Blog · 2026-09-30
Can Calling Masculinity "Toxic" Keep Men Out of CBT?
Yes. When therapy treats traditional masculinity itself as the problem, many men feel judged before they are helped. Christopher J. Ferguson’s 2026 review in Current Opinion in Psychology argues that framing masculinity as “toxic” can stigmatize men, weaken trust in care, and lead some men who would benefit from cognitive behavioral therapy (CBT) to stay away.
I see that tension in my work. I am Travis Hill, LPC-MHSP, at Navigate Life Counseling in Franklin, Tennessee. I work with adults on anger, anxiety, and relationships. I use CBT and mindfulness-based approaches. Harmful behavior is real. It is treatable. But treating manhood itself as a disease can shut the door on men who need skills—without shame.
This post summarizes Ferguson’s review for a general audience. I stay close to what the paper says, then share how those ideas land in the therapy room.
What Ferguson’s Review Covers
Ferguson, C.J. (2026). Toxic/problematic masculinity: A critical appraisal of its role in CBT. Current Opinion in Psychology, 70, 102308. https://doi.org/10.1016/j.copsyc.2026.102308
In August 2018, the American Psychological Association (APA) released practice guidelines for psychological practice with boys and men. Ferguson argues those guidelines overstated weak, mostly correlational evidence; used disparaging language toward traditional masculinity; and often treated challenging traditional masculine worldviews as a therapy goal—regardless of why the patient came. He contrasts that with British Psychological Society (BPS) guidance, which he describes as more positive and nuanced toward masculinity and more careful about how traditional men and families are described.
His larger concern matches the title: Portraying traditional masculinity as “toxic” is likely to cause harm—stigmatizing many men and their families, and reducing trust in the profession. As a result, many men who would have benefited from CBT may decline to get it. He also points toward a path that does not treat men’s issues and women’s issues as a zero-sum game.
The Field Has Shifted—Cultural Awareness Must Run Both Ways
Ferguson notes that therapy has become more female. Citing APA data, he reports that women have accounted for about three-fourths of new doctorates in psychology since at least 2011. He is not saying patients and therapists must match on gender. He is saying cultural awareness—long taught in CBT training—has to run both ways.
Good therapists notice when their own background and beliefs differ from a client’s. That includes male therapists working with women, and women working with men. When most new clinicians are women, Ferguson argues, there can be unintended extra pressure on male patients if their values are treated as outdated or inferior rather than understood.
He also cites Knox and colleagues: in recent clinical trials of psychotherapy or behavioral interventions for depression, men appear underrepresented. And he cites Barry (2023): the belief that masculinity has a negative influence on one’s behavior is related to reduced mental well-being. In plain terms, when men absorb the idea that masculinity itself is the problem, that belief can track with feeling worse—not better.
When “Toxic Masculinity” Gets Vague
Ferguson does not deny real harm. Violence, harassment, and other antisocial acts deserve clear condemnation. The problem, he writes, is that “toxic masculinity” is often vague. Commentators sometimes lump obviously harmful acts together with neutral or positive traits—stoicism, courage, protecting others, or simply preferring action over public emotion.
Both “toxic” and “traditional” masculinity, he notes, are often poorly defined and used as if they mean the same thing. When “traditional” gets defined only by its worst examples, positive traits get ignored or reframed as defects. Over time, that kind of language can feel anti-male to the people it is supposed to help—and can backfire as a public message about seeking care.
I hear versions of that barrier in the room. A man walks in already braced for blame. He expects to hear that his strength, drive, preference for action over talk, or way of protecting his family is the root problem. Sometimes he has read that “toxic masculinity” explains him. When trust drops, CBT gets harder. CBT asks people to examine thoughts and try new behaviors. That work needs a working alliance. If he believes the therapist sees his manhood as the enemy, he may cancel, never schedule, or sit and perform agreement while nothing real changes.
Name Specific Harmful Behaviors—Don’t Try to “Fix” Masculinity
Ferguson’s practical path is clear. Instead of disparaging masculinity as a whole, identify specific harmful behaviors—assaultive or antisocial acts, sexual harassment, prejudice, and other patterns that get in the way of the patient’s legitimate goals. Many of those behaviors are not exclusive to men, and they are not a required package deal with traditional values.
