The real reason why some men are still refusing to wear a mask

Since COVID-19 broke out in the United States, a certain image has become an icon of pandemic-era masculinity: a man walking down the street with a surgical mask pulled down so that it hugs his chin. He has made the effort to put on a mask, a nod to the public health messaging around mask wearing, but he just can’t bring himself to pull it up over his nose and mouth. Why?

Several surveys show that men in the United States are less likely to wear a mask to curb COVID-19 transmission than women. Much debate and speculation over why some men just won’t wear masks has focused on past research, which shows that men who identify with a certain brand of traditional masculinity tend to engage in expressly unhealthy behavior like eating junk food or avoiding annual doctor’s visits. A more recent survey from June found men were more likely than women to think masks were uncool or signaled weakness.

Preliminary research from Boston College Developmental Educational Psychology professor James Mahalik and doctoral students Michael Di Bianca and Michael Harris confirms the concept that men who identify with certain macho qualities are less likely to wear a mask. More specifically, their work suggests that a penchant for individualism and skepticism towards science may more directly correlate to one’s decision to don a mask. If the findings hold true, they could provide deeper insight into how to get more men to protect themselves and others against COVID-19.

To understand why some men don’t wear masks, Mahalik surveyed 596 men across 49 states, the vast majority of whom identify as heterosexual. The survey went out to men across a spectrum of ages and incomes, the latter of which varied from less than $10,000 a year to over $200,000 a year. Roughly a third of the participants were men of color. The survey asked men to rate whether they identified with certain masculine norms and indicate what they thought about the Center for Disease Control and Prevention’s recommendations for mitigating the spread of COVID-19. On whole, respondents felt positively about the guidelines around COVID-19 and said they complied with them (because this is self-reported data, researchers cannot confirm that men were actually or consistently wearing masks). Unsurprisingly, men who felt negatively about public health recommendations like social distancing and mask wearing, also held traditional masculine ideals around emotional self-control, self-reliance, dominance, winning, power over women, and heterosexual self presentation. But what was more interesting to Mahalik, was a separate finding:

“What we found was that more traditional masculine men found fewer benefits to following the CDC guidelines,” Mahalik says. “They saw more barriers in their way to following those guidelines. They had less confidence in science and they had less empathy towards people who are vulnerable or in high risk categories.” Mahalik and his colleagues posited these other prevalent ideas seem to be more directly related to men not wearing masks than traditional masculinity itself.

Up until this point, research seemed to indicate that a particular brand of hypermasculinity was closely related to whether men chose to lead healthy lives. It is well established that men who prize traditional masculine norms like toughness engage in more risky behavior and use preventative health services less. But this research suggests that these ancillary ideas around science and community may be more responsible for how traditionally masculine men think about wearing a mask. That finding has implications for how public health officials can appeal to these men. Rather than trying to convince uber-masculine men to change core elements of their identity, public health officials could instead focus on dismantling certain beliefs that may be leading them to be less healthy. In the case of COVID-19, public health officials might consider chipping away at the individualism that may keep men from wearing a mask by focusing on the more pro-social aspects of traditional masculinity.

“Instead of this notion of being dominant and controlling your emotions and being self reliant, how about being a guardian, being a protector? Those are very traditional masculine messages,” Mahalik says. Rather than a total rebranding of what it means to be masculine, this approach suggests refocusing the lens around traditional masculinity’s more positive aspects. A protector wears a mask, because they care about their community and their families; a guardian wants people to be safe.

There have been several efforts to adjust how men who identify with masculinity’s most rugged interpretations think about health. Between 2003 and 2005, the National Institutes of Health ran a campaign called “Real Men, Real Depression” to educate men on how to recognize depression in themselves. It hoped to destigmatize depression and counseling. A postmortem examination of the campaign found that the “Real Men, Real Depression” brochures were most effective for men who held negative associations with seeking help, though in general the campaign was not significantly more effective at normalizing depression in men than more gender neutral pamphlets.

A subsequent 2010 study that targeted men with symptoms of clinical depression who had not yet sought help found that the right marketing materials could change their ideas about depression and getting help. The trick was to be specific about the issues these men face. Researchers directly addressed how depression manifests in men and challenged the idea that seeking help is a sign of weakness. In their results, researchers said improved attitudes were particularly notable among men older than 23 years old who make less than $20,000 a year.

Mahalik’s research suggests something similar: that nuanced public health messaging could be the key to untangling men’s health problems. Strategizing on how to get men to wear masks may take further study. Mahalik says he would like to set up another survey that asks men to describe the barriers they see to wearing a mask. Other studies might explore why these men have low confidence in science or less empathy for others. In the meantime, Mahalik says, public health officials should be clear about the downstream benefits of wearing a mask.

“I’d love to get [country singer] Toby Keith doing [public service announcements] around mask wearing; talking about, I wear a mask all the time and this is important to me because I want to protect my community and I want to get this country open again—I want to see college basketball,” says Mahalik. “I think that’s the messenger, the message, and the kind of normative framework that would go a long way.”