The Impacts of Gender Role Socialization on Health and Culture

“We know that women are overwhelmingly victims [of sexual violence], and we know that men are overwhelmingly perpetrators,” says Johnson. “What about being a man increases that? We teach our boys to be strong and aggressive and not to take ’no’ for an answer, and then we teach our girls to be passive and pretty and nice and not to be assertive.

“In my mind this kind of creates this perfect scenario for sexual assault to happen, because if we’re teaching our boys not to take ’no’ for an answer, and we’re teaching our girls to be seen and not heard, that creates a really hard situation on both sides. ... There’s this socialization that occurs that makes sexual assault normative.”

Liang has conducted extensive research into men and masculinity, including the impact on health outcomes and gender role conflict among minority men, as he seeks to help men engage in healthier behaviors and improve their overall mental and physical health. He is among a team of scholars who helped draft the American Psychological Association’s first-ever set of “Guidelines for Psychological Practice with Boys and Men.” The newly released document, based on a synthesis of empirical and scholarly works, is meant to guide psychologists and researchers in their work with boys and men on masculinity issues.

Separately, Johnson has conducted extensive research and programming on rape culture. She co-authored the fifth edition of Women and Gender, a textbook released in November 2018 that explores women’s relationships, physical and mental health, and violence against women, among other areas. The book addresses the social construction of gender and explores ways to effect change, including through political advocacy.

In their work, both Liang and Johnson emphasize the need to understand gender differences.

“We need to interrogate gender, really unpack it, figure out what it means and how it contributes to people’s well-being—both men and women, and people who don’t identify as men or women,” Liang says. “[We need to] put it at the forefront, understand that gender-role ideology influences a lot of our behavior, influences a lot of our thinking and influences our perceptions.”

How Men Experience Masculinity

In helping to draft the American Psychological Association (APA)’s new “Guidelines for Psychological Practice with Boys and Men,” Liang drew on his extensive research into men’s experiences with masculinity and racism, especially those of men of color. He also has served as president of the APA’s Division 51, the Society for the Study of Men and Masculinities. He has done additional research into sexual violence prevention.

Liang worked on the APA guidelines in collaboration with other scholars over the past seven years, though efforts began earlier. In drawing on more than 40 years of research, the scholars also sought rounds of feedback from other experts and the public as they refined the document, which aims to help practitioners work more effectively with boys and men.

“Unfortunately psychology for a long, long time was looking at its constructs and engaging in its studies in a very androcentric way—so focusing on men but not really understanding men, centering psychological experiences based on men’s experiences, but not really understanding what men’s experiences are as it concerns gender,” Liang says.

The document recognizes the need to help boys and men—as well as their parents, teachers and coaches—gain awareness in how masculinity is defined in the context of life circumstances and how those social forces can be a detriment to mental health.

“Psychologists strive to recognize that masculinities are constructed based on social, cultural and contextual norms,” the first guideline states. The other nine guidelines address the impact of power and privilege, family relationships, education and public-health issues.

“One of the key things to come from the document is the importance of looking at something like masculinity,” Liang says. “Oftentimes, we think of gender as this immutable thing, that you’re born with it.” But, he adds, “You’re born with a sex, then you learn how to do gender.”

The new APA guidelines encourage researchers and practitioners to focus more attention on some of the ways that men engage in unhealthy forms of masculinity. They also encourage an understanding of how to capitalize on the more positive aspects of masculinity and how to engage in more positive health-related behaviors, such as a willingness to ask for help.

Men who have been socialized to appear tough but who are hurting might feel greater stigma if they were to seek help from a professional, Liang says. Instead, they might opt to deal with their pain by abusing substances or by hurting themselves or their partners.

“A man who is feeling some loss of power at work may cope with their loss of power by reasserting power at home,” he says. “It could be through physical violence or sexual violence.”

Though boys and men, as a group, tend to hold power and privilege, they also disproportionately face mental health issues, academic challenges and other health-related problems, the APA says in the document. Men account for three-quarters of all suicides, according to the Centers for Disease Control.

“Men on average die six years earlier than women,” says Liang. “Some of this can be attributed to higher completed suicides, but it’s also telling that men are more at risk for heart disease and stress-related illnesses. Instead of saying, ‘well, that’s how men are,’ we need to figure out why. Maybe if they engaged in help-seeking earlier, they’d be better off.” If they didn’t feel pressure to meet gender-role expectations or fear losing an opportunity at work, he says, they might take the time to go to a mental health practitioner or doctor.

