Macho, macho man: Masculinity is a major risk factor for COVID-19

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Doctor holding a large syringe aimed at Earth
World COVID-19 vaccine image by Alexandra Koch

Study shows “completely masculine” men more resistant to masks and a vaccine

HEALTH letters on a rainbow backround

Men are more skeptical than women about COVID-19 vaccines and wearing facemasks. But the real divide that threatens a “new normal” by late summer is between men who are trying to project masculinity and the men who aren’t. Men who assert a traditionally masculine gender identity are less likely to say that they’ll get the COVID-19 vaccine according to a new study at Fairleigh Dickenson University.

The data study shows more masculine men are likely to say that a vaccine may have side effects and are more resistant to wearing face masks for protection. They are also more likely to say they have been diagnosed with COVID-19.

“Men’s attempts to demonstrate what they believe to be masculine behavior may be holding back the country’s response to the COVID-19 pandemic,” said Dan Cassino, a professor at Fairleigh Dickinson University who studies masculinity, and the Director of the FDU Poll.  “Many men think that being tough is part of being masculine. That means not wearing a mask, or getting a vaccine. It means they figure they’ll be tough enough to survive COVID anyway.”

Resistance to measures designed to limit the spread of the virus leaves these men at greater risk for contracting it. Men who assert a “completely masculine” gender are more likely to report having been diagnosed with the COVID-19 virus recently: 2.2 percent of them say that they’ve been diagnosed, compared with 0.8 percent of other men. About 1.4 percent of women, across gender categories, say that they’ve recently been diagnosed with the virus.

Anonymous survey graphicAlthough the difference is rather small, the large sample size of the survey and the closeness of the figures to zero means that the difference is well within the normal range of statistical significance given a sample of over 6,000 respondents. Some individuals reported being unsure if they had been diagnosed or not, and were excluded from the analysis. If those individuals are included, 2.2 percent of “completely masculine” men say that they’ve been diagnosed, compared with 0.7 percent of other men. This figure also does not include individuals who may have been infected but didn’t see a medical professional.

“More masculine” men are three times as likely to report having been diagnosed with COVID-19

Put another way, men who are trying to assert their masculinity are just shy of three times as likely to report having been diagnosed with COVID-19. The results are not a problem of men bragging or over-reporting, says Cassino. “If anything, we’d guess that men concerned with their masculinity are less likely to see a doctor, so this is a real difference, rather than just a difference in reporting,” said Cassino.

“We can’t exclude the possibility that men are over-reporting having been diagnosed, but the results line up with all of the reported high-risk behaviors in this group. Trying to be macho has real consequences for some men,” said Cassino.

Respondents in the study were asked to place their gender identity on a six-point scale from “completely masculine” to “completely feminine.” About two-thirds of U.S. men (68 percent) place themselves as “completely masculine,” compared with 57 percent of women who say that they’re “completely feminine.”

Only about four percent of men say that they’re “feminine,” while eight percent of women call themselves “masculine.” Past research has shown this to be strongly related to age and religious views among men.

Those men who assert that they’re “completely masculine” are more likely than other men to express skepticism about Coronavirus vaccines and are less likely to say that they’ll take the vaccine. Thus, 21 percent of men who assert a “completely masculine” gender identity say that they’re “very unlikely” to get a coronavirus vaccination when it becomes available to them, compared with 17 percent of other men. And another key is this group is three times more likely to get COVID-19.

Other vaccine studies with the LGBTQ community are here.

“The idea here is that if you’re strong enough, you don’t need to take vaccines,” said Cassino. “For these men, saying that you don’t want to take preventative measures is a way of showing strength.”

Justifying reluctance to get the vaccine means that “masculine” men are more likely to say that vaccines are actually a bad thing. On average, men who insist on a “completely masculine” gender identity say that there’s a 22 percent chance that the vaccine will cause serious side effects, compared with 19 percent of other men. It’s no surprise, then, that 34 percent of them agree with a statement that COVID-19 vaccines have many harmful known side effects, compared to 27 percent of other men.

Reticence to embrace measures intended to limit the spread of COVID-19 extends past vaccine skepticism. Ten percent of “completely masculine” men said wearing a face mask is dangerous to the health of the wearer, compared to just six percent of other men. Seventeen percent of those men agree that masks are too uncomfortable to wear, compared with 13 percent of other men. They’re also resistant to the idea that they could be forced to wear a mask: 24 percent of them agree with the statement, “We live in a free country, and no one can force me to wear a mask,” compared with 17 percent of other men, and 18 percent of the overall population.

“Refusing to wear a mask is a public way for men to show how tough they are.”

“Refusing to wear a mask is a public way for men to show how tough they are,” said Cassino. “Unlike a vaccine, the absent mask is a visible symbol of your beliefs, a way to signal to everyone around you that you don’t need to take preventative measures.”

The same factors that lead men to avoid masks in an attempt to assert their masculinity also leads them to ignore other behaviors recommended by public health authorities. Forty-three percent of “completely masculine” men say that they’ve had visitors over at their residence recently, compared with 36 percent of other men. Sixteen percent say that they’ve attended a gathering of 10 or more people, compared with 10 percent of other men, and 11 percent of the overall population.

The analysis described here relies on data from surveys administered by the Understanding America Study, https://uasdata.usc.edu/index.php.  which is maintained by the Center for Economic and Social Research at the University of Southern California. The FDU Poll questions were included in the survey. Results are based on a sample size of 6,179, surveyed between Jan. 6 and Feb. 1, 2021.

The press release is here.