Involuntary Celibates and Forensic Psychiatry

The Incel Worldview

Cottee summarized the incel worldview succinctly as having three core tenants: misogyny, victimhood, and fatalism.¹⁰ To understand incel-motivated violence and risk assessment, it is helpful to first understand the particularities of the incel worldview and its expression in the incel argot, or sub-culturally specific language (See Table 1). Incels believe in a rigidly hierarchical “sexual marketplace” where physical characteristics such as height, facial bone structure, and muscle mass determine value.² Females’ supposed hypergamous nature (inborn tendency to mate with genetically superior males) leads to the incel’s “80–20 rule”: the top 20 percent of men, who are referred to as Chads and defined as conventionally attractive white males, monopolize the sexual and romantic attention of 80 percent of women. Women are categorized as Stacys, referring to hyperfeminine and highly attractive women, and Beckys, average or normal women.³ Females as a group are referred to as “foids” which stands for female-humanoid, a term meant to dehumanize women. Incels term the discrimination they face due to their inferior physical appearance as “societal lookism” and consider any attempt to increase their perceived attractiveness as “maxxing,” for example exercising as a means to increase their sexual market value is referred to as “gymaxxing.” ^11,12 These kinds of efforts are usually derided within the incel community as futile and examples of “copes.”

Misogyny can be defined as “a form of male hostility toward women and a way of acting that ensures male dominance over women” (Ref. 10, p 100). The logic of misogyny is asymmetric: women owe men care and sexual receptivity, whereas the inverse is not true.¹³ In addition, a double standard exists whereby nonmonogamy is positively regarded for men and negatively for women.¹¹ Furthermore, while claiming to be unable to find a sexual partner, incels place strict stipulations on female suitability. More specifically, incels prefer young, virginal, thin, blonde women.¹⁴ Incels refer to women as objects that confer social status among men.¹⁵ They are cast as shallow, manipulative, financially exploitative, and untrustworthy.¹⁴ Although the incel worldview is extreme, the notion of women as status objects, female beauty standards, and male entitlement are coterminous with wider structures of misogyny operating in society.^16,17

Incels form part of the broader “manosphere,” a loosely organized assemblage of diverse online subcultures that coalesce around a belief that men are disadvantaged by feminism.¹⁸ This belief has been termed the “Red Pill,” which is a reference to The Matrix.¹⁹ In The Matrix, the protagonist must choose whether to take the blue pill and remain in ignorant bliss, or take the red pill and be awoken to the harsh realities of the world.¹⁹ The Red Pill ideology refers to the project of “awaken[ing] men to feminism’s misandry and brainwashing” (Ref. 18, p 640). Groups within the manosphere include: Men’s Rights Advocates (MRA), who focus on men’s civil rights, custody, and family law discrimination; Men Going Their Own Way (MGTOW), who advocate for sex separatism; Pick Up Artists (PUAs), who sell sexual and romantic tips and tactics; Traditional Christian conservatives (TradCons), who espouse conservative views on marriage; and certain gamer or geek subgroups, who believe women do not belong in video game communities and have used strategies such as doxing, defined as publishing personal information about individuals on the internet, to discourage participation.^18,20,21 The beliefs in male oppression, the objectification of women, and the rhetoric of free speech and anti- political correctness unite the manosphere.¹⁸ Over time, membership in these communities has migrated from more moderate MRA or PUA sites to more extremely misogynistic MGTOW and incel sites. This has led to a shift of tactics away from political activism and toward personal attacks on individual feminists and shared expressions of anger.²²

The internet has played a crucial role in the development of the incel subculture, with members using messaging forums on social media sites such as Reddit to gather and discuss their beliefs. The original incel subreddit, r/incel, was banned from Reddit in 2017. Reddit noted that the forums were inciting violence against women in violation of their user policy. At the time of its disbanding, the group had 40,000 active members.¹ These groups have used public forums such as Reddit and Facebook in the past, but recently have begun de-platforming and using private end-to-end encrypted channels such as Discord and Telegram to gather, plan, and discuss.²³

