What if Masculinity Isn't the Problem?
A Case for Strengths-Based Therapy with Men
by Jacob Weissman
There's a word that's become almost unavoidable in conversations about men and mental health: toxic. Toxic masculinity. It's everywhere — in the research, in the culture, in the way therapists are trained to think about their male clients. There is some truth in it. Rigid adherence to traditional masculine norms can cause genuine harm, but the field of psychology has fixated on the rigid, "problematic" end of the masculinity spectrum. This leads to a biased and unhelpful picture of masculinity, made obvious when we take a look at the literature.
The 15% Problem
A content analysis of every article published in Psychology of Men & Masculinities — the APA's flagship journal for research on men — found that out of 590 articles published between 2000 and 2018, only 15% approached masculinity from a positive perspective (Cole, Moffitt-Carney, Patterson & Willard, 2021). Fifteen percent. The vast majority of the reviewed research approached masculinity through a negative lens.
This reflects a broader pattern in the field of psychology (and a broader human pattern). For most of the 20th century, psychological research was almost entirely focused on what goes wrong with people. It took the positive psychology movement — Martin Seligman and his focus on "flourishing" — to begin to rebalance things. To ask not just "what's broken?" but "what's working, and how do we build on it?" Many aspects of the field have made genuine attempts to catch up — to focus on "values" and "strengths." Masculinity research has not, and remains steeped in the old, pathologizing model. I see a through-line from this to the actual relationship men have with the mental health field.
A 2017 meta-analysis of 78 studies involving over 19,000 participants found that conformity to masculine norms was moderately and unfavorably related to psychological help-seeking (Wong, Ho, Wang & Miller, 2017). A more recent 2025 meta-analysis of 35 samples confirmed this pattern, finding that higher endorsement of traditional masculinity correlated with negative attitudes toward help-seeking and higher self-stigma around seeking help (Üzümçeker et al., 2025). In one sense, this makes perfect sense. Men, broadly speaking, have a harder time asking for help. Masculine norms often prize self-reliance and emotional control. But I believe this also points toward a disservice the field of psychology has done to men, writ large. The field of psychology, especially counseling psychology, has spent decades pathologizing masculinity — a trend that reached its peak with the APA's 2018 Guidelines for Psychological Practice with Boys and Men, which declared that "traditional masculinity ideology" is "psychologically harmful," drawing criticism from scholars across the field who argued the guidelines' language would actively discourage men from seeking help (Ferguson, 2022).
Alongside this, we've seen an accelerated feminization of the field — men now represent roughly 20% of psychology doctorate recipients, and in 2020 just 5% of psychologists under 30 were male (APA workforce data; Stone, 2023). At the master's level — where the majority of practicing therapists are trained — the picture is even starker: in counseling psychology, the largest subfield for master's recipients, men represent just 18% of degree earners (AIBM, 2025). The scarcity of male psychologists and therapists does not bode well for men's mental health. Research shows that men who see a therapist matching their gender preference report significantly higher satisfaction with therapy (Seidler, Rice, Oliffe, Fogarty & Dhillon, 2021). Unfortunately, there aren't many options for men whose preference is a male therapist. Women show a similar pattern — among those who express a preference, women are significantly more likely to prefer a female therapist (Liddon, Kingerlee & Barry, 2018).
I do not, by any means, think women cannot be effective therapists for men and vice versa. But I also think identity plays a massive role when it comes to the "intangibles" of therapy. I do a lot of OCD work, and there's a reason I often tell clients about my own journey with OCD. It helps them feel like I actually know something about what they're going through. Identity and shared experience matter in therapy.
The mental health field has radically fewer men than it did a few decades ago — making it doubly important for the field to portray an openness towards masculinity, and therefore men. The field of psychology — and mental health more broadly — has to invite men back to the table.
So How Do We Do This?
The solution is certainly not telling men they are toxic. But the solution is also, definitely, not doubling down — telling men to "just be a man" and push through it. Men have problems that need to be talked about, and worked through — like all human beings. What we need to do is meet men where they are, on their terms, with an understanding and appreciation for their values.
This should sound familiar to any therapist who has been in the field for more than an hour. It's so prominent in the field, it's basically a cliché — you have to meet people where they are. Our job is not to tell clients what they should think or believe. It is to help them from the aperture of their own values. We need to do this for men.
The Positive Psychology / Positive Masculinity Model
This is exactly what researchers Mark Kiselica and Matt Englar-Carlson set out to do. Their model — the Positive Psychology/Positive Masculinity Model (PPPM) — identifies ten strengths commonly associated with traditional masculinity. These are patterns that show up in how men actually live, connect, and cope (Kiselica & Englar-Carlson, 2010).
Here are a few I find particularly applicable for modern, American men:
Male Relational Styles
Men tend to build friendships through shared activity — working on something side by side, playing a sport, building something together. This gets dismissed sometimes as men "not knowing how to connect." But it is connection. It's just a different form of it.
Male Ways of Caring
Traditional masculinity encourages men to show care through action — through protecting and providing. The instinct to take care of people by taking proactive action in the world is not "problematic." It becomes a problem only when it's the only way a man knows how to express that he cares.
Generative Fatherhood
The drive to guide and inspire the next generation toward a better life. This is one of the most powerful motivators men have. It's also a big source of anxiety for men — "What if I'm not enough?", "What if I don't set a good example?"
The Worker-Provider Tradition
Work gives men a sense of meaning and purpose. As with all things, an all-consuming focus on work can be deleterious. But, often, a man's ability to work hard, and overcome obstacles, is a strength he can learn to utilize in other areas of his life.
