Two years after the November 2016 earthquake that tore through Kaikōura and the Waiau valley, Ashleigh Rushton and colleagues at Massey University sat down with 19 men from the rural districts the quake had hit, 17 of them Pākehā. The men still became emotional when they talked about it. They also worked, in the interview itself, at not being. The paper the researchers wrote is named for the phrase the men reached for: she’ll be right. Two years on, the distress was there in the room, and the men were spending effort keeping it out of their faces.
The American psychologist Ronald Levant has a name for what those men were doing, and he has spent thirty years testing it. He calls it normative male alexithymia.
What normative male alexithymia is
Normative male alexithymia is Levant’s term for a mild, common difficulty many men have in putting feelings into words, which he traces to being raised as a boy under a code that treats sadness, fear and tenderness as failures of manhood. Alexithymia on its own is a clinical trait, measured by questionnaire, made up of trouble identifying feelings, trouble describing them and a habit of attending to the external world rather than the internal one (what is alexithymia). Levant’s claim, set out in the early 1990s and restated in a 2011 review for the American Psychologist, is that a subclinical version of this is the ordinary product of male socialisation, which is why he calls it normative.
He and colleagues built a questionnaire for it in 2006, and in 2018 Levant and Mike Parent cut it to six items, tested on 505 American men recruited online. The short scale correlates moderately with the standard clinical measure, the Toronto Alexithymia Scale. It also predicts restrictive emotionality, the masculine norm of keeping feeling in, beyond what the Toronto scale predicts. Whatever the Levant scale is picking up, it is not quite the same thing as not knowing what you feel.
Men score higher, by a little
In 2009 Levant and colleagues pooled 41 samples and found men scored higher on alexithymia than women, with a small effect, d = 0.22. In 2024 Jara Mendia and a team at the University of the Basque Country updated the analysis with 120 studies published between 2004 and 2023, 145 samples and 88,721 people, and found the overall gap had not moved: d = 0.22 again. A difference that size means the two distributions mostly sit on top of each other. Most men score like most women. The gap widened to a medium effect in one place, externally oriented thinking, the habit of looking outward. And on one dimension the sign reversed. On difficulty identifying feelings, women reported more trouble than men.
The Finnish population study that fixed the prevalence figures had found the same shape twenty-five years earlier. In a sample of 1,285 adults, men were classed as alexithymic almost twice as often as women, 17 per cent against 10. But the difference lay in describing feelings and in externally oriented thinking. On difficulty identifying feelings there was no sex difference at all. The Finnish men were not worse than the women at knowing what they felt. They were worse at saying it, and more inclined to look somewhere else.
Where the training was supposed to happen
Levant’s explanation for the gap is upbringing, and for a long time the evidence for it was a set of small American studies of young children. In 1992 Janet Kuebli and Robyn Fivush visited 24 white, middle-class families and recorded each parent talking with their 40-month-old child about things they had done together. Mothers and fathers talked about emotion in similar ways, but both used more emotion words, and more varied ones, with daughters than with sons, and both brought up the sad parts of events more often with girls. A longitudinal study of 17 families from the same group found no difference between the children at 40 months, and by 70 months the girls were using more distinct emotion words than the boys. The account built on those studies was that the words are handed to daughters and withheld from sons, and the sons grow into men without them.
Larger pools of data do not show it. In 2019 Ana Aznar and Harriet Tenenbaum pooled the studies that compared mothers’ emotion talk with sons and with daughters, 34 samples and 3,649 participants, and found no difference. The effect was d = 0.04. Mothers, on the pooled data, talk about feelings with boys about as much as they do with girls.
And the children themselves, when watched rather than asked about, differ less than the stereotype says. Tara Chaplin and Amelia Aldao’s 2013 meta-analysis of 166 studies and 21,709 children from infancy to adolescence found gender differences in emotional expression that were significant but very small: girls showing slightly more positive emotion and slightly more sadness and anxiety, boys slightly more anger. The detail that matters is where the differences showed. They grew with age. They were smaller when the child was with a parent, and larger with unfamiliar adults and with peers, or when the child was alone.
On those three results, whatever a boy is taught about his face is taught mostly away from his parents, and over years. Jo River and Michael Flood heard the same thing from the other end of a life. In 2021 they published life-history interviews with 18 Australian men who had attempted suicide. The men had felt the full range. What they had learned as boys was that showing sadness cost masculine standing, and that showing anger, through violence, could raise it.
The word is there
Alexithymia means, from the Greek, no words for feeling. The experiments that get closest to the men in question suggest the words are present.
In 1998 Ann Kring and Albert Gordon at Vanderbilt showed undergraduates emotional films and measured three things: what their faces did, what they said they felt, and what their skin conductance did. The women were more expressive. On how much they felt, the men and women reported the same. The physiology differed in pattern rather than in amount. The difference was in the showing, not the having.
