Male Psychiatric Nurses in China Reveal How Double Stigma Forges Professional Identity

Men remain a small minority in nursing worldwide, and in psychiatric nursing their position is even more complicated. A new qualitative study from China, published in BMC Nursing, offers one of the most detailed accounts yet of how male psychiatric nurses actually build a professional identity in an environment where they face not one but two layers of stigma: the stereotype that nursing is women’s work, and the persistent social prejudice attached to mental health care itself. The research, conducted by a team at the Affiliated Kangning Hospital of Ningbo University, followed the career experiences of 16 male psychiatric nurses and traced how their sense of who they are as professionals evolved over time, often unevenly and sometimes painfully.

The study, led by Danni Chi and Lijun Zhao of the hospital’s Department of Psychiatry, used semi-structured interviews conducted between October and December 2025. The researchers analyzed the transcripts using reflexive thematic analysis, a qualitative method in which the researchers systematically code interview data and iteratively develop themes while remaining conscious of how their own perspectives shape the interpretation. The participants were all men working in a specialist psychiatric hospital, a setting where care depends on therapeutic relationships, sustained emotional labor, long-term patient contact, and, at times, exposure to aggression. The team registered the study with the Chinese Clinical Trial Registry and obtained ethical approval from the hospital’s ethics committee, with all participants providing informed consent.

From the interviews, the researchers developed three themes that together describe an arc of professional identity formation. The first, which they called stumbling into commitment, captures how these men arrived in psychiatric nursing in the first place. Some entered deliberately, choosing the specialty with open eyes. Others stumbled in through pragmatic routes, taking jobs that were available rather than jobs they had dreamed of. Either way, the early period was marked by shock. Confronting acutely ill patients, unpredictable behavior, and the emotional weight of psychiatric wards was a jarring experience for newcomers, and it coincided with the realization that they carried a double stigma, both as men in a feminized profession and as workers in a field many people fear or misunderstand.

That double stigma is one of the study’s most striking findings. In many societies, including China, nursing is coded as feminine, and male nurses routinely field questions about why they did not become doctors or why a man would choose a caring role at all. Psychiatric nursing adds another layer: mental illness itself remains heavily stigmatized, and those who work with psychiatric patients can absorb some of that social disapproval. The participants in this study had to negotiate both stereotypes simultaneously, explaining their career choices to families and friends while also managing the daily realities of a ward environment that outsiders often imagine inaccurately. Over time, however, the researchers found that the nurses gradually settled into the work, moving from initial disorientation toward a stable, committed professional stance.

The second theme, growing through relationships, describes the engine of that transformation. Professional growth, the participants reported, came primarily through people: patients, colleagues, and teams. Early in their careers, the nurses focused on completing tasks, administering medications, maintaining safety, and getting through shifts. But as they accumulated experience, their practice shifted toward something more relational and more preventive. They learned to read subtle changes in a patient’s demeanor, to anticipate escalation before it happened, and to build the kind of therapeutic alliance that psychiatric care depends on. This movement from task completion to relational and preventive judgment is, in the researchers’ framing, the core of professional identity development in this specialty.

Colleagues and teams played a crucial role in this learning process. Psychiatric nursing is inherently collaborative, and the male nurses described how experienced mentors and cohesive ward teams helped them interpret difficult situations, absorb the emotional demands of the work, and develop confidence in their own clinical judgment. The study’s findings suggest that mentorship is not a luxury in this field but a structural necessity, particularly for men who may lack role models who share their gender and their specialty. The authors argue that nursing managers should actively support mentorship and relational competence as part of professional development, rather than assuming that new nurses will simply pick these skills up on the job.

The third theme, strength in caring, addresses one of the most persistent stereotypes about male nurses: that their value lies primarily in physical strength. The study complicates that picture in an interesting way. Physical strength, the participants acknowledged, is genuinely useful in acute risk situations, such as when a patient in crisis poses a danger to themselves or others. But strength alone is not care. The nurses emphasized that physical capability only becomes professionally meaningful when it is integrated with restraint, protection, clinical judgment, and relational skill. De-escalating a tense situation through communication, knowing when and how to intervene safely, and maintaining the patient’s dignity throughout are what distinguish a competent psychiatric nurse from a strong body in scrubs.

This reframing matters because it challenges both the stereotype and the simplistic response to it. The male nurses in the study did not reject the expectation of strength; they incorporated it into a broader model of caring that they had built over years of practice. Their identity as professionals rested not on being the strongest person on the ward but on combining physical readiness with emotional attunement and clinical expertise. In this sense, the study offers a nuanced account of gender in nursing: rather than treating male nurses as either an anomaly or a corrective to a feminized profession, it shows how individual practitioners actively construct a workable identity out of the raw materials of stereotype, experience, and relationships.

The researchers also documented a less uplifting undercurrent. Alongside strong commitment and what they describe as pragmatic stability, participants gave a contrasting account of occupational fatigue. Years of emotional labor, exposure to aggression, and the cumulative strain of working in a stigmatized specialty take a toll. The study’s conclusion is candid on this point: professional identity in this group developed gradually and unevenly, shaped by pragmatic entry, early shock and strain, relational learning, and strength in caring, but sustainability over a full career is not guaranteed without institutional support. The authors call on nursing managers to support early adaptation, occupational safety, mentorship, relational competence, and long-term career sustainability, a list that reads as a practical agenda for retaining men in psychiatric nursing.

The broader significance of the study lies in what it reveals about workforce dynamics in mental health care. Nursing shortages are acute in psychiatric settings around the world, and men represent an underused talent pool in a profession that desperately needs staff. Understanding why male psychiatric nurses stay, and what nearly drives them away, is therefore not just an academic question but a workforce policy one. This study suggests that the critical window is early: the initial shock of the ward and the weight of double stigma are the moments when commitment is most fragile. Hospitals that invest in structured onboarding, mentorship, and safety may find that the men who stumble into psychiatric nursing can, with the right support, grow into some of its most committed practitioners.

Subject of Research: Professional identity development among male psychiatric nurses in China

Article Title: Professional identity development among male psychiatric nurses in China: a qualitative study

Article References: Chi, D., Zhao, L., Chi, A., Chen, N., Bao, Y., Chen, W., Dai, J., & Yang, B. (2026). Professional identity development among male psychiatric nurses in China: a qualitative study. BMC Nursing, 25(1), Article 874. https://doi.org/10.1186/s12912-026-05364-7

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05364-7

Keywords: male nurses, psychiatric nursing, professional identity, gender stereotypes, occupational stigma, qualitative research, thematic analysis, mental health care, nursing workforce, emotional labor, mentorship, China