Incels see themselves as oppressed by the misandry of feminist society.² There are multiple historic waves of feminist scholarship and activism as recently reviewed by Sidhu and Candilis.²⁴ The use of the terms feminism or feminist by incels loosely aligns with the goals of first- and second- wave feminism: recognition of equal civil rights, autonomy over bodies (including sexual autonomy), and integration into the labor market. Incels perceive liberalism and feminism as an existential threat¹⁶ and hold attachment to an idealized past when patriarchal monogamy was socially enforced.³ Alienated by a feminist cultural sensibility²⁵ and a labor market where underemployment and downward mobility are increasingly common,²⁶ they commiserate online in a type of “brotherhood of the shipwrecked and defeated” (Ref. 10, p 100). Kimmel’s theory of aggrieved entitlement describes the incel psychoaffective identity²⁷ as the belief that men have a right to women’s bodies and that denial of this right is a humiliating injustice.^28,29 It is a “gendered emotion, a fusion of that humiliating loss of manhood and the moral obligation and entitlement to get it back” (Ref. 30, p 454).

Fatalism is a core tenant of incel ideology espoused in the Black Pill belief, which acknowledges that “however hard he tries, the incel will never be able to have sex with a woman (outside of prostitution)” (Ref. 10, p 102). For Black-pilled incels, lookism is not only systematic but immutable, and they therefore reject any self-improvement schemes (copes). Seeing the incel reality “as it is” is a source of pride, “damnation is experienced as an existential state of true (blackpilled) consciousness and authentic existence” (Ref. 10, p 102). Inceldom is a considered a permanent condition⁴ characterized by a radical and positively evaluated lack of hope.¹² This leads to a glorification of suicide, or “roping,” not for eternal redemption but as an end to interminable suffering.³ Incels cite peer- reviewed studies in evolutionary psychology to advance their brand of biological determinism, claiming that appearance, intelligence, and personality are all genetically predetermined, thus immutable.²⁸

There appears to be a great deal of heterogeneity with how individual incels understand and employ this worldview in their self-conception. Additional research is needed to elucidate incels’ movements between the Red Pill and Black Pill ideological standpoints.

Literature Review

Our analysis of the peer-reviewed literature on incels reveals a nascent field of scholarship with diverse disciplinary contributions and a heavy reliance on gray literature. The first references to incels were in 2001 examining involuntary celibacy among both partnered and single men and women.^31,32 Subsequent articles were published in 2019 onward, reflecting the increased media and academic attention to the movement following the Toronto van attack. The current research is mainly from the field of gender/sexuality studies,^{11,13,14,16,18,33,–,35} followed by political science,^3,4,10,17 and sociology.^15,29,32,33 Smaller contributions arise from the fields of communications and linguistics,^16,22,25 computer science,^12,36 and criminology.^2,37

Most published research is qualitative and explores the incel worldview through discourse analysis of the now deleted sub-reddit threads r/incels and r/braincels, the deleted forum incels.me, and its current iteration, incels.co. One challenge associated with this research is the question of whether to study those people who post and consume online incel content or those who have committed violence espousing an incel motivation. The majority of the published work assumes a contiguity between these groups by taking the latter as an extreme manifestation of the former; however, there remains little empirical evidence to support this assumption. Researching incels may be further complicated by their reticence to participate in academic research, driven by hesitance to self-identify as incels following mass violence incidents.