Individuals need to be cognizant of gender, much like being aware of their racial biases, Liang says. With concerns over men’s suicide rates and drug addictions rising, “we need to understand how men are coping with job loss, with underemployment,” he says. “If we were to center gender, then we might be able to help these men in different ways.”

Although examining gender can be useful in identifying possible disparities between men and women in such areas as health, education and the justice system, Liang says, the guidelines underscore the importance of moving away from gender as an independent variable in studies.

“We know that gender-based violence—sexual violence in particular, intimate partner violence—disproportionately impacts women more than men,” he says as an example. “And we know that because our data tells us that. But that’s all it tells us—that there are differences. The next layer is, why are there these differences?”

Understanding Rape Culture

Johnson focuses her research and programs on rape culture, an area that first piqued her interest while she was working in rape prevention as an undergraduate.

“The original set of rape prevention programming was really focused on, ‘men, here’s how not to rape. Women, here’s how not to get raped.’” But in reviewing the programming’s effectiveness, she says, researchers found a rebound effect—that participants, instead of benefiting from the program, were later found to be perpetrators and victims at higher rates than non-participants and were more likely to accept rape myths.

Johnson wondered, how could talking about rape cause someone to actually be more likely to have those experiences or hold more strongly to their beliefs?

As a protective mechanism, Johnson says, some people might discard sexual assault data, if, for example, it occurs more often than they thought and if the numbers seem overwhelming. Instead, she says, those individuals will hold steadfast to cultural beliefs that only certain types of people commit such acts or that certain types of people are victims.

“I was fascinated with, how do we get through that, how do we disrupt that narrative or that idea?” Johnson says. “And I think it goes to more deeply ingrained ideas. So I started to study, what are the factors that predict sexual violence or predict acceptance of these rape myths?”

Approaching her work from the standpoint of perpetrators, Johnson continued her studies at the University of Akron. Her advisor in the master’s and doctoral program focused on victims.

“Our work melded together well, because she was coming from the victims’ side, which is very important, and I had a lens of perpetrators,” she says. In intimate partner violence, victims often have strong feelings for their attackers, she points out. “I think being able, in some way, to not demonize the perpetrator was really helpful in my work.

“I kind of come from the standpoint that great people can do really terrible things,” she says. “It’s a hard line to walk, though, because you don’t want to be a rape apologist. At the same time, in this narrative where we keep saying, ‘they’re terrible, they’re horrible,’ we’re not going to get anywhere in society, because people are going to hold strong to those beliefs.”

Johnson started looking at factors that can lead to problem behaviors, such as alcohol misuse, and circumstances, such as proximity to military and college campuses, where young people are coming into early adulthood and experiencing many freedoms for the first time.

She considered: “What role does culture play in creating this behavior or making these behaviors acceptable—these behaviors being rape, domestic violence, violence against LGBTQ individuals and the targeting of certain people? What about our society allows that to happen or excuses that when it does happen?”

She pointed to the APA’s newest guidelines, which address the negative effects of toxic masculinity on boys and men, as well as the fact that men are more likely to be victims of a violent crime, more likely to be perpetrators of violent crimes and more likely to use more lethal means of suicide. “That’s really important for us to think about,” she says.

On the other hand, Johnson says, toxic masculinity leads to “really devastating consequences” for women and girls, including increased rates of intimate partner violence, as it continues to perpetuate an unequal balance in society, where women are perceived as less than men.

The APA’s 11 “Guidelines for Psychological Practice with Girls and Women,” released about a decade ago, noted that psychologists, in their work, should consider the effects of socialization and stereotyping on women and girls.

“We see a lot of research and statistics showing that women and girls are at higher risk for mental health diagnoses,” Johnson says. “They tend to have higher rates of depression, higher rates of suicide attempts and higher rates of anxiety disorders, including post-traumatic stress disorder. It’s really easier to pathologize women, and say, well, there must be something wrong with women, or something wrong about being a woman that creates this increased risk and these increased rates.

“The guidelines really go to say that the reason these rates are different is not because of being a woman but because of the societal consequences of being a woman,” she says. “Within our society, we tend to devalue women and not believe in their competence, not believe in their ability, which leads them to have less resources and access to support, which then results in these increased rates of mental health diagnoses.”