Levant himself ran the sharper test. In 2014 he, Philip Allen and Mei-Ching Lien gave 85 college men a lexical decision task, in which a word flashes and you say as fast as you can whether it is a real word. Men who scored high on alexithymia made more errors on emotion words that masculine norms discourage, words for vulnerability and attachment, and no more errors than other men on emotion words the norms permit. The disruption appeared when the word had been on screen for 500 milliseconds, which the authors note is slow enough for conscious processing. A word a man had not learned would fail at any speed. These failed once there was time to notice what they were.
Their reading, from that and from a companion survey of 258 men, is that the mechanism is suppression rather than repression. The feeling is registered and the word for it arrives, and it is stopped after that, fast enough to look like absence from the outside, and after enough years from the inside too.
What it costs, and whose masculinity this is
The cost has been measured in Australian men more carefully than almost anywhere. The Australian Longitudinal Study on Male Health, Ten to Men, enrolled more than 14,000 men and boys in 2013 and 2014 and has been following them since. In the baseline data, Jane Pirkis and colleagues found that of all the masculine norms measured, self-reliance stood out as a risk factor for suicidal thinking, with the odds raised by a third after other predictors were controlled. In 2024 Ruben Benakovic and colleagues used two waves of the same cohort, 8,214 men, and found that men in the high-conformity group for emotional control at the first wave had higher odds of suicidal ideation at the second. Danielle Herreen’s analysis of the same cohort found conformity to masculine norms falls with age, but that among the men who keep it, it is most strongly tied to current depressive symptoms in the oldest group, the 51 to 55 year olds.
But the thing being described is one culture’s masculinity, not men as such. Levant’s own data make the point. In 2013 he and Joel Wong reanalysed a sample of 1,127 Americans, Black, Latino and White, and found that the link between endorsing traditional masculine ideology and alexithymia was stronger for White men than for Black and Latino men. The same beliefs about what a man is did not have the same grip on all who held them.
Aotearoa carries that contrast inside one country. Rushton’s men were raised on she’ll be right. The Tangi Research Programme at the University of Waikato, co-led by Linda Nikora, describes tangihanga as the ultimate form of Māori cultural expression, and the word itself, tangi, means to weep, to grieve and mourn. A boy raised inside that rite and a boy raised on she’ll be right are not being given the same instruction about what a man’s face is for, and the research on normative male alexithymia has almost entirely been done on the second boy.
What is settled, and what is not
Men score a little higher than women on alexithymia questionnaires, and the gap has been stable for twenty years. It lies in describing feelings and in looking away from them, not in identifying them. Men report feeling as much as women and show less. The learning does not seem to happen through parents talking less about feelings with sons; the pooled data show no such difference. In the largest male cohort in this part of the world, emotional control and self-reliance predict later suicidal thinking.
What is not settled is whether alexithymia is the right word. Levant’s term says the man has no words. His own lexical task says the man has them and stops them. The Kaikōura interviews say he spends effort doing it, two years on, in front of a stranger with a recorder. None of these studies measures what it is like to carry a feeling that has been named inside and not said, across a working life, or what that does over time to the naming itself.
FAQ
What is normative male alexithymia?
It is Ronald Levant’s term for a mild, widespread difficulty that many men have in putting feelings into words, which he attributes to being raised under masculine norms that discourage expressing sadness, fear and tenderness. It is called normative because Levant treats it as the ordinary result of male socialisation rather than a disorder. He and colleagues built a questionnaire for it, the Normative Male Alexithymia Scale, with a six-item short form published in 2018.
Is normative male alexithymia the same as alexithymia?
No. Clinical alexithymia is a personality trait measured by the Toronto Alexithymia Scale, covering difficulty identifying feelings, difficulty describing them and an externally oriented thinking style. Levant’s scale correlates moderately with the Toronto scale but predicts restrictive emotionality beyond it, which suggests it captures something more like a learned reluctance to express than an inability to feel.
Do men feel less emotion than women?
The evidence says no. In laboratory studies where men and women watch the same emotional films, women show more on their faces but the two groups report feeling the same amount. Men score higher on alexithymia questionnaires on average, but the gap is small and lies mainly in describing feelings and in attending to them, not in identifying them. A Finnish population study found no sex difference at all on difficulty identifying feelings.
Do parents talk about feelings less with boys?
Early American studies of a few dozen families found parents used more and more varied emotion words with daughters. A 2019 meta-analysis pooling 34 samples and 3,649 participants found no difference in how much mothers talk about emotion with sons versus daughters. A separate meta-analysis of 166 studies found that gender differences in children’s emotional expression are very small, grow with age, and are smaller with parents than with peers and unfamiliar adults.
If this is the kind of thinking that doesn't leave when the tab closes.
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