The American Psychological  Association released its guidelines for psychological practice with boys and men in August of 2018. It seems to have taken a while for these guidelines to trickle down to the lay press. Since the document (it’s below this piece) is more of a political statement than a therapeutic one it’s had the predictable effect of alienating about half the population that’s read or heard of it. Given its dense and cliché laden prose, I suspect that few who’ve opined about the guidelines have actually read them all the way through. But I have and here’s my take on them. First a few preliminary comments.

In about 50 years of clinical practice, I can’t recall ever referring a patient (the APA calls them ‘clients’) to a clinical psychologist. I asked a former colleague if they (I’m being very woke about pronouns) had ever referred a patient to a clinical psychologist. Again the answer was no. There is a tension between medical practitioners and clinical psychologists that you likely already perceive. The later feeling that they are condescended to by the former, when the truth is that they are being ignored. I must confess, however, that are some in the profession with good judgment and professional acumen. I suspect that representatives from this minority were uninvolved with the preparation of these guidelines.

The APA document starts with the assumption that masculinity is a problem. It then goes on with mind numbing repetition to make the same points over and over again. See it’s even got me repeating myself. When you read about ‘power’, ‘privilege’, ‘patriarchal society’ on almost every page you can tell the politics of the the authors of this screed. There’s even a reference to ‘social justice’ that sneaked in. The Nation could just as easily have written these guidelines, though the prose would have been better.

Basically the guidelines are an ad promoting the services of those who wrote it. If you’re a boy or a man, live with a boy or a man, think you’re a boy or a man, interact with a boy or a man, treat a boy or a man you’d better head straight for the nearest clinical psychologist and get yourself straightened out because you are a victim of gender bias. There’s so much focus on gay/lesbian/bisexual/transgender ‘clients’ that you’d think they constitute more than half the population rather than the approximately 2% that they number. Much of the lay population thinks their number is much closer to 50% rather than 2%.

The APA makes such strikingly unoriginal observations that men are more violent than women, that they are more likely to be in prison, and that better educated males make more money. Who knew? But they did get my attention when they discussed postpartum depression in fathers. The entire document makes no distinction between associations and causation.

Then they’ll throw this at you: “Boys and men have been the focus of psychological research and practice as a normative referent for behavior rather than as gendered human beings.” And there’s my favorite, “Further, psychologists may utilize available assessment instruments to help boys and men discover the benefits and costs of their gendered social learning (Mahalik, Talmadge, Locke,& Scott, 2005), such as the Male Role Attitudes Scale (Pleck et al., 1994), the Male Role Norms Inventory, Short Form (Levant, Hall, & Rankin, 2013), and the Conformity to Masculine Norms Inventory (Mahalik et al., 2003), as well as measures of gender role conflict (O’Neil, Helms, Gable, David, & Wrightsman, 1986), gender role stress (Eisler & Skidmore, 1987), and normative male alexithymia (Levant et al., 2006).” If ‘alexithymia’ is not on the tip of your tongue, look it up.

These sound like sentences from one of those made up papers that were sent to journals that were once on the fringe of academia, but now are likely to be seen as mainstream.  In its continuing dissection of masculinity the guidelines observe that “ideal dominant masculinity is generally unattainable for most men.” Isn’t such the case with any ideal? That’s not an argument against trying to be better.

Basically, if there’s anything useful in this document it’s that people should be treated with decency and respect and that none of us is immune to some bias or other against which we should always be on guard. Clinicians of whatever stripe should do their absolute best irrespective of whom they are treating. But we already knew that.

Most of what clinical psychologists treat can easily be handled by the well trained general pediatrician or internist along with a social worker. The really serious mental problems will be referred to a psychiatrist. These guidelines are little more than an attempt to maintain the income of a superfluous profession. I’d certainly be reluctant to trust anybody’s deranged psyche to someone who believes the nonsense that permeates all of these guidelines. Furthermore, they are yet another attempt to medicalize the serious issues and problems that characterize human interactions.

This document is a relatively mild expression of the insanity about sex that seems to have possessed close to half the US population. We are faced with a new form of the emperor’s new clothes. We have seemingly millions of people proclaiming their sexual practices either to a lot of other people who don’t want to hear about them or to those who lack any sense of the ridiculous. If departing from usual practices is acceptable it certainly is no more a marker of virtue than is not doing so. Men can have their jiggly bits cut off and walk around in dresses if they please, but when the California State Senate bans ‘he’ and ‘she’ (OK it’s just a committee) perhaps we should reconsider where we are and how we got here. In a world full or war, famine, pestilence, and death perhaps we should consider that toxic masculinity (the APA seems to think all forms of masculinity toxic) and pronouns are at the bottom of the list of our problems. Man up!

As already mentioned the complete guidelines are below. Be warned getting through them is a slog.

APA GUIDELINES for Dealing with Boys and Men