In a 2017 study, Johnson investigates a proposed model of rape culture that incorporates traditional gender roles, sexism, adversarial sexual beliefs, hostility towards women and acceptance of violence. The 2017 study, “An Empirical Exploration into the Measurement of Rape Culture,” finds support for that model of rape culture, demonstrating the importance of targeting these factors in rape prevention programming. The study, co-authored by Dawn M. Johnson, was published in the Journal of Interpersonal Violence.

In a theoretical study published in 2017 in the Journal of Bisexuality, Johnson seeks to understand why bisexual women are more vulnerable to sexual assaults. (Research indicates that 75 percent of bisexual women experience sexual violence at one point in their lives.) She and co-author MaryBeth Grove offer several possible reasons, including substance misuse, hypersexualization and biphobia, in which bisexuals are feared or disliked because of their attraction to more than one gender.

With an aim to get people to own their behaviors so that they can move forward and help create a safer society, Johnson designs and implements programs to raise consciousness around rape culture and teach strategies to directly, or indirectly, intervene to prevent assaults.

She is leading a program at Lehigh called “Define It,” which is centered on rape prevention in the Lesbian, Gay, Bisexual, Transgender and Queer/Questing community on campus. She received a Faculty Research Grant to develop the program, which examines bystander behavior, rape culture, substance use, social influence and sexual/gender identity in sexual assaults among the LGBTQ college community. Johnson hopes to add to the limited research on rape culture and bystander behavior in the LGBTQ community.

Along with Lucy Napper, assistant professor of psychology, Johnson also is helping to develop a multi-tiered program to address alcohol abuse, sexual assault and sexual risk behavior on college campuses. The work is funded through a grant from the National Institutes of Health.

Exploring Sexual Consent

In research that dovetails with Johnson’s work, Liang focuses on gender-based violence and men and masculinity, especially how men of color experience masculinity. In addition to his research informing the new guidelines of the American Psychological Association, Liang creates programs to help young men develop strategies to succeed in school and beyond.

In a study titled “Exploring Sexual Consent and Hostile Masculine Norms Using the Theory of Planned Behavior,” Liang and co-authors Christina Hermann and Brooke E. DeSipio examine the role of masculine norms in explaining men’s intentions to have consensual sex.

The study, published in 2018 in the journal Psychology of Men & Masculinity, notes that sexual victimization rates are high on college campuses, with about 15 percent of undergraduate women experiencing rape or attempted rape their first year. By sophomore year, the study noted, 37 percent of undergraduate women experience sexual violence.

As part of the study, undergraduate men were asked to complete surveys on whether they conformed to violence and power over women or rejected that kind of behavior. They also were surveyed about their attitudes in asking for consent and whether they read body language to determine consent. Men who endorsed hostile masculine norms reported a greater lack of control over asking for consent, the study shows.

“Our greater understanding of how men’s endorsement of masculine norms influences their sexual behavior also provides an important source of intervention and prevention,” Liang and the co-authors write. “Educators may seek to incorporate a discussion of masculine norms and gender roles into sexual violence prevention programs aimed at young men.”

Liang also looks at how ethnic minority men experience racism and the pressures they face to conform to gender roles. Though the field has improved, he says, he has been critical of research that uses a narrow lens to study masculinity, by primarily looking at middle-class, college-educated or college-attending white men.

“That’s an important area to study, but it’s dangerous to generalize from those studies to the experiences of men of color,” he says. “My push and approach has been to look at masculinity from a more intersectional experience. What that means is, that instead of saying, ‘everyone experiences masculinity in this way,’ it’s, well, ‘what is masculinity for black men,’” as well as for Latinos and Asian American men.

Men of color don’t necessarily experience “male privilege,” or economic and social advantages, solely on the basis of their sex, he says. Based on how race operates, men of color are going to experience and perform their gender differently, he says.

In a study published in Psychology of Men & Masculinity, Liang and co-authors Jime Salcedo and Holly A. Miller of the University of La Verne explore whether racism exacerbates or buffers the relationships between Latino masculinity ideologies (caballerismo and machismo) and gender role conflict. The researchers surveyed 148 Latino men recruited through e-mail.

The findings suggest that Latino men who feel a responsibility to protect and provide for their family and who perceive racism on the job or in other settings may feel a heightened need to demonstrate success. The study results direct clinicians to analyze gender, race and racism experiences in their work.