Demographics

Most research characterizes incels as young, straight, white men.^{11,16,18,25,35} For example, two articles used the demographic of 18- to 30-year old men as a proxy for the incel community.^34,37 There are limited empirical data to support this characterization, however.^{11,16,18,25,35} A March 2020 membership survey from incels.co is cited in several studies.^4,10,38 In this survey, over four-fifths (82%) of the 665 survey respondents identified themselves as between the ages of 18 and 30, and 55 percent identified as white or Caucasian, with the remaining 45 percent fairly equally distributed among Black, Latino, Asian, Indian, and Middle Eastern. Geographically, most incels were located in Europe (43%) and North America (38%), with smaller numbers in Central and South America, Asia, Oceania, and Africa. Similarly, a study using text profiling software to detect demographics of forum users found a majority were “adolescent, male, and slightly less educated” (Ref. 12, p 13). A key problem when researching incel forums is the variability of posting frequency, with a minority of users posting the majority of the hateful or violent content. Any difference in demographics between those that post actively and those that consume passively is unknown. In sum, incel online membership may be more heterogeneous than assumed, especially in terms of race.

Two articles address the demographics of those who commit incel-motivated violence. In their search for “self-identified incels,” Williams and Arntfield list seven offenders and describe them as white males, aged 17–48, likely to be virginal, and showing characteristics of autism spectrum disorder (ASD).²⁸ In contrast, Hoffman and colleagues found that two of three offenders who committed clear incel-motivated violence were of mixed race rather than white.⁴ One explanation for the difference in these findings is that these small studies vary in their approach to classifying which offenses are clearly motivated by incel ideology, as opposed to those that are more tenuously attributed to incel beliefs and therefore not included in the research.

Comparing with Other Groups

Although the incel subculture is a relatively new phenomenon, comparisons can be made to other more rigorously characterized subcultures with similar characteristics to provide some insight into this population. Ideologically, the antifeminism that defines incel philosophy can be found reflected in other similarly insular groups, including Men Going Their Own Way (MGTOW) and the Proud Boys. MGTOW is a group that attributes the destruction of Western society to feminism, which they believe has rendered men inconsequential.^18,33 MGTOW advocate separating entirely from society and women.³³ The Proud Boys, a white supremacist group active in North America and designated a terrorist group in Canada, originated during the 2016 American presidential election. The Proud Boys have built a platform based on white supremacy, anti-Semitism, and antifeminist rhetoric.^39,40 They refuse female membership, recommending instead that women “get married, have babies, and take care of [their] families” (Ref. 41, p 1). This more traditionalist view of societal gender roles is shared by jihadists, who defend what they consider acceptable Muslim womanhood.¹⁰ Although there are a number of similarities between incels and jihadists, including a preoccupation with sex and suicide attacks, there are also several key differences. The jihadi believe they are defending women and hope to bring about change in society; however, incels who are black-pilled do not believe in the possibility of social change or redemption for women or for themselves. In addition, the jihadi use sex and sexuality as a means of encouraging martyrdom among their members.^4,10 Although incels also use terminology related to martyrdom, labeling those who have committed violence under the incel title as “saints” and idealizing them, they do not believe in another world’s paradise.^3,10

Although incel ideology is primarily defined by misogyny, their rhetoric also references racial language and racist stereotypes. Incel philosophy centers whiteness as the ideal, with nonwhite incels referring to themselves as “ricecels” (Asian incels) or “currycels” (Indian incels). Chads are exclusively white males, and different language is used to refer to nonwhite alpha males, such as Tyrone for Black men and Chang for Asian men. This emphasis on race is a common characteristic of many extremist hate groups, including neo-Nazis and the Ku Klux Klan.⁴² Social media posts and manifestos written by members of the incel community use disparaging, racist language similar to that used by white supremacist groups when recruiting members.^3,29,43 Despite these similarities between incels and these extremist hate groups, a crucial difference is that the KKK and neo-Nazis prohibit membership of nonwhite individuals, where incels do not. In fact, some incel subgroups go so far as to believe that one cannot be a true incel if one is white due to the societal privilege white men possess. Inherent to this conception is the idea that other cultures and ethnicities are at a disadvantage when it comes to dating and romance.^2,3

