The more men act like the stereotype of a real man’s man, the more mental health problems they run into. A new study finds a man’s sexism isn’t just a problem that women have to deal with, but it’s also closely linked with psychological issues like depression, substance abuse, and body image problems. (And yes, we understand if you’re not exactly overflowing with sympathy right now.)

“What we found was the more people adhere or conform to masculine norms, the poorer individuals’ mental health outcomes,” Indiana University researcher S. Joel Wong told Vocativ.

Sexism remains, first and foremost, a social injustice affecting women. But understanding how sexism also causes problems for sexist men could point to better and more strategic ways to help everyone in the long run.

Wong and his colleagues surveyed 78 different studies with a total of nearly 20,000 participants to reach their conclusion. They looked at 11 stereotypically masculine behaviors, including a need for emotional control, a propensity for violence, disdain toward gay people and homosexuality, a sexually promiscuous “playboy” lifestyle, and a need to show power over women, among others.

Of these, two of the most obviously misogynistic behaviors — being a playboy and seeking power over women — were those most associated with mental health issues, like depression and psychological distress. Meanwhile, other traditionally masculine norms didn’t seem to have as big an effect on mental health, such as putting a lot of value on work, Wong said.

One male behavior that showed strong links to mental health issues was self-reliance, or a reluctance to seek help from anyone else. This leads neatly into the researchers’ other finding: The men who engaged in sexist behaviors and had mental health issues were also those least likely to seek help.

“It’s kind of like a double whammy, the way I look at it, because the individuals who were conforming most to masculine norms were least likely to seek help, but also most likely to have poor mental health,” said Wong. “So these are the ones who most need mental health but have the poorest attitudes to seeking such help.”

As to why this link between sexism and mental health problems exists, Wong suggested men who display sexist behaviors are more likely to be ostracized for their attitudes today than decades ago. Being sexist can be socially isolating and that can lead to issues like depression or substance abuse.

Alternatives to therapy may be needed to help reach such men, Wong said. Moving therapy online or offering self-help options could let men work through their mental health issues – and maybe their sexist views as well – without compromising their image of self-reliance. Another possibility would be to position help not as “therapy,” which carries a stigma in a stereotypically masculine worldview, but as “coaching.”

If all this sounds like going out of one’s way to coddle the fragile sensibilities of men, well, congratulations, you’ve spotted one of the many ludicrous contradictions of the patriarchy (nor should any of this should be taken as an argument against calling men out on their sexism, just so we’re clear.)

More The Sustained Online Sexism Against Hillary Clinton

And admittedly, there’s a rather obvious rebuttal to the idea that those who boast about sexual assault get pushback, and he’s set to be inaugurated as the 45th President of the United States on January 20, 2017.

“In many ways, Trump exemplifies many of the inappropriate masculine norms, particularly power over women,” said Wong. “That’s a challenge…in my view because we don’t want to normalize this.”

When asked whether part of Donald Trump’s success lay in speaking to the same male insecurity about changing social norms that might also be tied up in these mental health issues – such as Trump’s railing against “political correctness” – Wong said this was an interesting idea, but he didn’t have the data to speak to that question.