Male gender expression in schools is associated with substance abuse later in life

A new study led by researchers at the University of Chicago found that changes in male gender expression from adolescence to young adulthood align closely with the gender norms present in individuals’ school environments, and that these trajectories are associated with subsequent patterns of substance abuse.

Amidst a growing consensus among social science researchers that separates gender from biological sex, gender has come to be defined as a constellation of expected behaviors, attributes, preferences and beliefs typically associated with a specific gender identity. Prior research shows that traditional models of male gender identity, constructed over time through sociocultural processes and interactions, can be a risk factor for unhealthy behaviors.

With that background, the UChicago researchers set out to explore how sociocultural pressures around male gender in particular might evolve in relation to environmental factors, and how that change could impact a person's long-term health in specific ways.

“There’s a real misconception that men aren’t particularly sensitive or emotional,” said Nathaniel Glasser, MD, a general internist and pediatrician at UChicago Medicine and lead author on the paper. “In reality, I think men’s emotions simply present differently because of the impact of sociocultural narratives telling them not to express emotions through tears or words that construe weakness. And they can face especially harsh social and psychological penalties if they fail to live up to the norms of their gender identity.”

“We set out to investigate how that often-overlooked sensitivity among cisgender men might manifest in a reluctance to engage in healthy behaviors, as well as an over-engagement in health risk behaviors in an effort to convey dominance and reduce vulnerability,” Glasser said.

The researchers found that the way adolescent boys at a school are enacting their gender has a significant impact on other males who attend that school, shaping the ways those same males respond to sociocultural pressures around male gender as young adults. That in turn predicts their likelihood of engaging in substance abuse.

Adolescent boys whose gender expression was further from their school’s norm showed the greatest change in their gender expression as young adults, shifting toward that local norm of their school. Those who displayed the greatest changes were also the most likely to abuse substances including alcohol, cigarettes, marijuana and recreational drugs as young adults.

Reference: Male gender expression in schools is associated with substance abuse later in life; Journal of Adolescent Health, DOI: 10.1016/j.jadohealth.2023.11.018