From Uber to Nike to CBS, recent exposés have revealed seemingly dysfunctional workplaces rife with misconduct, bullying, and sexual harassment. For example, Susan Fowler’s 2017 blog about Uber detailed not only her recollections of being repeatedly harassed, but what she described as a “game-of-thrones” environment, in which managers sought to one-up and sabotage colleagues to get ahead. A New York Times investigation described Uber as a “Hobbesian environment…in which workers are pitted against one another and where a blind eye is turned to infractions from top performers.”
Why do companies get caught up in illegal behavior, harassment, and toxic leadership? Our research identifies an underlying cause: what we call a “masculinity contest culture.” This kind of culture endorses winner-take-all competition, where winners demonstrate stereotypically masculine traits such as emotional toughness, physical stamina, and ruthlessness. It produces organizational dysfunction, as employees become hyper competitive to win.
Masculinity Contest Cultures
We surveyed thousands of workers in the U.S. and Canada from different organizations. Respondents rated whether various masculine qualities were highly prized in their workplace; they also reported on other organizational characteristics and their personal outcomes. Four masculine norms, which together define masculinity contest culture, emerged as highly correlated with each other and with organizational dysfunction:
“Show no weakness”: a workplace that demands swaggering confidence, never admitting doubt or mistakes, and suppressing any tender or vulnerable emotions (“no sissy stuff”).
“Strength and stamina”: a workplace that prizes strong or athletic people (even in white collar work) or those who show off their endurance (e.g., by working extreme hours).
“Put work first”: a workplace where nothing outside the organization (e.g., family) can interfere with work, where taking a break or a leave represents an impermissible lack of commitment.
“Dog eat dog”: a workplace filled with ruthless competition, where “winners” (the most masculine) focus on defeating “losers” (the less masculine), and no one is trusted.
These norms take root in organizations because behaving in accordance with them is what makes someone a “man.” As phrases like “man up” illustrate, being a man is something men must prove — not just once, but repeatedly. In many cultures around the world, someone becomes a “man” by behaving in ways that conform with cultural beliefs about what men are like — dominant, tough, risk taking, aggressive, rule breaking.
And it doesn’t take much to make men feel like “less of a man.” Men react defensively when they even just think about job loss, or receive feedback suggesting they have a “feminine” personality.
What all of this means is that masculinity is precarious: hard won, and easily lost. And the need to repeatedly prove manhood can lead men to behave aggressively, take unwarranted risks, work extreme hours, engage in cut-throat competition, and sexually harass women (or other men), especially when they feel a masculinity threat.
At work, this pressure to prove “I have what it takes” shifts the focus from accomplishing the organization’s mission to proving one’s masculinity. The result: endless “mine’s bigger than yours” contests, such as taking on and bragging about heavy workloads or long hours, cutting corners to out-earn others, and taking unreasonable risks either physically (in blue-collar jobs) or in decision-making (e.g., rogue traders in finance). The competition breeds unspoken anxiety (because admitting anxiety is seen as weak) and defensiveness (e.g., blaming subordinates for any failure), undermining cooperation, psychological safety, trust in coworkers, and the ability to admit uncertainty or mistakes. Together this creates miserable, counterproductive work environments that increase stress, burnout, and turnover.
Masculinity contests are most prevalent — and vicious — in male-dominated occupations where extreme and precarious resources are at stake (fame, power, wealth, safety). Think about finance and tech startups, where billions of dollars are quickly made or lost; surgery, where high-stakes operations leave no room for error; and military and police units, where risky jobs are performed under strict chains of command.
Where does this leave women? Like everyone else, women must try to play the game to survive, and the few who succeed may do so by behaving just as badly as the men vying to win. But the game is rigged against women and minorities: Suspected of not “having what it takes,” they must work harder to prove themselves while facing backlash for displaying dominant behaviors like anger and self-promotion. Women and minorities thus face a double-bind that makes them less likely to succeed; they may find it easier to survive by playing supporting roles to men who are winning the contest.
