Performing Strength: Racialized Masculinity in the Lived Experiences of Black Men at Risk of Suicide

Abstract

Suicide rates among Black men in the United States have increased significantly in recent decades, yet limited research explores how intersecting systems of oppression contribute to this trend. This study examines how racial identity and gender norms intersect to shape suicide risk among Black men with lived experiences of suicidal thoughts and behaviors. We conducted semi-structured qualitative interviews with Black adult men (n = 15) in Maryland who had a history of suicidal ideation or behavior from February 2022 to October 2023. Using thematic analysis and an intersectional framework, we explored how racialized masculinity, public and private regard, and cultural norms around emotional expression influence mental health and help-seeking. Participants described navigating a racialized ideal of masculinity that emphasized toughness, emotional suppression, and self-reliance. These expectations, compounded by systemic racism and internalized stigma, created barriers to vulnerability and support-seeking in moments of crisis. Racial identity, particularly public regard and centrality, shaped how men internalized and performed masculine roles. Many reported gender role stress resulting from the conflict between emotional needs and societal demands, which contributed to isolation and elevated suicide risk. Our study results emphasize the importance of enacting gendered and culturally responsive approaches to suicide prevention efforts. These efforts should also acknowledge and mitigate the compounded effects of racial oppression and gender expectations.

Introduction

Suicide is a major public health crisis in the United States and one of the leading causes of preventable, premature death globally. Alarmingly, in recent decades, suicide rates among Black Americans have significantly increased, emerging as a hidden and largely unaddressed epidemic (Cubbage & Adams, 2023; Emergency Task Force on Black Youth Suicide and Mental Health, 2018; Joe et al., 2006; Lindsey et al., 2019; Sheftall et al., 2022). Although the overall suicide rate among Black Americans (8.80 per 100,000) remains lower than that of other racial groups, it has steadily increased annually (Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control, National Center for Injury Prevention and Control, 2023; Ramchand et al., 2021). This trend is particularly concerning among Black men (Adams & Thorpe, 2023). Suicide rates among Black adult men increased by approximately 26% between 2018 and 2023, rising from 14.92 to 18.82 deaths per 100,000, and making suicide the third leading cause of death for Black young adult men (Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control, National Center for Injury Prevention and Control, 2023; Gordon et al., 2020; Lindsey et al., 2019). This concerning rise highlights an urgent need to examine the unique social and structural forces shaping mental health in this population (Johnson et al., 2024).

Emerging research identifies racism and rigid gender norms as key contributors to emotional distress and suicidality among Black boys and men (Adams et al., 2025; Coleman, 2015; Lateef et al., 2025; Pirkis et al., 2017). Black men often navigate a complex social terrain where ideals of masculinity, such as emotional restraint, toughness, and self-reliance, intersect with persistent experiences of racism and marginalization (Hammond, 2012; Hammond & Mattis, 2005; Lateef et al., 2025; Matthews et al., 2013). These compounding pressures may catalyze distinct vulnerabilities to seeking support and ultimately receiving treatment for emotional distress. Yet, there is a critical need for more research examining how racial identity shapes mental health outcomes among Black men, particularly in the context of suicidal behavior.

Racial identity is a multidimensional construct that encompasses the significance and meaning individuals attribute to their racial group membership. According to the Multidimensional Model of Racial Identity (MMRI), key dimensions include centrality (the extent to which race is central to an individual’s self-concept), private regard (one’s personal feelings about being a member of their racial group), public regard (perceptions of how others view their racial group), and ideology (beliefs about how members of the racial group should behave) (Seaton et al., 2009; Sellers et al., 1998). This framework allows for a clearer understanding of how racial identity shapes psychological processes and vulnerability to distress, particularly in contexts of racialized stress.

Suicide research has largely focused on individual risk factors, often overlooking the broader, systemic forces that shape vulnerability. Extant scholarship challenges this narrow lens, emphasizing the importance of applying an intersectional framework in understanding suicide risk for Black Americans (Canetto, 2021; Opara et al., 2020; Standley, 2022; Wiglesworth et al., 2022). Coined by Kimberlé Crenshaw (1989, 1991), intersectionality describes “the ways that multiple forms of structural inequality or disadvantage intersects and creates obstacles that are often not understood within conventional or single-axis ways of thinking.” The application of intersectionality to Black men’s suicide risk may provide further insight as to how racialized and patriarchal systems interact to create distinct pathways to suicide risk (English et al., 2022; Homan et al., 2021). Rather than treating race and gender as isolated factors, intersectionality acknowledges that these systems are mutually and systemically enforced, creating unique vulnerabilities that cannot be fully understood in isolation. For Black men, the compounded impact of systemic racism and the patriarchy may contribute to heightened psychological distress, including suicide risk. Extant research that applies an intersectional approach to understand Black men’s suicide risk is limited, yet essential for understanding a more nuanced analysis of these interconnected systems to inform targeted, culturally responsive interventions.

