What Are Little Boys Made of? A Review of Leonard Sax, Boys Adrift: The Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men. New York: Basic Books, 2007

Keen powers of cultural observation are not necessary for one to be aware of the phenomenon that Leonard Sax calls a "growing epidemic" in contemporary America- unmotivated boys and underachieving young men. More and more of today's young males are disengaging from school, not pursuing vocation, and opting out of real-world pursuits. While Sax notes that not all boys and young men are affected with this malaise, it characterizes a considerable number. It is not uncommon for twenty- and thirty-something young men to leave college, get part-time jobs, move back in with their parents, and spend their considerable free time playing Xbox. All the while, they are untroubled by their aimless circumstances and oblivious to the concerns of their parents and girlfriends. Sax is certainly not the first to observe this distressing trend of "boys adrift." However, through his experience as a family physician and research psychologist, he contributes to the subject by identifying what he believes are the five factors driving this problem: changes at school, video games, medications for ADHD, endocrine disruptors, and the devaluation of masculinity.

By "changes at school," Sax has in mind modifications in teaching methods in recent years. Studies of human brain development have shown differences in the developmental trajectories of boys compared with girls. Particularly, the language area of the brain in young girls develops earlier than in boys. Thus, in general, boys may not be develop-mentally ready to learn reading and writing at the same time that girls are ready. The problem, says Sax, is that recent decades have witnessed a gender blind acceleration in the pace of education. Today's kindergarten curriculum resembles the first-grade curriculum of thirty years ago. While girls may be ready for this level of learning, the difference in readiness for boys between the ages of five and seven means that a boy's first experience at school may be profoundly frustrating. Compounding the problem, Sax argues, is the curriculum shift away from experiential knowledge to solely theoretical knowledge. Cognitive-based educational strategies ignore the important question: what motivates kids to learn? Boys especially benefit from direct experience. According to Sax, if boys are challenged to learn something before being developmentally ready and they are not properly motivated to learn (through experiential knowledge, as well as, Sax adds, through the right kind of competition), they are more likely to develop a negative attitude toward education and disengage from school.

The second factor Sax identifies is perhaps the least surprising to many: playing video games. Sax suggests that video games feed the desire for control over one's environment, especially prevalent in many boys. Given this and their addictive nature, it is not difficult to see how a boy's connectedness with the real world can be affected and his motivation "derailed." Boys who care nothing for schoolwork will spend hours improving their Halo score.

Other negative affects suggested by researchers include poor academic performance and antisocial behavior. Moreover, Sax argues, video games teach the wrong lessons about masculinity: in the video game world one can wreak havoc and simply walk away.

Not only has video game use exploded in recent decades, so has use of Sax's third factor: medications for ADHD. In 2007, boys were thirty times more likely to be taking medications for Attention Deficit Hyperactivity Disorder (ADHD) than in 1987. Why? Sax suggests several reasons, such as a cultural shift away from personal responsibility and toward third-party explanations (i.e., your son is not disobedient; he has "Oppositional-Defiant Disorder"). Another reason is the curriculum acceleration noted earlier: if a kindergartener frequently fidgets and has trouble focusing on how to read and write, there's a good chance his teacher may suggest an ADHD evaluation. However, many health plans do not cover a complete neurodevelopmental assessment. Instead, according to Sax, many doctors believe in the "empirical trial of medication" (88). So, many boys are placed on ADHD medications and, as a result, are found to have improved attention spans and academic performance. Problem solved, right? Actually, Sax notes a recent study revealing that children not diagnosed with ADHD who were given medication demonstrated improved performance by the same degree as kids who were diagnosed.

Thus, a "positive" response to ADHD medication is no confirmation of an ADHD diagnosis. Moreover, Sax cites international examples of independent researchers who found that, in laboratory animals, stimulant medications (like those used for ADHD) damage a part of the developing brain responsible for translating motivation into action. The result in animals is a loss of drive in adulthood. Of course, Sax is quick to note that the risks are not proven in humans. But who is warning parents and doctors about even possible risks?

The fourth factor that Sax believes is contributing to "boys adrift" was, for me, the most unexpected. Many modern synthetic chemicals are "endocrine disruptors," that is, substances that mimic the action of human sex hormones-the majority mimicking female hormones. Children are exposed to these chemicals in various ways: through certain pesticide-treated foods and from plastic containers in which small amounts of the chemicals leach into the liquid. Sax claims a growing body of evidence exists demonstrating that endocrine disrupting chemicals accelerate puberty in girls and may delay or disrupt puberty in boys. In addition, lab animals exposed to these chemicals are developmentally affected-with males affected motivationally. Scientists are only beginning to examine the potential long-term health risks of exposure to these chemicals.