The business case against masculinity contests
Organizations rely on cooperative teamwork to succeed. But masculinity contests lead people to focus on burnishing their personal image and status at the expense of others, even their organizations. Our research documents numerous negative consequences that harm the bottom line and put the organization’s effectiveness and reputation at risk. Organizations that score high on masculinity contest culture tend to have toxic leaders who abuse and bully others to protect their own egos; low psychological safety such that employees do not feel accepted or respected, feeling unsafe to express themselves, take risks, or share new ideas; low work/family support among leaders, discouraging work-life balance; sexist climates where women experience either hostility or patronizing behavior; harassment and bullying, including sexual harassment, racial harassment, social humiliation and physical intimidation; higher rates of burnout and turnover; and higher rates of illness and depression among both male and female employees.
These problems create both direct costs (through turnover and harassment lawsuits) and indirect costs (through decreased innovation due to low psychological safety). Put simply, masculinity contest cultures are toxic to organizations and the men and women within them. In extreme cases, such as Uber, the pressure cooker explodes, severely damaging or even destroying the organization.
Changing masculinity contest cultures
Despite being toxic, masculinity contest cultures persist for two reasons: (1) the association between toxic masculinity and success is so strong that people feel compelled to keep playing the game, despite the dysfunctional behavior it produces, and (2) questioning the masculinity contest marks one as a “loser,” which disincentivizes people from pushing back. Dropping a diversity initiative onto these types of workplaces is unlikely to create meaningful change. In fact, current interventions, like those to prevent sexual harassment, typically fail or even backfire in these environments (by creating more harassment). Real change requires shutting down this game.
To accomplish this, organizations need to perform deeper, more committed work to examine and diagnose their cultures. These efforts must be led by those who have the power to spark serious reform. It is crucial to generate awareness of the masculinity contest and its role in creating organizational problems. For instance, people tend to attribute sexual harassment to a “few bad apples,” ignoring how an organization’s culture unleashed, allowed, and may have even rewarded the misconduct. When organizations do not tolerate bullying and harassment, the bad apples are kept in check and good apples do not go bad.
Two specific actions are a good place to start:
Establish a stronger focus on the organization’s mission. Current trainings backfire, in part, because they focus on compliance and “what not to do,” are often framed as trying to “make things better for the women and minorities” rather than for everyone, and seem unconnected to the organization’s core mission. Effective interventions require authentic and meaningful connections to core organizational values and goals.
For example, researchers have documented how an energy company undermined masculinity contest norms on oil rigs through a safety intervention. The bottom line demanded reform: oil rig disasters cost lives and money, environmental destruction, legal liability, and severe reputational damage. Leaders convinced workers that increased safety was central to the mission; and they monitored and rewarded desired behavior change. Workers were rewarded for voicing doubts or uncertainties about a procedure (rather than “showing no weakness”), for listening to each other (rather than obeying the “strongest” alpha male), for valuing safety and taking breaks (rather than “putting work first”), and for cooperating with and caring for coworkers (rather than “dog eat dog” competition). The need to prove manhood proved incompatible with the new mission-based rules. Not only were accidents and injuries reduced, but so was bullying, harassment, burnout, and stress.
Organizations can leverage other core goals to motivate reform. Given the inherent dysfunctionality masculinity contest cultures create, chances are that almost any mission-related reform can help. For example, research demonstrates a common characteristic among innovative teams: psychological safety. Team members know that they can raise questions or voice doubts without eliciting ridicule or rejection. An initiative to foster innovation via greater psychological safety would naturally dampen the masculinity contest. As a by-product, the work environment should become more hospitable and inclusive toward women and minorities; after all, whose ideas are most often summarily ignored or dismissed in masculinity contest cultures?