Few studies have examined how racial identity relates to suicide risk among Black men, particularly through an intersectional framework that considers mutually reinforcing systems of oppression. The concept of masculine role strain was initially introduced to describe the psychological toll of conforming to hegemonic masculine norms among Black men, noting that such strain is exacerbated by racism and can lead to poor mental health outcomes (Hammond, 2012). Similarly, Watkins et al. (2006) found that many Black men experience emotional restriction and social isolation due to both racialized stigma and gendered expectations, which may limit help-seeking and contribute to internalized distress (Watkins et al., 2006). Though not explicitly focused on suicidality, these studies demonstrate the need to move beyond single-axis approaches and consider how intersecting systems of oppression may provide additional insight toward Black men’s suicide risk.

To address these gaps, our study qualitatively assessed how racism and masculinity operate in the lived experience of Black men to create heightened contextual risk of suicide. Using an intersectional framework, this study seeks to uncover the racialized and gendered systems of oppression influence the rise in suicide among Black men. Specifically, the objective of this study is to explicitly interrogate the intersectional influences of race and gender, as well as the MMRI dimensions of centrality, public regard, and private regard. By grounding our analysis in these dimensions, we aim to clarify how Black men’s self-perceptions of racial identity and their beliefs about how others perceive their racial group intersect with experiences of gendered and racialized oppression to shape distinct pathways to suicide risk and resilience. This approach provides a nuanced understanding of how these identities and systemic forces co-construct vulnerability and opportunities for intervention in moments of crisis for Black men at elevated risk for suicidality. Exploring the intersections of race, gender, and systemic inequities not only highlights the potential susceptibility of suicide faced by Black men but offers a pathway to address these deeply entrenched systems in future multilevel prevention efforts.

Method

Data and Study Population

The data from this study were part of a larger mixed-methods project that focused on suicide risk among Black men (Adams et al., 2021). Participants included 15 Black adult men (M_age = 32.1) with a history of suicidal thoughts and behaviors who were residing in Maryland counties where mobile crisis support was available at the time of their interview and did not present with active psychosis or cognitive deficits. We assessed history of suicidal ideation or behavior through participant self-report as part of the eligibility screening. Each of the 15 men participated in one 60- to 90-min semi-structured qualitative interview focusing on their overall mental health concerns, racism-related stressors, and other momentary factors that may have triggered suicidal thoughts and behaviors.

A semi-structured interview guide was created for the project with questions on each of the domains listed in Table 1. The interview guide domains were designed to align with the constructs of belongingness and burdensomeness articulated in the interpersonal theory of suicide (Joiner & Van Orden 2010). Questions addressing social support, socialization, and community connections probe participants’ experiences of belonging—such as feeling valued in relationships, accessing support, and navigating collective environments. In contrast, questions on attitudes/beliefs, general mental health concerns, and the impact of racism are structured to explore perceived burdensomeness, including feelings about the effects of one’s mental health on loved ones or the emotional consequences of racial discrimination. Suicide-specific questions and probes regarding timing, contextual stressors, and deterrents examine both the presence and absence of belonging, perceived burdensomeness, and additional theory constructs, such as hopelessness and acquired capability. Interviews were conducted between February 2022 and October 2023. We also conducted a 90-min member checking focus group with three recontacted participants. Member-check feedback was incorporated to refine and validate thematic interpretations, with input from participating men used to confirm accuracy and enhance the credibility of emergent themes (Birt et al., 2016). All interviews were conducted via Zoom and audio-recorded and transcribed using the platform. A member of the study team de-identified and cleaned each transcript. Participants were paid U.S.$25 to complete the interview.

Table 1.

Semi-Structured Interview Guide.

