

Key insights about masculinity

This research uncovered several important traits often associated with men:

Strength and aggression

Men are generally physically stronger and show more aggression than women. However, this isn’t always negative; controlled aggression can be vital in professions like the military or policing, where strength and assertiveness are necessary.

Risk-taking and competition

Men tend to take more risks and be more competitive. This trait has positive sides too, for example, firefighters risk their lives to save others, showing courage and determination.

Confidence

Men often feel more confident about their skills, even at school, which can influence their behaviour and achievements.

Learning and behavioural challenges

Men are more likely to face learning difficulties or behavioural problems and get into trouble more often.

Health risks

Men have higher rates of accidents and certain health issues, reflecting different biological vulnerabilities. 

One fascinating biological fact is that testosterone production in male fetuses begins very early, around eight weeks into pregnancy, and peaks between weeks 10 and 15. This hormone influences brain and body development, affecting traits like impulsivity, risk-taking, pain tolerance, and even conditions such as ADHD.

This means that many characteristics we commonly link with masculinity, like toughness, confidence, and independence, have deep biological and hormonal roots, not just societal origins.

What is hegemonic masculinity?

The idea of hegemonic masculinity describes the dominant cultural ideal of manhood, a narrow and often unrealistic set of traits men are expected to have. This ideal emphasises things like emotional control, dominance, physical strength, competitiveness, and heterosexuality. Men who do not fit this mold may feel inferior or flawed, which can seriously affect their mental health.

From my experience as a therapist, I see how these rigid expectations create internal conflicts for men. Society often expects men to be the primary providers, protectors, and emotionally tough. At the same time, men face real risks, higher chances of violent attacks, responsibility for financial support, and struggles like losing access to children or homes after separation. These pressures can be overwhelming.

The complexity of masculinity: Biology meets culture

The bottom line is that masculinity is shaped by a mix of biology, hormones, evolution, and some social factors. It’s not just what society tells men to be, but also innate traits and learned behaviours that develop throughout life.

In therapy, I’ve noticed that encouraging men to “open up” emotionally doesn’t always work as expected. For some men, their idea of being “open” might look very different, influenced by their upbringing, culture, and biology. This creates a complex tug-of-war between how they feel, what they think they should feel, and societal expectations.

So, where does toxic masculinity fit in?

Toxic masculinity refers to the harmful side of some masculine norms, like the belief that men should never show emotions, must always be tough, or that aggression is the only way to solve problems. These pressures damage men’s mental health and their relationships.

However, it’s important to distinguish toxic traits from positive masculinity. For example, competition, protection, assertiveness, and emotional strength (CBT has its roots in Stoicism) are not inherently bad. Problems arise when these traits become rigid rules that suppress vulnerability or encourage harmful behaviour.

Social reductionism and media bias

One problem with how masculinity is discussed is social reductionism, simplifying complex social behaviours down to one cause. This often means reducing masculinity to just aggression and control, ignoring other important factors like culture, biology, personal experience, or childhood trauma.

This oversimplification fuels stereotypes that all men are violent or emotionally distant, which isn’t true and can be harmful. Media coverage sometimes reinforces this bias, showing men only in negative roles or portraying masculinity as outdated or toxic.

The think tank Civitas surveyed boys between the ages of 12 - 16 years, and 41% of them were told that they were a problem to society.

Positive masculinity: A better way forward

Male-centred therapy

The good news is that we can promote positive masculinity, a version of manhood that balances strength with empathy, protection with respect, and emotional resilience with openness.

Sandra Bem’s research in the 1970s introduced the idea of psychological androgyny, where individuals blend both masculine and feminine traits. People who embrace this balance tend to be more adaptable and emotionally healthy.

I have noticed that this concept encourages men to break free from rigid gender roles and allows men to express a broader range of emotions and behaviours

By acknowledging the biological, psychological, and social complexities of masculinity, I can better support men in:

• Expressing emotions in healthy ways without shame.
• Understanding that strength includes vulnerability.
• Building positive relationships based on respect and care.
• Rejecting harmful pressures without losing their sense of self.

Final thoughts

In conclusion, masculinity is a rich and complex experience influenced by biology, culture, and personal history. The label “toxic masculinity” can sometimes unfairly oversimplify this complexity and harm men’s mental health by making them feel flawed or misunderstood. 

Instead, I focus on encouraging positive masculinity, where men are free to be strong, caring, vulnerable, and responsible all at once. This balanced approach supports better mental health outcomes and healthier relationships.

All the findings, combined with my own lived experience, allow me to have an unjudgmental and empathetic approach in my private practice.