Male Courage and Risk-Taking
The willingness to face danger or uncertainty when something important is at stake. In a therapeutic context, this can translate into a willingness to sit with emotional discomfort rather than avoid it — which, interestingly, is the foundation of most evidence-based treatment.
Kiselica and Englar-Carlson contend that, if therapy focuses on helping men move towards these strengths, they will not only access therapy more willingly, but discover meaningful, purposive solutions for their problems. This focus on strengths and meaning seems key. A values-based focus like this is, in my clinical experience, one of the most important elements of good therapy. Therapy is hard. Change is hard. But it is easier when people can see what it will give them — the shining star in the sky it will make accessible. The Positive Masculinity Model helps provide men with a "why" — and even a "how" — for the hard work of therapy.
Men are not a diagnosis. Masculinity is not a disease, and therapy doesn't have to start by tearing something down.
Sometimes the most useful thing is to help a man see clearly what he's already carrying — and figure out how to carry it better.
Frequently Asked Questions
Is "positive masculinity" the same as ignoring toxic behaviors?
No. Positive masculinity doesn't deny that rigid masculine norms can cause harm. It holds that masculinity also contains genuine strengths — like protective instincts, group orientation, generative fatherhood, and courage — that can be channeled constructively. A strengths-based approach works with these qualities, which often makes men more willing to examine the parts that aren't working.
What is the Positive Psychology/Positive Masculinity Model (PPPM)?
PPPM is a framework developed by Mark Kiselica and Matt Englar-Carlson that identifies ten strengths associated with traditional masculinity. These include male relational styles, ways of caring, self-reliance, the worker-provider tradition, courage, group orientation, humor, and generative fatherhood. It's designed to give clinicians a strengths-based framework for working with boys and men (Kiselica & Englar-Carlson, 2010).
Does research support strengths-based therapy with men?
The evidence is growing but still early. The Wong et al. (2017) meta-analysis found that conformity to masculine norms was moderately related to lower help-seeking — suggesting that traditional approaches may be alienating the men who need help most. Studies on positive masculine ideologies like caballerismo in Latino communities have found positive associations with social support and life satisfaction (Estrada & Arciniega, 2015). More controlled studies are needed, but the clinical rationale is strong.
Why don't men seek therapy?
Multiple factors: stigma around emotional vulnerability, unfamiliarity with the process, past experiences with therapy that felt pathologizing, and practical barriers like cost and scheduling. Research consistently shows that the more strongly a man conforms to traditional masculine norms — particularly self-reliance and emotional control — the less likely he is to seek help.
What should I look for in a therapist who works with men?
Someone who understands masculine psychology without either pathologizing it or uncritically affirming it. A good therapist for men will acknowledge your strengths, create a space where directness is welcome, and help you do deeper work at a pace that respects your autonomy.
Can therapy help men who feel like they "don't need therapy"?
Often, yes — and that feeling itself is worth exploring. Many men who initially resist therapy discover that what they were calling "fine" was actually numbness, avoidance, or quiet suffering. A strengths-based approach can be effective here because it doesn't start by telling a man he's broken. It starts by meeting him where he is.
References
American Institute for Boys and Men. (2025). Where are the men? Male representation in social work and psychology. https://aibm.org/research/men-in-social-work-psychology/
Cole, B. P., Moffitt-Carney, K., Patterson, T. P., & Willard, R. (2021). Psychology of Men and Masculinities' focus on positive aspects of men's functioning: A content analysis and call to action. Psychology of Men & Masculinities, 22(1), 39–47. https://doi.org/10.1037/men0000264
Estrada, F., & Arciniega, G. M. (2015). Positive masculinity among Latino men and the direct and indirect effects on well-being. Journal of Multicultural Counseling and Development, 43, 191–205. https://doi.org/10.1002/jmcd.12014
Ferguson, C. J. (2022). The American Psychological Association's practice guidelines for men and boys: Are they hurting rather than helping male mental wellness? New Ideas in Psychology, 67, 100960.
Kiselica, M. S., & Englar-Carlson, M. (2010). Identifying, affirming, and building upon male strengths: The positive psychology/positive masculinity model of psychotherapy with boys and men. Psychotherapy: Theory, Research, Practice, Training, 47, 276–287. https://doi.org/10.1037/a0021159
Liddon, L., Kingerlee, R., & Barry, J. A. (2018). Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking. British Journal of Clinical Psychology, 57(1), 42–58. https://doi.org/10.1111/bjc.12147
Seidler, Z. E., Rice, S. M., Oliffe, J. L., Fogarty, A. S., & Dhillon, H. M. (2021). Men's preferences for therapist gender: Predictors and impact on satisfaction with therapy. Counselling Psychology Quarterly, 35(1), 173–189. https://doi.org/10.1080/09515070.2021.1940866
Stone, J. (2023). Where have all the male therapists gone? Psychology Today. https://www.psychologytoday.com/us/blog/the-souls-of-men/202302/where-have-all-the-male-therapists-gone
Üzümçeker, E., et al. (2025). Traditional masculinity and men's psychological help-seeking: A meta-analysis. International Journal of Psychology, 60(2). https://doi.org/10.1002/ijop.70031
Wong, Y. J., Ho, M.-H. R., Wang, S.-Y., & Miller, I. S. K. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal of Counseling Psychology, 64(1), 80–93. https://doi.org/10.1037/cou0000176