Topic areas	Questions and probes
General Mental Health Questions	What have been your major mental health concerns so far?
	(Probes: diagnosis, severity, payment/insurance, need for care, etc.)
	How disabling has [previously mentioned mental health] been for you?
Attitudes/Beliefs	When you experience [previously mentioned mental health] concerns, how do you feel about having those concerns?
	Alternatively, when you think about others that share your (mental health concern), what is your opinion of them and what they are experiencing
Socialization	Prior to your experience with (mental health concerns/conditions), did you have an opinion about people experiencing those same issues?
	Where or with whom did you first learn about these opinions?
	(Probes: who—family, peers, romantic partners, etc.)
Social Support	What people or places do you use in the community to maintain your mental health (i.e., friends/family, community organizations, schools, etc.)?
	Alternatively, what people or places do you try to engage with or avoid when addressing your mental health concerns?
	(Probes: educational/training background, work, and home contexts)
Suicide-Specific Questions	I want to switch gears and talk about your experience with suicide, specifically. Can you share what was happening in your environment in the month leading up to your suicide experience?
	(Probes: timing, events in their social context [e.g., work, home, social life], emotions surrounding their suicide experience)
	Can you walk me through the timing of events prior to your experience with suicide. What was happening one day before? One week before?
Racial Discrimination	Some people believe that experiencing the issues you mentioned above [name the issues that they mention] can affect suicidal thoughts or behaviors. As a Black man, you may face other outside influences that affect your mental health, particularly related to racism. What are your thoughts on how your experiences with racism may have occurred in your suicide experience?
	(Probe: timing [e.g., day before, week before, month before])
	(Probe: mechanisms between discrimination and the interpersonal theory of suicide—belonging, perceived burden to loved one, hopelessness, acquired capability for suicide)
	(Probe: multi-sector pieces such as school, work contexts, and structural influences—policy, neighborhoods, etc.)
Proximal Stressors Prior to Suicide	Which of the stressful experiences you mentioned, such as [name the issues that they mention], have the most immediate impact on your mental health? What thoughts typically occur in that moment?
Deterrents	What thoughts typically deter you from committing suicide?
	Alternatively, what thoughts or issues support your emotional and mental health? What thoughts help you avoid suicidal behaviors?
	(Probes: timing of thought/issue, sequence of events, mechanisms)

Participants were recruited via clinician referral and through MyChart, the web-based patient portal of the Epic Electronic Medical Record system. Interested respondents were required to complete an online interest survey to determine eligibility. Informed consent was obtained by the research coordinator prior to conducting the interview. Participants who had previously consented to being recontacted were approached by the research coordinator to gauge their interest in participating in the focus group. If participants expressed interest, informed consent was obtained. All recruitment and study procedures were approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board (#00013672) in December 2020.

Data Analysis

The analytic team consisted of master’s and PhD-level researchers trained in qualitative methods, public mental health, and mental health disparities. Prior to coding, the analytic team reviewed studies related to racism, masculinity, and health to inform the development of the preliminary codebook. Specifically, the study team focused on theoretical frameworks on hegemonic masculinity (Connell, 1995), racial identity (Sellers et al., 1998), masculinity ideologies in the context of race, health, and help-seeking (Addis & Mahalik, 2003; Courtenay, 2009; Hammond & Mattis, 2005), and the gender role strain paradigm among Black American men (Rogers et al., 2015). The team engaged in reflexive discussions throughout the analytic process, acknowledging how our professional backgrounds, racial and gender identities, and lived experiences with mental health systems could shape our interpretations.

A deductive analytic approach was used to establish that existing theories of masculinity informed the initial development of codes. Inductive open coding approaches were then used to ensure the codebook contributed to producing themes that were meaningful to the research questions. A preliminary codebook was created and then tested on one of the transcripts. Four team members blind coded this transcript and then came together and reconciled code definitions. Afterward, two team members continued blind coding the rest of the transcripts. The team conducted weekly qualitative consensus to identify inductive codes, clarify discrepancies, and discuss emerging themes until thematic saturation was achieved (Guest et al., 2020). Interviewers wrote field notes immediately after each interview to capture contextual details, nonverbal observations, and preliminary analytic insights that informed subsequent data collection and analysis. In addition to reviewing field notes, the team maintained analytic memos to document coding decisions, theme development, and reflections on emerging interpretations. These products served as a record of analytic transparency and supported the dependability of the findings. All qualitative coding and analysis were conducted using Dedoose v. 9.0.17 (Dedoose, 2021).

