Men whose image of themselves falls short of the traditional masculine gender norms, and who feel that others think this about them too, may be more prone to violence than men who feel comfortable in their own skin, suggests research published online in the journal Injury Prevention.

How men perceive traditional male gender norms and masculinity can affect their behaviour. In general, 'macho,' highly masculine men are more likely to engage in stereotypical male behaviours, such as risk taking, substance misuse, and acts of aggression, say the researchers.

But they wanted to find out if 'male discrepancy stress'--which describes men who see themselves as not only falling short of traditional masculine gender norms but who also worry that others view them in this light as well--had any impact on these behaviours.

They therefore analysed the responses of 600 US men in 2012 to an online survey about their perceptions of male gender and how their own self-image fitted in with this, and risky behaviours.

The prevalence of injury sustained through violence and risky behaviours is highest in men aged 18 to 44, which also happens to be the largest male age group in the US, so all the survey participants were aged between 18 and 50.

Analysis of the results showed that men who considered themselves less masculine than average and who experienced male discrepancy stress were more likely to say they had committed violent assaults with a weapon as well as assaults resulting in injury to the victim than those who didn't feel highly masculine, but who didn't worry about it.

There was no association between discrepancy stress and average daily use of alcohol or drugs, but men who felt less masculine, and who weren't worried about it were the least likely to report violence or driving while under the influence.

"This may suggest that substance use/abuse behaviours are less salient methods of demonstrating traditional masculinity in contrast to behaviours related to sex and violence, perhaps due to the potentially private nature of the habit," suggest the researchers.

While highly masculine men are at high risk of violence, less masculine men who experience discrepancy stress may be equally at risk, say the researchers.

"These data suggest that efforts to reduce men's risk of behaviour likely to result in injury should, in part, focus on the means by which masculine socialization and acceptance of gender norms may induce distress in boys and men," they conclude.