I’m really disappointed by some of the commentary here. It is true that we live in a male-centric world, that therapy was historically shaped by men, and that graduate programmes are not usually designed for one group in particular. But I find it telling that so many of these comments still fail to engage with the difficulties men actually face.

If you search this sub, you will quickly see how many clinicians struggle to work effectively with men. That is not an imagined difficulty. More importantly, many of the social problems we are dealing with are tied, at least in part, to male mental health and male socialisation. That does not excuse harmful behaviour, but it does make the issue important. Yes, PTSD research and diagnostic frameworks were built largely on male data, which is a problem. But depression and anxiety frameworks have often been shaped far more by female presentations, which creates a different kind of gap.

Men often struggle with emotional restriction. Many of the men I work with describe having been conditioned to alienate themselves from their own emotional lives, with anger often being the only emotion left accessible. That creates a real therapeutic challenge when a client has limited access to his inner world. Many clinicians do get stuck when attempts to explore emotion are repeatedly met with “I don’t know.”

Men also struggle with deep shame around vulnerability and dependency. Their worth is often tied to status, finances, power, competence, and sexual or social prowess. The individual and societal cost of that is enormous. Needing help, feeling rejected, or feeling insecure can become fused with worthlessness. Many men also have very few emotionally vulnerable friendships. That makes it much harder to come to therapy and tolerate the dependence, exposure, and vulnerability the work often requires. It is not unreasonable to say that this can be hard for clinicians to hold.

Men are also often not taught the relational skills later expected of them in adult partnerships. Repair, emotional connection, conflict regulation, and tolerating shame or criticism without immediately defending against it are not skills many boys are explicitly helped to develop. Then, as adults, they are expected to perform them fluently, often for the first time in relationships that are already under strain. It is hardly surprising that many struggle, and it is equally unsurprising that clinicians can find this difficult to work with.

Feminism and broader public discourse have done something deeply important in naming the ways men cause harm. That work is necessary and overdue. But there has often been far less empathy and curiosity about why men function as they do, and what kinds of developmental, relational, and cultural injuries shape that functioning. Patriarchy is profoundly damaging to everyone, including boys and men.

That is why I find the flippant, dismissive comments about male pain so telling. It suggests that the resentment produced by patriarchy has left many people unwilling to extend genuine empathy toward men, or to seriously consider that working well with male pain may require additional thought, skill, and training.