It’s all too common of an occurrence with the overwhelming demand for mental health treatment: A woman, unable to find a male psychotherapist for her husband, left me a concerned voicemail inquiring about my availability.
When I finally connected with her spouse directly, it turned out that, much like me, his boyhood had centered around physical competition and the resulting friendships that he’d made. He spent his teenage and young adult years absorbing tackles and relishing in camaraderie as he assembled and disassembled his armor in locker rooms. But in doing so, he’d also buried vibrant parts of himself that were difficult to put into words.
Although this particular version of masculinity may seem like an overgeneralization, countless, diverse variations of my patient exist—humans hungry for deeper self-exploration but waiting for the right conditions to begin.
A commonly cited reason for ending treatment among men is the “lack of connection or understanding with their therapist,” according to one study. Men are less likely to seek therapy and drop out sooner, hindering the effectiveness of treatment. Men may be more likely to consider and then enter treatment if they believe that they belong, and part of that may mean perceiving that a practitioner has also traversed boyhood’s treacherous terrains.
When communicated between men, seemingly banal phrases such as “I hear you, man,” depending on their pitch and intonation, can land like a melody full of meaning. It may directly signal love or be a more subtle nod to the shared experience of enduring play-through-pain cultural programming.
As one of the only men during much of my doctoral training, I often felt like a reluctant ambassador for half of the human population, and it was alienating. It was meaningful to have a male therapist of my own.
The frequent Hollywood portrayals of male psychotherapists seem misleading, as men make up just 24 percent of U.S. therapists. A closer look into the psychology workforce indicates that in 2020, just five percent of psychologists under 30 were male, with 22 percent of this demographic belonging to marginalized racial/ethnic communities.
There’s an even greater need for male psychotherapists of color to reflect more accurately the communities we serve.
Although these numbers improved in 2021, declining male representation in the field is consistent with the trends in other helping professions. What does this underrepresentation indicate for the coming generations in need of care?
The multifaceted roles of male therapists
Viscerally, I understood the thrills and letdowns of my patient’s rough-and-tumble boyhood. A cultural fluency bounced between us. What we seemed to know about one another strengthened our rapport. Yet, my not-knowing stance toward him would set the rest of our work in motion.
Cultural solidarity may help secure a therapeutic alliance, but differences in identity can bring a fresh perspective. Some men understandably may prefer a female or nonbinary therapist, or an individual of a different race, ethnicity, or religion, as it can be a safer haven for unrestrained expression.
Sometimes, male therapists, as emissaries, serve as a corrective experience for women who may have endured negative encounters with men. While male therapists are not superior, they are valuable practitioners and should be an option for prospective patients who deserve choice.
By drawing attention to the shortage of male therapists, my intent is not to undermine the challenges faced by girls and women nor to detract from the needs of other underrepresented groups. It’s to shine a light into an overlooked gap that impacts us all in this age where “American men are in crisis.”
What happened to the male therapists?
Why don’t men want to become therapists when they once did? There seems to be a combination of possible cultural and economic reasons/factors. This is a partial list:
- Socialization to deprioritize feelings and face-to-face sharing; psychotherapy appears soft/weak
- An interest, on average, in things versus people
- Changes in the marketplace and salaries motivated men to pursue other, more lucrative paths
- Loss of perceived prestige
- The cost of higher education combined with incommensurate earning potential
- A lack of exposure to the profession as therapy patients
- A sense that the field has adopted a narrow ideological focus and become “feminized” and unwelcoming
While life coaches and other voices have helped fill this void, “manosphere” grifters emerging from the social media sewers have swooped in, amassing followers by slinging provocative, red-meat misinformation about what it means to be a real man.
As we strive towards gender fairness in America, I hope more men will pursue this profession, which can offer flexible working hours and is endlessly fulfilling. The answers to how to address this shortage in the short term are best for another post. But a long-term, sustainable plan begins with our sons.
We encourage girls to enter STEM fields. We must apply the same efforts toward boys to consider healthcare and education careers.
Lately, I’ve also been thinking about how “interpersonal curiosity”—active listening while maintaining a sense of wonder—plays into this discussion. It’s an under-valued skill, but one that fuels psychotherapists’ everyday relational work. A deep sensitivity to others and the skillset of self-awareness and interpersonal insight aren’t incompatible with being a protector, provider, or competitor; they are just fundamental human skills. We should engender boys with a sense of belonging to this so-called “soft” side and, as young men, help make them more aware of psychotherapy as a viable, purpose-filled career path.
The idea here is not to force our sons into trajectories they have no interest in; it’s to stir their imagination and welcome those who are.
Nevertheless, we are in gifted hands if my colleagues are any indication of psychotherapy’s direction. But as is too often the case across American homes and inside therapy offices: the emotional heavy lifting is shouldered mainly by women.