In another study, also published in Psychology of Men & Masculinity, Liang and co-author Lizette Ojeda of Texas A&M University examine the role of bicultural stress, ethnic identity and Latino ideologies of machismo and caballerismo on multiple coping strategies among 93 Mexican American adolescent men. The study suggests that adolescent men who experience bicultural stress cope by giving up, laughing it off or leaving the matter to a higher power. The findings also suggest that when Mexican American adolescent men feel positive about their ethnicity, they are less likely to cope with life’s problems by using substances.

Putting Gender Symmetry in Context

As part of her research, Johnson explores the controversial issue of gender symmetry, which holds that women carry out violence against their partners at roughly the same rate as men.

In a theoretical study titled “It is and It is Not: The Importance of Context when Exploring Gender Differences in Perpetration of Physical Partner Violence,” published in 2016 in the Journal of Family Violence, Johnson and co-authors Samantha C. Holmes and Dawn M. Johnson accept gender symmetry while acknowledging the complexity of the issue.

Johnson says opposing camps waste time by arguing over whether gender symmetry exists and should focus instead on what to do about intimate partner violence.

“It can be that if we look at the population at large, and we count shoving a partner or calling a partner names as violence, then sure, women are just as likely to swear at their partner, call them names, shove them,” she says. “It’s like this cultural norm. That happens, and I think that’s an issue. We need to start thinking about, why are we okay with degrading our partners and putting our hands on our partners? Why has that become acceptable?”

She says programming could focus on respect, consent and how to handle a disagreement.

Still, she adds, women are significantly more likely to be killed or hospitalized at the hands of abusive partners, and that issue, too, needs to be addressed.

As comparison, the study raises the disparity in jail rates among young minority men arrested for drug crimes. Knowing only that black men are jailed at much higher rates than their white counterparts can lead to the assumption that black men commit drug crimes at higher rates. However, the study says, literature has shown that discriminatory policies, not race, account for the disparate jail rates.

“My argument,” says Johnson, “is, we should stop arguing about [gender symmetry] and acknowledge, ‘okay, yeah, these are both true. But what can we do? What next?’”

In a 2016 study published in the Journal of Interpersonal Violence, Johnson and several co-authors investigated the prevalence and predictors of intimate partner violence, sampling 227 women residing in shelters for battered women. The study found that while most of the women reported engaging in some form of violence against their partner, few of the women (5.3 percent) endorsed violence that was not mutual.

The study, “Prevalence and Predictors of Bidirectional Violence in Survivors of Intimate Partner Violence Residing at Shelters,” also showed the women experienced more severe abuse at the hands of their partners than they committed.

“We found that almost all instances of women’s use of violence was bi-directional, which means that they were not acting independently of violence,” and in many cases, they acted in self-defense, Johnson says. “You might have shoved them to get them off from beating you.”

The study, she says, underscores the importance of context in talking about gender symmetry.

Raising Awareness

As they conduct separate but related research, Liang and Johnson recognize the importance of raising awareness about gender socialization, rape culture, and the impact of gender-role ideology on men’s and women’s health and well-being.

Specifically, Liang hopes that the release of the APA’s “Guidelines for Psychological Practice with Boys and Men” leads to more people having more compassion for the challenges that boys and men experience in daily life.

“I hope policy makers consider devoting more funding to further support research to study how masculinity ideologies may be helpful and harmful to the health and well-being of men and boys, as well as the people with whom they interact,” he says.

He also hopes that schools consider the behaviors of boys, particularly boys of color, with more compassion. “School disciplinary policy, for instance, could be more sensitive to how boys’ behavior may be symptomatic of other problems,” he says. “Their greater likelihood of engaging in externalizing behaviors results in more of them receiving more harsh discipline when they may actually need more mental health support.”

Concerning rape culture, Johnson emphasizes the need to make women and men more aware of how they are socialized to be and how that can impact their relationships. She says schools, even on the elementary level, could introduce programming that fosters discussion of healthy relationships and issues of consent. The earlier that prevention work starts, Johnson says, the more effective it can be.

“There are sex education programs that are appropriate for elementary school kids,” she says. “Start that track so hopefully we won’t eventually need rape prevention programs in college.”

Illustrations by Jacob Haupt

This story originally appeared as "Centering Gender" in the 2019 Lehigh Research Review.