Results

Participant demographic characteristics, including age, education, relationship status, and employment, are summarized in Table 2. Participants ranged from 18 to 79 years of age, with an average age of 32.1 (SD = 14.2) years. The majority (14/15, 93.3%) of our participants took a survey on demographics. Many (5/14, 35.7%) of our sample had completed a high school degree, followed by some college with no degree (4/14, 28.6%), associate degree or bachelor’s degree (2/14, 14.3%), master’s degree (2/14, 14.3%), and some high school no diploma or equivalent (1/14, 7.1%). Furthermore, participants had a spectrum of sexual orientations, including heterosexual (7/14, 50%), gay (2/14, 14.3%), pansexual (2/14, 14.3%), bisexual (1/14, 7.1%), and questioning (1/14, 7.1%). One participant chose not to disclose his sexual orientation. Half of the surveyed participants were employed (7/14, 50%), with three being employed full-time and four being employed part-time. A majority of the participants reported being single (10/14, 71.4%), followed by married (2/14, 14.3%), separated (1/14, 7.1%), and divorced (1/14, 7.1%).

Table 2.

Demographic Characteristics of Participants.

Variable	n (%)	M	SD	Range
Age		32.1	14.2	18–79
Sexual orientation
Heterosexual	7 (50.0)
Gay	2 (14.3)
Bisexual	1 (7.1)
Pansexual	2 (14.3)
Questioning	1 (7.1)
Did not disclose	1 (7.1)
Marital status
Single	10 (71.4)
Married	2 (14.3)
Separated	1 (7.1)
Divorced	1 (7.1)
Employment status
Employed	7 (50.0)
Part time	4 (28.6)
Full time	3 (21.4)
Unemployed	7 (50.0)
Education
Some high school	1 (7.1)
High school diploma	5 (35.7)
Some college	4 (28.6)
Associate or bachelor’s degree	2 (14.3)
Master’s degree	2 (14.3)

Note. One participant did not complete the demographics survey.

Theme 1: Racial Identity and Marginalized Masculinity: Structural Constraints on Emotional Expression Among Black Men

Across narratives, participants described the heavy burden of navigating masculinity shaped not only by broader social expectations of manhood, but also by the legacies of racism. While strength and stoicism were described as conditions for maintaining their sense of manhood, these same ideals often created barriers to help-seeking and discouraged emotional expression. Participants emphasized that the ideal of masculinity available to them was both narrow and racialized. This belief system, often described as a generational “training,” embodied silence and shame around emotional disclosure:

And I think that it’s kinda ironic because, if you think about it, we are the one race that would definitely have a lot of mental health seeing as though what we dealt with, you know, being Black in America. If you think of it as whole, we would definitely need mental health, you know, but we are so trained to not think that way in a way to secure this way of thinking where we have to be strong. And if we’re not strong we will all fall apart. And so when we think like that, we don’t address certain issues that go on within our community, and some people get left behind. (014)

Some participants spoke to a personal history of enduring physical, sexual, or emotional trauma in silence, often without any support systems in place. For some, the gendered and cultural expectation of self-reliance was so entrenched that they withheld disclosures of trauma for years, which heightened their risk for suicide. As one participant noted:

No, I just talk to myself. I’ve always been able to deal with all of my problems on my own. I didn’t even tell anyone when I was molested until I was over 25 . . . I just hope that I’m strong enough to keep my mind, like I’ve been able to keep my mind. (005)

Participants described masculinity as performative, especially in contexts where being “tough” was required to survive. The tension between societal expectations and internal needs created a deep conflict. Many acknowledged that this performance was less about exerting control over others (a key feature of hegemonic masculinity) and more about controlling their own vulnerability in a world that does not protect Black men:

I feel like being a Black man is so performative . . . we’re masculine, we’re like strong and tough, because we have to be to like get through everything and we can’t let ourselves show any weakness. We can’t be weak. (002)

Collectively, these accounts demonstrate how participants’ internal self-perceptions (private regard) and their understanding of how others viewed them (public regard) jointly shaped the performance of racialized masculinity.