Parallels can also be drawn between incels and cults. Cults are defined as groups in which members have a rigid adherence to a set of beliefs that is distinct from commonly accepted religious doctrines.⁴⁴ To those not indoctrinated in the cult, these beliefs often appear bizarre and perhaps even delusional.⁴⁵ Cults often have dominant individuals,⁴⁴ somewhat similar to the incel veneration of members who have committed acts of violence as martyrs or saints.^3,4,10 Another similarity to the incel subculture is that members of cults often perform violent and suicidal acts in the name of their belief system.^3,4,10,44

These groups are similar in that their level of adherence to their philosophies may be characterized as extreme overvalued beliefs.^45,–,47 The term extreme overvalued belief was proposed to describe a belief shared by members of a culture, religion or subculture, to which an individual has an intense emotional commitment.^46,47 These beliefs often grow and become more firmly held over time and individuals with such beliefs may perform violent acts stemming from these beliefs.^46,47 The incel ideology meets suggested criteria for an extreme belief system.²

Some men who self-identify as incels have planned and committed acts of violence and mass murder related to their incel beliefs;^4,6,–,9 thus, consideration of common characteristics of mass murderers may further assist in evaluation of incels. Although mass murderers are a heterogenous group, mass murderers and incels share several characteristics, including a history of being bullied as a child, poor self-esteem, perceived social rejection and isolation, externalization of blame, resentment toward others, antisocial, rigid, narcissistic, and grandiose personality traits, and revenge fantasies.⁴⁸

A careful consideration of both similarities and differences between incels and other groups may provide insight into characteristics and their pathway to radicalization; however, it also demonstrates a need for more rigorous research into the subculture as a whole.

Psychiatric Comorbidities

Most of the information available about members of incel communities has been gathered from self-report surveys that do not assess for mental illness in a structured manner. Although this survey data helps to elucidate potential psychiatric comorbidities in the incel population, self-reported symptoms and diagnoses, particularly in responses to a nonstandardized survey, may be unreliable. In a 2019 survey from incels.co, one of the largest existing online communities of incels, 88 percent of the 665 respondents indicated feeling unhappy with their lives, 68 percent reported that they experienced depression, and 74 percent reported experiencing “constant” anxiety and emotional distress.^4,10,38 The survey did not include information about how many responders were currently undergoing mental health treatment.

In addition, two-thirds (68%) of the 2019 respondents reported having thoughts of suicide.³⁸ In comparison, the 1-year prevalence of suicidal ideation in a community sample of men was 6.1 percent for those aged 18–25, 4.3 percent for those aged 26–49, and 26 percent for community members who identified as having depression.^49,50 In an analysis of 50 cases of violence perpetrated by incels, over half of the perpetrators died by suicide or reported suicidal ideation during the incident. Many incels wrote suicide notes prior to acts of violence.¹ In addition, suicide is a common topic on incel forums, where incels discuss hopelessness about the future and frustration at their perceived inability to form meaningful relationships. Suicide is referred to as “roping” and factors worsening suicidal ideation as “suifuel.”

The incel forums also encourage speaking negatively about one’s physical appearance as well as posting pictures and receiving critique from others, which may further contribute to negative self-concepts or depression. Furthermore, the emphasis within incel subculture on a specific physical appearance has led some to undergo extensive plastic surgery. Although there are no available data on rates of body dysmorphic disorder within the community, 60 percent of survey respondents reported considering plastic surgery for esthetic improvement.³⁸

In addition, over a quarter (29%) of self-identifying incels reported being on the autism spectrum.³⁸ This is significantly higher than the 1 percent baseline prevalence of autism.⁵¹ After the Toronto van attack, the possible connection between ASD and incel-related violence garnered media attention. The defense unsuccessfully sought a verdict of Not Criminally Responsible as a result of impaired theory of mind, asserting that the perpetrator’s ASD diagnosis rendered him incapable of understanding the wrongness of his actions.⁵² Several prominent autism advocacy groups objected to this approach, noting it perpetuated harmful stereotypes about neurodevelopmental disabilities.^53,54 Caution is needed in connecting ASD and extremist beliefs given the lack of empiric data supporting such a connection.⁵⁵

Although these surveys help to elucidate potential psychiatric comorbidities in the incel population, data are self-reported and only from a small subset of the community. Further research is needed in this area to adequately classify the psychiatric comorbidities of the incel population. It is clear, however, that many incels report a degree of psychiatric symptomatology that could be addressed through therapy and psychopharmacology.

