High levels of masculinity linked to increased suicide risk

Daniel Coleman

Researchers have found that high traditional masculinity, or HTM, is associated with risk for death by suicide among men, according to study findings published in JAMA Psychiatry.

“Although HTM has been discussed as a potential risk factor for suicide, this is the first evidence that it is associated with suicide," Daniel Coleman, PhD, of the Graduate School of Social Service at Fordham University in New York, told Healio Psychiatry. "Further, it was associated with all the other risk factors for death by suicide, suggesting it may be an underlying risk for multiple pathways to death by suicide."

According to the researchers, men die by suicide 3.5 times more often than women. Thus, they examined the role of HTM — a set of norms including emotional restriction, aggressiveness and competitiveness — as a potential driver of this gender disparity. To do so, they conducted a secondary analysis of data from a nationally representative study of adolescents into adulthood called the Add Health Study. This study began with 20,745 adolescents in 1995. In 2014, researchers matched it with death records using the National Death Index. They used a method novel to suicide research to replicate an established procedure for scoring gender-typed behaviors and attitudes in which one latent probability variable of identifying as male was generated from 16 gender-discriminating variables. These included physically fit, not crying, not emotional, not moody, risk taking, fighting and liking yourself. Those who scored 73% probability or higher for identifying as male were coded as HTM.

In their analysis of this prior research, Coleman and colleagues found that of 22 suicide deaths, 21 were men (OR = 21.7; 95% CI, 2.9-161). Men coded as HTM were 2.4 times more likely to die by suicide than those without this designation; however, they found no association between HTM and suicide attempts. Further, those in the HTM group were slightly more likely to report easy gun access (OR = 1.1; 95% CI, 1.01-1.2) and had modestly lower depression levels.

“In male suicide death, HTM may be an underlying influence increasing the probability of externalizing behavior risk factors, such as anger, violence, gun access and school problems,” the researchers wrote. “The finding that almost all suicide decedents were men underlines the central role of gender in suicide death.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.