He argues that trying to “fix” masculinity as a therapy goal is unlikely to help. Broad sociopolitical remakes of manhood are a poor fit for CBT. Narrow, clearly defined behaviors that conflict with the patient’s own wellness goals are a better target.
That matches how I work. Target behavior, not identity. We talk about what you do when you are flooded. We talk about what you tell yourself before you explode or shut down. We practice other options. We do not start from “your masculinity is toxic.”
What Ethical CBT With Men Looks Like (In Plain Words)
Ferguson offers several suggestions for CBT with men and boys. Here is how I would put them in everyday clinical language.
Leave therapist politics at the door. CBT works best as skills care, not as a lecture on the therapist’s worldview. The primary goal is evidence-based help for this patient’s goals and health.
Patient goals first. If a thought is causing distress—for example, “I am not a real man unless I’m physically aggressive”—cognitive restructuring can be a good fit. Ferguson uses that kind of example. The key is that the work is directed by the patient’s needs, not by the therapist’s private vision of “healthy masculinity.”
Protect the therapeutic alliance. Keep one foot in the patient’s world and one foot in careful clinical judgment. Pushing a sociopolitical agenda that the patient does not share can break the alliance CBT needs to work.
Use evidence-based CBT skills. Behavioral activation, cognitive restructuring, and problem-solving are the kinds of tools Ferguson highlights. Trim practices that are not empirically supported.
Respect traditional and non-traditional men without a zero-sum frame. Supporting gay men, trans men, men with more feminine traits, or men who hold progressive values does not require disparaging traditional men. Respect is not a pie that runs out. Men should have freedom to express masculinity in ways that fit them—without being forced into either a rigid old script or a progressive new one.
Harmful Patterns Are Real—and Treatable
Let me say this plainly so no one hears the wrong message.
Some men struggle with rage, control, emotional shutdown, or ways of relating that hurt partners and kids. Those patterns matter. They can wreck relationships and health. In therapy, we name them and work on them. CBT fits: notice the thought, check the feeling, choose a better action.
I do not soft-pedal harm. Clients come because something is not working—anger that scares the people they love, anxiety that isolates them, relationship habits that keep repeating. My job is to help them build skills, not to lecture them about who they are allowed to be as men.
Many men value responsibility, protection, competence, and steadiness. Those values can support change. They can become reasons to learn better skills for the people they love. Reframing values is different from shaming identity.
Women’s Care and Men’s Care Are Not Opposites
Ferguson’s closing point is one I share. The welfare of men and women, traditional and non-traditional, need not be in competition. Good intentions to address women’s issues matter. Women deserve competent, respectful care. Insight about power, safety, and fairness in relationships has helped many therapists do better work.
What does not help is turning therapy into a culture-war rant—or treating men’s help-seeking as optional. Helping a man regulate anger does not take anything from women. Helping a woman set boundaries does not require pathologizing masculinity as a whole. Relationship work often improves when both people get tools.
Adults in my office get respect, clarity, and practical work. No slogan wars. No zero-sum scorekeeping.
Bottom Line
Calling traditional masculinity “toxic” may keep some men out of CBT—not because they refuse growth, but because they hear judgment of who they are rather than an offer of skills for what they do. Ferguson’s 2026 review raises that concern with attention to the APA’s 2018 boys-and-men guidelines, the gender shift in the profession, gaps in research samples, and the vagueness of “toxic masculinity” language. In my room in Franklin, I take it as a reminder: name specific harmful behaviors tied to the patient’s goals. Use CBT skills. Leave politics at the door. Respect men across backgrounds. Women’s care and men’s care are not a zero-sum game.
If you are an adult in the Franklin, Tennessee area and want practical CBT-informed work on anger, anxiety, or relationships, learn more about Navigate Life Counseling. Therapy is collaborative. Results vary. This article is education, not personal advice or a clinical assessment.
Sources
This post summarizes Ferguson’s review for a general audience; it is not a substitute for reading the paper.
Ferguson, C.J. (2026). Toxic/problematic masculinity: A critical appraisal of its role in CBT. Current Opinion in Psychology, 70, 102308. https://doi.org/10.1016/j.copsyc.2026.102308
ScienceDirect: https://www.sciencedirect.com/science/article/pii/S2352250X26000448
Last updated: September 30, 2026 (CT).
Related at Navigate Life Counseling: cognitive-behavioral therapy for anger management, anxiety counseling in Franklin, TN, and individual relationship counseling.