Psychiatric Evaluation of the Incel

Self-identified incels have perpetrated several mass violence events in recent years, including the 2014 Isla Vista shooting¹, the 2018 Toronto van attack,^1,5 the 2018 Tallahassee yoga studio shooting,¹ and more recently a stabbing on a train in Japan,⁶ a mass-shooting in England,^8,9 and an aborted shooting in Ohio.⁷ Forensic psychiatrists may be tasked with evaluating incels in competency to stand trial evaluations, mitigation of penalty evaluations, sanity evaluations, and violence and suicide risk assessments. As discussed previously, many individuals who self-identify as incels also report suicidal thoughts, mood symptoms including depression and anxiety, and ASD traits.³⁸ As in any psychiatric or forensic evaluation, the evaluator should screen for psychiatric comorbidities and evaluate their potential impact on the forensic referral question or treatment.

Extreme overvalued beliefs shared by members of a subculture, such as those espoused by incels or sovereign citizens,⁴⁷ should be discerned from delusions or psychotic beliefs. Psychiatrists should become familiar with vernacular and beliefs shared by members of the incel subculture to identify the presence of these extreme overvalued beliefs in an individual and help to distinguish these beliefs from true delusions. In addition, care should be made to evaluate for nondelusional symptoms of psychosis. The presence or absence of disorganization, negative symptoms, and hallucinations can help distinguish genuine psychotic illness from extreme overvalued beliefs.

It is helpful to ascertain whether these are new or long-term beliefs and how intensely they are held, and to assess participation with others with these beliefs, including on the internet. Because incel beliefs may appear delusional to someone without knowledge of the subgroup, incels may be referred for competency to stand trial or sanity evaluations, as happens with soverign citizens.⁵⁷ With both groups, it can be helpful for the evaluator to have knowledge about group worldview and vocabulary.⁵⁶ The presence of an extreme overvalued belief alone does not inherently impair an individual’s competency to stand trial or knowledge of the wrongfulness of their actions. In fact, courts in general do not acknowledge shared beliefs as the product of mental illness.⁴⁷ Finally, it is important to consider how the incel beliefs may be related to the legal question posed and the defendant’s legal situation, as seen with the perpetrator of the 2018 Toronto van attack. Preceding the attack, he posted on Facebook a reference to the perpetrator of the Isla Vista attack and specifically cited the “Incel rebellion.”⁵⁸ He later told detectives he had been motivated by rejection by women and the incel movement, to which he was exposed through chatrooms. In her verdict, the judge determined that he had mentioned the incel movement to increase the media attention surrounding his attack, based on interviews with forensic psychiatrists.⁵⁸ Notably, multiple forensic psychiatrists reported that he was hyper-focused on the Isla Vista attacker and his manifesto, as well as mass-murders in general. This fascination was deemed by Bradford to be in keeping with an overvalued idea rather than a psychotic delusion and was determined to be “not of the kind of intensity required to ground a defense under s. 16 of the Criminal Code” (Ref. 58, pg 54).