Intersecting Racial Identity and Masculinity

Racial identity, how Black men saw themselves (private regard) and how they believed others viewed them (public regard), deeply shaped their help-seeking behaviors, perceptions of masculinity, and their enactment of gender norms. Many men described feeling publicly dismissed by society due to their marginalized status as Black men, which was compounded internal beliefs and reinforced emotional withdrawal. Participants described how their private self-perceptions were shaped by a racialized masculinity that discouraged emotional expression. Men were often taught through socialization that to be a man, and especially to be a Black man, meant being tough, stoic, and emotionally contained in a world that would not support them. These lessons were socialized and subsequently internalized early, making it hard to maintain hope when dealing with emotional distress. For many, masculinity was not just about their own individual private regard, but was shaped through broader, public regard and racialized expectations that discouraged vulnerability, reinforced silence, and intensified distress. As one participant described:

So, I know for those factors played to people, especially Black men, the mentality of, hey, if I can’t progress . . . you start feeling the blocks stacking up against you more and more. As much as you try to knock them down, there’s more things that get on top. So, racism . . . it definitely has its place in suicide amongst Black men and minorities period, because we will always feel like the deck is stacked against us. (010)

Their identity is not defined solely by Blackness, but by the lived experience of being a Black man. This intersection shapes how they navigate the world, as their Blackness is often interpreted through the lens of masculinity, and their masculinity is shaped by how society views and treats Black men. From early socialization to institutional interactions, they face expectations and stereotypes that are racialized and gendered simultaneously. Understanding racial centrality for Black men therefore requires attention to the specific ways Black male identity is constructed, constrained, and expressed. This perspective is essential for capturing the full impact of structural racism and gendered oppression on their mental health, self-perception, and coping strategies.

Cultural Barriers to Seeking Help

Finally, participants spoke to how mental health was perceived in their communities. Several men described cultural norms, rooted in the Diaspora, which framed help-seeking as a weakness or something that simply was not for them. Therapy was seen as something “white people did,” while they were taught to “tough it out.” These narratives, again, were passed down doubly, shaping what was seen as acceptable and leaving many without the tools or language to ask for support:

We keep ourselves in this thing, where mental health . . . is just seen as a white thing . . . That’s what we say—we don’t understand that when we do these things we hurt ourselves. (014)

Theme 2: Gender Role Stress as a consequence of Intersectional Stereotypes

As detailed in Theme 1, Black men described how social and emotional pressures created a self-reinforcing feedback loop of stress and mental health challenges that perpetuated psychological distress. The intersection of racial identity and masculinity placed many participants in a psychological double bind, leading to gender role stress, the strain experienced when individuals feel unable to meet internalized or externally imposed expectations of manhood. For Black men, this stress was intensified by cultural norms and social messages that equated emotional expression with weakness and vulnerability with failure. The internal conflict between emotional needs and societal demands contributed to emotional suppression, isolation, and suicidality. This dynamic reflected a stress pathway in which social isolation and emotional suppression heightened perceptions of burdensomeness and disconnection from others, reinforcing the psychological double-bind participants described.

Reinforcing Stressors

The societal expectations of strength and toughness coupled with the isolation created by racism and masculinity norms, formed a set of reinforcing stressors. Participants described how the pressure to meet these racialized masculine ideals, both from within their communities and from society at large, was destabilizing:

Living as a Black man is very different to living as a White man, and having, like, the expectations of that, both within your community and outside of it. So maybe bringing up how like having to like be masculine and like be a man based off of what your people think is like a man can really affect that. Being like strong and unwavering in the face of like literally everything when that’s impossible for somebody to do without struggling a bit. So, I guess, living up to this like hyper masculine ideal that sort of promoted really could and does contribute to, you know, bad mental health.(002)

This quote highlights how masculinity is experienced in isolation, but as a racialized role, shaped by both community and broader societal expectations. The impossible expectations of unwavering strengths create a constant tension between internal experience and external performance.

