Manly Men Beware

March 3, 2020

High traditional masculinity (HTM) men are more likely to die by suicide than non-HTM men, but they are less likely to report suicide ideation.

The National Longitudinal Study of Adolescent to Adult Health (Add Health), was started in 1994.1 US adolescents in grades 7 to 12 were asked to complete a detailed survey. Subsequent data collection has traced the adolescents to their late 30s and 40s. Findings indicate that the incidence of dying by suicide is 3.5-fold higher in men than in women.2 This disparity may be due to high traditional masculinity (HTM), which includes competitiveness, emotional restriction, and aggression.3

Using Add Health data from a previous study that had identified 9 variables associated with suicide,4 Coleman and colleagues3 undertook a secondary study to determine the role of HTM in suicide. The risk factors included suicide by a family member, being expelled from school, running away from home, using a weapon, being of white race, etc. Their analysis showed a substantial association between HTM and the 9 factors; suicide by a family member had the strongest correlation.

There had been 22 completed suicides; of which 21 were men. Moreover, HTM men were 2.4 times more likely to die by suicide than non-HTM men, but they were 1.45 times less likely to report suicide ideation. The HTM men were also more likely to report gun access and had lower depression levels. The researchers concluded that: “In male suicide death, HTM may be an underlying influence increasing the probability of externalizing behavior risk factors, such as anger, violence, gun access, and school problems.”5


1. RTI International. The National Longitudinal Study of Adolescent to Adult Health.
2. Hedegaard H, Curtin SC, Warner M. Suicide Mortality in the United States, 1999-2017. Atlanta GA: Centers for Disease Control and Prevention; 2018.
3. Coleman D. Traditional masculinity as a risk factor for suicidal ideation: cross-sectional and prospective evidence from a study of young adults. Arch Suicide Res. 2015;19:366-384.
4. Feigelman W, Joiner T, Rosen Z, Silva C. Investigating correlates of suicide among male youth: questioning the close affinity between suicide attempts and deaths. Suicide Life Threat Behav. 2016;46:191-205.
5. Coleman D, Feigelman W, Rosen Z. Association of hight traditional masculinity and risk of suicide death: secondary analysis of the Add Health Survey. JAMA Psychiatry. February 2020; Epub ahead of print.