The feminist movement of the 1960s and 1970s drastically changed gender expectations in America, opening the door for women to explore new careers—careers once available exclusively to men. Women have capitalized on these opportunities and have excelled in what was once considered a "man’s" world. However, it is unfortunate that the reverse is not true for men entering professions once dominated by women. Men encounter more negative criticism from the public for entering female-identified professions;1 thus the entry of men into feminine occupations is less common.2 The men who do enter these occupations risk their gender identity being questioned.3 One such "feminine" profession is nursing, but it has not always been that way.
Before modern day nursing, men were nurses, not women. The earliest recorded nursing school was established in India around 250 B.C. It was exclusively for men; women were not allowed to attend because it was believed that women were not as pure as men.4 As time passed, organized religion took the lead in caring for the sick. During the era of the Bubonic plague, the Christian brotherhood nursed the sick and buried the dead. Saint Benedict founded the Benedictine Nursing Order and the Catholic Church ordained the Knights Hospitallers.5 During times of war, it was common for men to volunteer as nurses. The famous poet Walt Whitman volunteered as a nurse during the American Civil War.6
In the 1800s, nurses were uneducated, of low status, often prisoners or prostitutes and considered cheap unskilled labor.7 Modern day nursing began with Florence Nightingale.
What could have been a momentous leap forward for both male and female nurses preempted the decline of the male nurse. Nightingale ushered in trained professional nurses who transformed nursing into an acceptable and respectable occupation for women. Unfortunately, men were forced out of nursing due to stereotypes. It was believed that women were naturally better at nurturing the sick—more affectionate and more caring than men.8 In the early 1900s, women’s domestic roles played into the stereotype. The fact that men had shown compassion and caring as nurses throughout history was ignored.
The early labor movements and success of women’s suffrage in the early 1900s also contributed to the decline in the number of male nurses. In 1901, the Army Nurse Corps became part of the Army Medical Department, but only women were allowed to serve as nurses. This injustice ended in 1955 when government legislation opened the door for male Army nurses. Also in 1901, the American Nurses Association (ANA), at the time as the Nurses Associated Alumnae, was formed. Men were excluded from ANA until 1930.9 Even as late as 1982, men still experienced obstacles in being accepted into nursing school. The Supreme Court ruled that an individual’s constitutional rights were violated when he was refused admission into the Mississippi University for Women’s School of Nursing. Justice Sandra Day O’Connor stated that "excluding males from admission to the School of Nursing tends to perpetuate the stereotyped view of nursing as an exclusively woman’s job. The policy lends credibility to the old view that women, not men, should become nurses, and makes the assumption that nursing is a field for women a self-fulfilling prophecy."10 It has been a slow process incorporating men back into the nursing profession, and the percentage of male nurses (5%–6%) has remained virtually unchanged for decades.11
But what exactly is masculinity and femininity? Masculinity and femininity are abstract concepts based on gender; it is expected that males will be masculine and females will be feminine.12 Until the mid-1970s, it was believed that masculinity and femininity were bipolar, thus conceptualized as being at opposite ends of a single continuous spectrum. This theory made it impossible for men or women to possess both types of attributes simultaneously. Bem’s psychological androgyny theory challenged that assumption.12 Psychological androgyny theory treats masculinity and femininity as two independent dimensions. According to this theory, masculinity and femininity are two separate entities; therefore, an individual can possess both masculine and feminine attributes simultaneously. Androgyny denotes the integration of femininity and masculinity within a single individual. If individuals lack dominance in either trait (masculinity or femininity), they are considered undifferentiated. According to Tillman & Machtmes, masculinity and sexual orientation are often used interchangeably.13 This use of language has contributed to male nurses being stereotyped as homosexual by the public, making some heterosexual men reluctant to enter the profession. Fortunately, men who do enter the profession represent nurses as individuals who enjoy working with people and are kind, caring and highly respected. Some men consider caring (defined by society as a feminine trait) as a natural masculine trait, synonymous with providing and protecting.14 In contrast, television and the movies portray nursing as mundane and monotonous, with nurses holding subservient roles.15
Several studies have investigated how nurses were classified using the new theory of androgyny. Culkin, Tricarico and Cohen examined the sex-role orientation of 68 nursing students at a small community college (20 male and 48 female) to determine if male students were more androgynous than female students. They found that male nursing students were no more androgynous than female students.16 In a similar study conducted by Pontin, 23 nurses (10 men and 13 women) in the United Kingdom were surveyed in regard to their sex-role orientation. Pontin also found that men and women were equally androgynous.17 McCutcheon conducted a study to examine the relationship between the work experience of male nurses and sex-role orientation in the Orlando, Florida area. McCutcheon found that experienced male nurses were no more feminine than inexperienced male nurses. Therefore, McCutcheon concluded that the nursing profession does not feminize the male nurse.18 A study by Fisher was conducted at a hospital in Sydney, Australia, to determine if sex-role identity differences existed between male and female registered nurses. The study found no significant difference in masculine and feminine scores between male and female nurses, and sex type categories. However, when male nurses from this study were compared to Bem’s sample of men, Fisher found a significant difference between the two. More men in the nursing profession were cross-typed as feminine.19 A more recent study conducted in Ireland had similar findings. Loughrey concluded that the sample of male nurses adhered to female norms more so than male norms.20
The review of literature showed a need for wide-scale research within the United States, and a nationwide study was conducted in April 2009 to determine if male nursing students are as feminine as female nursing students and to determine if male nursing students are more feminine than the "normal" male. Members of the National Student Nurses Association (NSNA) were asked to participate in the study. Twenty-eight men and 81 women completed an online survey for a total sample size of 109 nursing students. The survey consisted of several descriptive identifiers and 30 personality characteristic questions based on the short-form Bem Sex-Role Inventory (BSRI). The BSRI is a psychoanalytical instrument consisting of 30 personality characteristic questions that are used to determine gender-role orientation. Ten questions are stereotypically feminine, 10 are stereotypically masculine and 10 are filler questions that have no bearing on individual scores. Data was collected from April 24 through May 22, 2009 and analyzed using the Statistical Package for the Social Sciences (SPSS). The sample obtained represented 37 of the 50 states comprising the United States.
The results of the study showed that a significant difference does exist between male and female nursing students in regard to sex-role orientation. The men entering the nursing profession are very masculine and no more feminine than the "normal" male. Contrary to popular belief, the nursing profession attracts men who exhibit a high degree of masculinity; therefore, male nurses should not be stereotyped as feminine. If McCutcheon is correct and nursing does not feminize men, then the next generation of male nurses will be more masculine then male nurses of the past.