Gender Role Stress and Emotional Consequences

Several men described how gender role expectations were explicitly socialized through families, media, and society, subsequently reinforcing the idea that emotional expression was not compatible with Black masculinity. These messages were internalized over time, contributing to emotional distress and feelings of inadequacy when those ideals could not be met:

. . . growing up as a young male you’re taught that, you know if you’re sad, or depressed, that is something you should just be able to snap out of. Or you know you should just be able to focus on, you know, what the good things are just, you know, put anything that’s wrong at the back of your mind and not focus on it. And you know, just the way I was taught growing up, like, you know, that depression is bad and looked upon as weak for men. [. . .] I mean, through society, through the media, sometimes even through, you know, family members, it’s just something that’s ingrained, you know. If, you know, if you get hurt, walk it off, don’t cry. You know those messages being . . . those messages being repeated in various phrases throughout my childhood and in early adulthood. (007)

This quote reflects how emotional suppression became a learned behavior, reinforced across multiple contexts. The result was a deeply internalized belief that distress should be hidden, denied, or minimized, leaving many men without language to process their mental health struggles. Together, these narratives demonstrate how oppressive systems of gender and racism create chronic stress and emotional constraint in the lives of Black men at risk of suicide.

Conceptual Pathway Linking Racialized Masculinity to Suicide Risk

Figure 1 illustrates the overarching conceptual pathway that emerged from our thematic analysis, integrating insights from Themes 1 (“Racial Identity and Marginalized Masculinity”) and 2 (“Gender Role Stress as a Consequence of Intersectional Stereotypes”). The model depicts how racial identity, particularly dimensions of public regard and centrality, and traditional norms emphasizing toughness, stoicism, and self-reliance intersect to produce racialized masculinity, or the lived experience of being a Black man navigating overlapping systems of racialized and gendered expectation. Participants described feeling constantly evaluated or dismissed as Black men (“the deck is stacked against you”), reflecting low public regard and heightened racial centrality that intensified racism-related vigilance and stress. Concurrently, they described being “trained” to suppress emotions and avoid help-seeking, illustrating how internalized masculine ideals conflicted with emotional needs. Together, these dynamics fostered emotional suppression and gender role stress, which evolved into social isolation and perceived burdensomeness, mirroring the mechanisms articulated in the interpersonal theory of suicide.

Figure 1.

Conceptual Pathway Illustrating the Intersection of Racial Identity, Masculinity Norms, and Suicide Risk Among Black Men.

Discussion

Our qualitative study explores the interplay of how intersectional norms around racism and traditional masculinity shape suicide risk among Black men. Consistent with the gender role strain paradigm (Pleck, 1995), participants described internal conflict between emotional needs and socially sanctioned expectations of strength, toughness, and stoicism. However, for Black men in our study, masculinity was inherently racialized and included with pointed reflections on the contradiction of being expected to endure the cumulative traumas of racism, violence, and isolation while being denied the psychological space to process them. Our study affirms previous research that previously demonstrated that these hegemonic ideals were not only gendered, but also racialized among Black men and are informed by both historical and ongoing experiences of racism (Adams et al., 2025; Hammond & Mattis, 2005).

Socialization mechanisms around manhood often shape Black men’s norms related to emotional control, and self-reliance (Lateef, 2023; Lateef et al., 2024). These gendered expectations commonly reflect dominant Western ideals of masculinity, which emphasize autonomy and emotional suppression, and often stand in contrast to Afrocentric worldviews that prioritize interdependence, compassion, and communal well-being, values more closely aligned with positive psychology frameworks within Black communities (Lateef, 2023; Lateef et al., 2025). Although intended to promote resilience, these norms may discourage emotional expression and frame help-seeking as weakness, leading many Black men to internalize distress and disengage from mental health services. As these ideals become reinforced through both racialized and gendered socialization, they may also elevate suicide risk by encouraging silence and reducing access to supportive care (Lateef et al., 2024, 2025).

Participants described feeling devalued and overlooked by society because of persistent racism, which reinforced the need to project control and emotional strength in their expressions of manhood. In these narratives, key aspects of racial identity, particularly public regard and centrality, were closely linked to their understanding of masculine norms. Public regard, or how Black men believed others viewed them, was shaped by stereotypes that framed them as threatening, emotionally distant, or fundamentally flawed. These external perceptions contributed to feelings of alienation and reinforced internalized beliefs of unworthiness and hopelessness.

Racial centrality, or the importance of being Black to one’s identity, was described as deeply shaped by both racial and gendered expectations. While hegemonic masculinity emphasizes emotional stoicism and self-reliance, racialized masculinity intensifies these demands by portraying Black men as inherently resilient and unbreakable. As a result, many participants expressed stigma around help-seeking, viewing emotional vulnerability as incompatible with being a strong Black man. This reluctance, when combined with limited access to culturally responsive mental health care, led to increased suicide risk factors related to feelings of burdensomeness and isolation. Although these constructs were not always articulated directly by participants, both were identified theoretically through coded excerpts describing social withdrawal and perceived lack of value to others, consistent with the interpersonal theory of suicide. Our results demonstrate that racial identity is not abstracted from masculinity but rather embodied through the ways society racializes Black male bodies, regulates their emotions, and criminalizes their existence. Recognizing this layered centrality is critical for understanding how structural forces and psychosocial experiences work synergistically to shape suicide risk and coping strategies of Black men.

