Examining the Role of Traditional Masculinity and Depression in Men's Risk for Contracting COVID-19

Abstract

In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men's health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictions. Furthermore, infection risk and traditional masculinity should be investigated in a differentiated manner including gender role orientation, underlying traditional masculine ideologies and male gender role conflict. In this pre-registered online survey conducted during March/April 2021 in German-speaking countries in Europe, 490 men completed questionnaires regarding contracting COVID-19 as confirmed by a validated test, fear of COVID-19 (FCV-19S), and experience of psychological burden due to COVID-19. In addition, depression symptomatology was assessed by using prototypical internalizing and male-typical externalizing depression symptoms. Furthermore, self-identified masculine gender orientation, endorsement of traditional masculinity ideologies, and gender role conflict were measured. A total of 6.9% of men (n = 34) reported having contracted COVID-19 since the beginning of the pandemic. Group comparisons revealed that men who had contracted COVID-19 exhibited higher overall traditional masculine ideology and gender role conflict. Logistic regression controlling for confounders (age, income, education, and sexual orientation) indicated that only depression symptoms are independently associated with the risk of having contracted COVID-19. While prototypical depression symptoms were negatively associated with the risk of having contracted COVID-19, male-typical externalizing depression symptoms were positively associated with the risk of contracting COVID-19. For traditional masculinity, no robust association for an increased risk of contracting COVID-19 could be established, while higher male-typical externalizing depression symptoms were associated with an increased risk of contracting COVID-19.

Keywords: COVID-19; MDRS-22; depression; traditional male role norms; traditional masculinity.

Figure 1

Flow diagram of the inclusion and exclusion process. Note: N = number of participants.

Figure 2

Mean score comparisons between men with and without COVID-19 infection and their two- and one-sided 95% confidence intervals. Note: ^a PHQ-9 = Patient Health Questionnaire-9; ^b MDRS-22 = Male Depression Risk Scale-22; ^c BSRI (m) = Bem Sex-Role Inventory (masculinity subscale); ^d MRNI = Male Role Norms Inventory (subscales: NT = Negativity toward Sexual Minorities; RE = Restrictive Emotionality; SR = Self-reliance through Mechanical Skills; AF = Avoidance of Femininity; IS = Importance of Sex; D = Dominance; T = Toughness); ^e GRCS = Gender Role Conflict Scale (subscales: SPC = Success, Power, Competition; RE = Restrictive Emotionality; RABBM = Restrictive Affectionate Behavior Between Men; CBWFR = Conflicts Between Work and Leisure–Family Relations); ^f FCV-19S = Fear of COVID-19 Scale; ^g CPSS = COVID-19 Pandemic Stress Scale; * = p < 0.05.

Figure 3

Standardized odds ratios for COVID-19 infection and their two- and one-sided 95% confidence intervals. Note: OR = Odds ratio; ^a PHQ-9 = Patient health Questionnaire-9; ^b MDRS-22 = Male Depression Risk Scale-22; ^c BSRI (m) = Bem Sex-Role Inventory (masculinity subscale); ^d MRNI = Male Role Norms Inventory (subscales: NT = Negativity toward Sexual Minorities; RE = Restrictive Emotionality; SR = Self-reliance through Mechanical Skills; AF = Avoidance of Femininity; IS = Importance of Sex; D = Dominance; T = Toughness; ^e GRCS = Gender Role Conflict Scale (subscales: SPC = Success, Power, Competition; RE = Restrictive Emotionality; RABBM = Restrictive Affectionate Behavior Between Men; CBWFR = Conflicts Between Work and Leisure–Family Relations); ^f FCV-19S = Fear of COVID-19 Scale; ^g CPSS = COVID-19 Pandemic Stress Scale. * = p < 0.05.

Figure 4

(A–C) depict differences in COVID-19 and depression symptoms, fear of COVID-19, and COVID-19 pandemic-related stress between men with low and high traditional masculinity. (A) compares the frequency of reported symptoms by high versus low masculine role orientation. (B) compares the frequency of reported symptoms by high versus low endorsement of traditional masculinity ideologies. (C) compares the frequency of reported symptoms by high versus low gender role conflict. Note: S. = symptoms, mal. = malaise, low/high = below/above the median. ^a PHQ-9 = Patient health Questionnaire-9; ^b MDRS-22 = Male Depression Risk Scale-22; (masculinity subscale); ^d MRNI = Male Role Norms Inventory; ^e GRCS = Gender Role Conflict Scale; ^f FCV-19S = Fear of COVID-19 Scale; ^g CPSS = COVID-19 Pandemic Stress Scale. * = p < 0.05.