Forensic psychiatrists may also be asked to evaluate suicide and violence risk in individuals associated with the incel subculture. Those asked to evaluate an incel’s violence and suicide risk should aim to provide a structured clinical risk assessment, which allows for the integration of clinical judgment with empirical data. The lack of research into inceldom has contributed to relative difficulty reliably identifying incel-specific violence and suicide risk factors. Further research in this area is warranted so that psychiatrists can incorporate new findings into their practice. An analysis of incels and their patterns of suicide and homicide present some findings of common factors in these cases, including level of indoctrination.¹

An assessment of incel violence risk should begin with the general practices in a violence risk assessment, including assessment of substance use, mental illness, and demographic factors.⁵⁹ Past violence is the best predictor of future violence; thus, it is important to gather a detailed history of violence.^59,60 Several specific violence risk factors have been posited (Table 2).¹ Incels can display both affective violence and planned, predatory behaviors.¹ Psychiatrists should also evaluate the magnitude of threatened potential harm, the likelihood of a future violent act, the imminence of this harm, and the frequency of the threatened harm. A fifth element to consider is situational factors, which can include access to weapons as well as association with a criminally offending peer group.⁵⁹ Perceived community support for acts of violence, as seen through the “sanctification” of past perpetrators,^3,10,29 should also be considered a risk factor.⁶¹

Leakage of indications of intended violence to third parties can be verbal or via email, text, or social media. Incels who have committed or planned acts of violence have written and released manifestos, including the 2014 Isla Vista shooter (“My twisted world”)⁶² and an Ohio-based man who planned an attack but was arrested prior to carrying it out (“Isolated”).⁷ One man in England posted videos on YouTube detailing his views on women and identifying himself as “a terminator” prior to a mass-shooting after which he completed suicide.⁹ Studies of mass murderers have also revealed patterns of warning behaviors that should raise concern for future violence.⁶³ Identification with “previous attackers … or as an agent to advance a particular cause or belief system” (Ref. 63, p 215–216) is one such warning behavior of particular relevance to the incel group, which has been known to glorify individuals who have carried out mass violence.^3,10,29 Identification of leakage should raise concern for potential violence.^1,63 Of course, psychiatrists should be aware of their jurisdiction’s Duty to Protect statutes and follow such guidelines if any threat toward an identifiable individual is made.

Violence risk assessments with notable findings should prompt the evaluator to also conduct a suicide assessment for several reasons. Many of the violence risk factors such as hopelessness, substance use, stressful life events, poor social support, and access to firearms are also suicide risk factors.⁶⁴ In general, individuals who commit mass murder do it expecting to be killed by police or to commit suicide.⁶⁵ Incels may be a group at higher risk of suicide (including homicide-suicide) than the general population given their self-reported anxiety, depression, and suicidal thoughts, as well as community support for suicide in the online spaces they frequent.^38,61 Over half of the incels who perpetrated acts of violence died by suicide and many reported suicidal ideation or wrote suicide notes.¹ When performing a risk assessment or treating a self-identified incel clinically, a careful suicide risk assessment should be conducted, and attempts should be made to address dynamic suicide risk factors. In general, risk assessments should be individualized.

Treatment of the Incel

There is limited empiric research on treatment of the incel. Psychiatric comorbidities should be identified and treated. When treating a patient who self-identifies or is suspected to be a member of the incel group, an evaluation of violence and suicide risks should be carefully completed. Van Brunt presents several case studies of treatment of individuals who identified as incels and posits that a therapy-focused approach to treatment may be helpful.¹ Therapeutic modalities, including motivational interviewing, Rational Emotive Behavioral Therapy, and narrative therapy, can provide an individual with an outlet for emotional expression as well as tools to reframe and address negative beliefs. This may be helpful in addressing the fatalism central to incel ideology. Van Brunt¹ emphasizes active listening without judgment and an emphasis on the individual’s strengths. These therapeutic modalities can also be helpful in guiding an incel to reframe negative stories in a way that promotes an improved sense of self-efficacy and a shift to constructive problem-solving. Psychiatrists should identify and promote stabilizing influences, including positive social relationships, to promote connectedness to and empathy for others.¹ Cues can also be taken from the treatment of individuals with Cluster B personality disorders, who, like incels,¹ can display both affective and impulsive as well as preplanned acts of aggression. In addition to therapy-focused approaches to treatment, antipsychotic agents and mood stabilizers can reduce risk of impulsivity and anger in these populations.⁶⁶