These findings are consistent with prior research demonstrating that chronic exposure to racial discrimination can erode self-worth, increase emotional suppression, and discourage mental health help-seeking (Adams et al., 2025; Powell et al., 2016; Watkins & Neighbors, 2007). Our study builds on this work by showing how public regard and racial centrality shape internalized masculine norms in ways that intensify gender role stress and emotional withdrawal. Our findings highlight that the ways Black men learn about masculinity through racial and cultural socialization provide a sense of identity but can also make it harder for them to express emotions openly. As echoed in prior theories on masculinity and health (Addis & Mahalik, 2003; Courtenay, 2000, 2009), these norms can discourage open dialogue about mental health and frame seeking help as antithetical to manhood.

This study has several limitations. Our sample reflects individuals engaged in formal psychiatric care and may omit the experiences of community-dwelling Black men who face structural barriers to mental health services, including stigma and limited access. In addition, masculinity was not an explicit focus of our interview protocol. While relevant themes may have surfaced, our emphasis on racism and suicide may have resulted in missed opportunities to more directly explore the role of intersectional experiences. These limitations point to the importance of future research that broadens the scope to include non-clinical populations and explicitly interrogates intersections of race, gender, and mental health.

Despite these limitations, this study is among the first to critically examine how intersecting systems of oppression mutually shape and intensify suicide risk among Black men. Rather than focusing on single-axis explanations, we highlight an intersectional lens that recognizes how multiple structural forces simultaneously position Black men in ways that compound suicide risk. By centering lived experiences, our analysis offers a more comprehensive and nuanced understanding of how social positioning and cultural scripts around race, racism, and manhood interact in moments of crisis. Future research could expand on our study’s findings by explicitly querying how masculinity and racial socialization confers to increase suicide risk across key developmental stages, such as adolescence or early adulthood.

Implications for Clinical Practice, Community Engagement, and Policy

Our findings hold important implications for clinical practice, community engagement, and broader policy and structural reform aimed at reducing suicide risk among Black men. First, clinicians should adopt culturally responsive, gender-informed approaches that acknowledge how racialized masculinity influences emotional expression and help-seeking. Integrating discussions of racial identity and masculine norms into assessment and treatment may help men contextualize distress without pathologizing resilience. Routine screening for racism-related stressors, isolation, and role strain may enhance suicide prevention efforts. Training in structural and cultural humility can further improve therapeutic alliances with Black male clients.

Next, community-based and digital, online platforms represent critical spaces for engagement. Digital environments, such as moderated online forums, peer-led livestreams, and social media campaigns can model vulnerability and normalize emotional disclosure among Black men (Naslund et al., 2020). Collaborations with barbershops, faith-based organizations, and culturally centered community programs can extend reach to men who remain disconnected from formal care (Coleman, 2015; Hammond, 2012; Van Valkenburgh, 2021). Co-designed digital tools that reflect racialized and gendered experiences can reduce stigma and foster belonging.

Finally, policy efforts should prioritize funding and infrastructure that address racism as a social determinant of mental health. Expanding culturally competent crisis response services, diversifying the behavioral health workforce, and investing in prevention initiatives led by trusted community stakeholders are essential. Structural interventions, such as anti-racist training mandates, equity audits within health systems, and data disaggregation by race and gender, are necessary to dismantle systemic barriers that sustain suicide risk among Black men.

Conclusion

To effectively address the rising rates of suicide risk among Black men, future research and prevention efforts must account for the interwoven impact of racism and patriarchal gender norms. These structural forces shape not only how Black men experience emotional distress, but also how they interpret and respond to it in moments of crisis. Central to this work is the creation of spaces that affirm vulnerability, which include environments where Black men can safely express emotional pain without fear of judgment, stigma, or further marginalization. Culturally grounded, gender-responsive approaches are essential to dismantling the silence around mental health and fostering pathways to healing and connection.