Next Sax includes a chapter titled "Failure to Launch," describing the end result that these combined social and biological issues have in the lives of today's young men. The most fascinating aspect of the chapter is the numerous selected emails that he received in response to an op-ed piece and online chat that he hosted for the Washington Post in 2006. Unmarried young men still living with their parents and lacking direction unashamedly and indignantly wrote Sax asking, "So what's the problem?" Driven young women repeatedly admitted with chagrin to having boyfriends or husbands who fit Sax's description. Concerned mothers confessed that he accurately portrayed their sons. Clearly, Sax has struck a nerve for many.

Finally, Sax addresses the fifth factor, the devaluation and disintegration of the masculine ideal. He highlights the fact that enduring cultures- cultures that have remained intact for hundreds or thousands of years- use traditions and customs to mark a transition to manhood. We moderns look condescendingly on such traditions, but we do so to our own peril, Sax argues. Our neglect of the transition to manhood is contributing to the epidemic of underachieving young men. Manhood is something a boy accomplishes through the guidance of men. Whether through formal ceremonies or a more gradual process, men in enduring cultures teach boys what is expected of a man. According to Sax, "being a man means using your strength in the service of others" (181). Though he says his definition is not the only one, he insists that we must decide- individually and collectively- how to define masculinity. If we do not, the marketplace will be sure to define it for us. Sax concludes with a chapter offering practical strategies to counteract the five factors.

Sax's book is a fascinating read. There are probably few people who would disagree with his overall concern (except perhaps the young men in question) or who are unable personally to identify a boy or young man who fits the description. Sax's conversational style also makes the book an easy read. His many examples- from his medical practice and from his own interaction with boys and their parents- are engaging. And yet the abundance of endnotes documenting research and scientific studies demonstrates that Sax has done his homework.

As noted above, the chapter on endocrine disruptors was unanticipated and disturbing. Certainly, Christians should become informed about any risks posed by these synthetic chemicals and, as new scientific evidence comes to light, should seek to ensure accountability in the manufacture and use of them. However, while these substances may have a genuine biological influence on boys (and girls), I remain unpersuaded that this is a significant contributor to the real problem of "boys adrift."

Above all, I am convinced that unmotivated boys and underachieving young men are primarily (though not solely) a product of the devaluation of masculinity and the inability of our culture to articulate what it means to be a man. In a culture in which it is anathema to affirm sex differences, it should not surprise us that today's young men are muddled about manhood. When told to "grow up," they have no clear picture of what that looks like. Sax's discussions of changes in education and medications for ADHD are further evidence of a gender-blind society that takes no account of differences between boys and girls-except when boys need medication to cure them of their boyishness. If we are unable to affirm any longer to our boys that being a man involves the noble roles of leading, providing, and protecting, we will continue to see young men shirking responsibility, living off of their parents, and devoting their attention to more motivating pursuits-like video games. Sax is right. Gender matters.

Make no mistake: Sax does not write as a complementarian. Though he admires enduring cultures that mark a transition to manhood, he finds it unfortunate that many of them are "sexist"- that is, certain roles in those cultures are restricted to men (206; the examples he gives involve religious leadership). He also claims to "fully endorse the idea of a full-time homemaker father," though he admits, "very few men make that choice" (129). Those who acknowledge the biblical teaching of complementary roles for men and women will view these matters quite differently. It is interesting that Sax is quick to chastise twenty-first-century American condescension toward enduring cultures that guide boys into manhood. Yet he clearly argues from that same twenty-first-century American point-of-view when he warns his readers about the "narrow and limiting" gender roles of those enduring cultures.

Neither does Sax write as an evangelical Christian. He is unconcerned with the specific religious beliefs of various cultures, but rather with the common ways in which they teach the next generation- in gender-separate communities- what is expected of men and women (168-69). He asserts, "Traditional Judaism, the various Christian denominations, as well as Islam, all have long traditions of gender-separate activities" (205). That may be so. However, a biblical view of men and women is worlds apart from that of Islam. In addition, Sax's agenda to reclaim masculinity does not entail an opposition to homosexuality. After all, in "numerous" cultures, homosexuality is a "normal masculine or even hypermasculine orientation" (168). However, this observation highlights the weakness of Sax's efforts to define what it means to be a man. Without a standard for defining manhood, one is left to observing the common traits of various cultures. While such an exercise can be helpful, those who understand the effects of human depravity know that it will ultimately prove disastrous. If God is the author of our sexual differentiation, we should expect to see common evidence of his design across cultures and throughout history. Yet Christians also know that, post-Fall, manhood is corrupted, and diverse cultures display common corruptions (e.g., homosexuality, abuse of women, etc.). Comparing cultural attributes of manhood will not enable one to arrive at the ideal. For that, Scripture is essential.

These criticisms are simply a reminder that we must engage everything from a biblical worldview. They are not intended to detract from the importance of Sax's book. Not only are there significant cultural factors with which Christians must engage, we must also be intentional in teaching manhood to our sons. If we do not, they will definitely learn a deceptive and corrosive "manhood" elsewhere.

Church leaders, parents, and educators who are concerned about boys need to read Boys Adrift. If read with biblical discernment, it will help Christians further comprehend the culture in which we live, as we seek to raise our boys into godly men.