Dispel misconceptions that “everyone endorses this.” People fail to question masculinity contest norms lest they be tagged as a whiny, soft loser. As a result, everyone goes along to get along, publicly reinforcing norms they privately hate — people stay late just to be seen as putting work first, or laugh at a joke they actually think is offensive. Because people publicly uphold the norms, it appears as though everyone endorses them. Research has shown that people in masculinity contest cultures think their coworkers embrace these norms when in fact they do not, breeding pervasive but silent dissatisfaction alongside active complicity as people stay quiet to prove they belong.
Leaders can remedy this misperception by publicly rejecting masculinity contest norms and empowering others to voice their previously secret dissent. But they also need to walk the talk by changing reward systems, modeling new behavior, and punishing the misconduct previously overlooked or rewarded. Leaders also need to ensure that people who speak up are no longer punished or retaliated against for doing so, either formally (e.g., with job consequences) or informally (e.g., by reputation and ostracism).
When masculinity contest cultures become “the way business gets done,” both organizations and the people within them suffer. Your organization may have a masculinity contest culture if, for example, expressing doubt is forbidden, “jocks” are preferred even though athleticism is irrelevant to job tasks, extreme hours are viewed as a badge of honor, or coworkers are treated as competitors rather than colleagues. Solving the problem requires meaningful commitment to culture change — to creating a work environment in which mission takes precedence over masculinity.
When it comes to health care costs, America’s employers are at a crossroads. Competing for scarce labor in a tight market, they will have trouble continuing to shift medical bills onto employees as they have for several decades.
That means that to control costs going forward, employers may have to confront the true underlying causes of rising health care expenditures: high prices and health care inefficiencies. To address these challenges, they will have to band together in purchasing coalitions that give them the local market power to force health systems to reform.
Employers are the largest single provider and purchaser of health insurance in the United States, covering over 150 million workers and their dependents and purchasing 34% of all health care dispensed in the country. As a potential force for change, only the U.S. government can rival America’s business community.
So what’s the problem? There seems growing nervousness among employers that they’ve pushed high deductibles about as far as they can. Workers’ increasing out-of-pocket costs are creating widespread discontent with the underlying costs of care — a problem largely driven by the high prices charged to private payers for health services and pharmaceuticals. Data from the Commonwealth Fund’s biennial survey of the American public shows that the percent of U.S. workers who are underinsured — face out-of-pocket health care expenses greater than 10% of their income excluding premiums — increased from 10% in 2003 to 24% percent in 2016. Between 2011 and 2017, employees’ premiums and deductibles grew faster than their median income. Beyond this, studies clearly show that when workers face high upfront payments, they frequently skip services, some of which are critical to their long-term health and productivity, a pattern that must worry responsible employers.
Add to this picture the increasingly competitive labor market — which limits the tools companies can use to constrain health spending — and it becomes clear that employers may have to find new ways to tame the health care cost tiger in the future. They may have to address the underlying reasons for rising health care premiums, rather than just shifting more of those expenditures off their own books.
Those fundamental reasons are varied and complex but at least two stand out. The first is that health care providers charge employers very high prices — way higher than those paid by public insurers like Medicare and Medicaid. The second is that our health care system is highly inefficient and wasteful. It has enormous administrative costs. Care is fragmented and uncoordinated. We have too many high-priced specialists and not enough high-quality primary care to keep patients out of emergency rooms and hospitals when they could be cared for in less expensive (and dangerous) settings. In other words, employers need to get better deals on prices and remake our health care system while they’re at it.
Employers are not new to this game. For decades, large sophisticated companies have undertaken pioneering experiments with reshaping the health care system. As far back as the early 1990s, Pitney Bowes focused on patient education and consumerism and prevention and care management to slow cost growth. Companies such as Boeing have experimented with direct purchasing of health care from providers, securing better prices, and eliminating the administrative costs of insurers. Other employers such as Walmart have cut deals to send their high-end elective procedures (e.g., open-heart surgery, hip and knee replacements) to centers of excellence that offered lower prices and higher quality. Employers have instituted wellness programs in the (now disappointed) hopes that health maintenance could lower costs of care. And companies have come together in regional coalitions such as the Pacific Business Group on Health and the Midwest Business Group on Health for the purpose of sharing lessons on how to become better health care purchasers.
The latest venture in employer health innovation is, of course, the alliance of Amazon, Berkshire Hathaway, and JPMorgan Chase. The as yet unnamed joint venture, led by the highly respected Dr. Atul Gawande, is promising to solve the health care conundrum for its parent companies and perhaps for the nation as a whole.
The fact is, however, that until employers switched to high-deductible plans, they enjoyed relatively little success in restraining health spending. This disappointing record reflects persistent challenges to their cost-control efforts.
The first challenge is lack of purchasing power. All health care is local, and efforts to negotiate better prices and reform health care delivery depend on an employer’s ability to force price concessions and behavior change from local physicians and health care institutions. Collectively, employers may constitute an important share of health providers’ market. But individually, with the exception of a few companies in a few markets, such as Boeing and Amazon in Seattle, no one employer has enough leverage to wrangle price concessions from area doctors and hospitals or induce them to reshape the way they do business. This is true even for large national companies because their aggregate workforce is spread across tens or hundreds of localities.
Efforts to form purchasing coalitions in local markets have had modest impact at best because employers have so little else in common and because antitrust laws limit their ability to collaborate. The growing consolidation among providers — 90% of metropolitan areas have highly concentrated hospital markets and 65% have highly concentrated specialist physician markets — also works to employers’ disadvantage.
A second challenge facing employers is lack of sophistication as health care purchasers. Medicine is complicated, and while there are a handful of large employers such as Comcast or Walmart with the funds and motivation to hire sophisticated health benefits specialists, there are 7 million to 8 million mid-size and small employers who have their hands full just managing their core business in turbulent times. Even if they had the leverage to demand delivery system reforms from providers, most CEOs and CFOs largely lack the time and patience to grasp the complex, non-intuitive, and often experimental interventions involved: accountable care organizations, value-based purchasing, outcomes based pharmaceutical pricing and so on. Better to raise deductibles and move on.
A third challenge is that when employers try to reform health care, they can easily alienate employees. To get better health care deals, employers often have to channel their workers to a select group of providers who offer lower prices and/or better quality. This can sometimes mean bypassing prominent but highest-priced local facilities and specialists where workers are already getting their care or want to if they ever need it — for example, the Partners HealthCare system in Boston, Memorial Sloan Kettering in New York City, and MD Anderson Cancer Center in Houston. In tight labor markets, the last thing employers want to do is to get between workers and their doctors.
To achieve the kind of gains in controlling health care costs that employers want, they will have to get bigger and smarter in the future.
They will need to band together in local purchasing alliances, come to agreement on common features of health insurance products, and then, working with local insurers, wrangle price and delivery concessions from local providers. This will likely require newfound willingness on the part of employers to surrender the freedom to tailor each insurance product to their own specific preferences. It will also require that, working together, employers immerse themselves in the complex details of reforming health care delivery systems so that they push insurers to insist on greater provider accountability for cost and quality, better primary care and prevention, improved care coordination, reduction in administrative costs, and a variety of other nitty gritty health care reforms.
Employers will not be able to do this without help from government. They may need antitrust allowances to band together for joint purchasing of care. They will also need state and federal antitrust authorities to break up increasingly dominant local provider coalitions. They will certainly want to strongly encourage federal and state authorities to pursue value-based payment programs for federally insured populations in the hope that employed populations will benefit from these reforms as well. Some employers may even decide — despite innate opposition to government regulation — that the only way for them to stay in the business of providing insurance to employees will be to have government regulate health care prices in their states. This is the tactic that most industrialized countries use to keep health care affordable for their populations.
The alternative to these fairly radical changes in employer behavior is continuing the hollowing out of employer-sponsored insurance. Aside from the pain this will inflict on workers and their families, this trend could cause the American public generally to lose faith in our current system of employer-sponsored insurance, and open the way politically for alternatives, including government-provided coverage.