Last week, President Trump was finally photographed wearing a mask, several months into the coronavirus pandemic. His long reluctance has reinforced conservative perceptions that wearing a mask is a partisan act and not just a minor inconvenience that helps protect public health.

So why have U.S. conservatives been so reluctant to put on masks? Washington Post columnist Monica Hesse recently argued that mask-wearing challenges American beliefs about manhood and leadership, and indeed scholarship finds that voters pay close attention to how masculinity is represented.

However, there is more to the cultural politics of masks than gender identity. To understand mask aversion, it’s useful to examine how ideas about manhood intersect with notions about disability and personal freedom.

American culture depicts masks as unnatural

In some countries, including many Asian countries, mask-wearing is a matter of cultural etiquette. It signals respect for others and a commitment to personal health in normal times, and compliance with safety measures during a pandemic.

The United States is different. For many Americans, masks are stigmatized as symbols of sickness and disability. President Trump has mocked and exploited disability for political gain, depicting any kind of perceived weakness as akin to “losing.” This taps into long-standing themes in U.S. culture.

Historians of disability and medicine have shown how markers of sickness, illness or disability have been stigmatized as immoral, impoverished and weak. My own doctoral research analyzed how early American cinema depicted disability. Up until the mid-1940s, Hollywood cinema had mostly depicted disabled bodies as feminized, prone, lazy, immoral and freakish. Physical disability reflected moral inadequacies in movies, such as Tod Browning’s 1932 film “Freaks; such images persisted for decades afterward.

Film depictions of disability changed after World War II, as American culture worked to reintegrate wounded veterans. What came next were “social problem” movies that tried to reconcile wartime disability with suburban life and traditional gender roles. In the decades since, disability rights advocates pressed for changes in policy, like the passage of the 1990 Americans With Disabilities Act, and representation, pushing for more and better representations of disability in popular culture.

Still, U.S. political culture has often continued to associate signs of illness and disability with suspect morality and perceived effeminacy; consider the ways political operatives have weaponized the perceived mental and physical frailties of two current presidential candidates: incumbent President Trump (R) and his presumed Democratic challenger, Joe Biden. Current fights over masks thus reflect a deep-seated and fraught relationship with anything that smacks of illness or contagion.

For Trump supporters, masks may seem like a kind of problematic prosthetic, an outward manifestation that something is wrong, sick or aberrant. This helps explain why some conservatives denounce masks as “muzzles.”

The muzzle metaphor resonates with arguments that masks are a form of oppression, too. When former vice president Richard B. Cheney was photographed wearing a mask and a cowboy hat, adding on Twitter the hashtag #RealMenWearMasks, he was retweeted by critics of the president who praised Cheney for transgressing Trump anti-mask orthodoxy, and scorned by Trump supporters for being a “joke” because “masks are for sheep.”

Conservatives perceive masks as attacks on personal liberty

Notions of masculinity are only part of the mask aversion story. Although many Republican leaders now publicly support mask-wearing, many Trump supporters seem to care less about Cheney’s notions of manhood than the fight against liberals, whom they perceive as wanting to “cancel” their free speech rights, and against a government they feel is controlling and oppressive. This opposition to masks among many in Trump’s base led governors in Republican states such as Florida and Arizona to act slowly on mask mandates. This form of Trump support may also help explain why many women on the right also fight these mandates.

Hesse’s column misses the ways in which the fear of masks taps neatly into right-wing media ecosystem mythologies. For Trump loyalists, the mask covers the mouth, which may trigger beliefs that liberals want to limit “free speech,” an important flash point for those on the right. Mask mythologies resonate with intricate conspiracy theories on the far right positing that government cabals, organized by “the deep state,” are orchestrating the coronavirus pandemic to make it easier to control Americans.

Masks are racialized as well. Because many in the United States wrongly associate mask-wearing with Asian identities, those who believe the debunked conspiracy theory that China intentionally launched the pandemic as a weapon were probably even less inclined to mask up.

All this has led to a variety of themes in current conservative discourse: that masks are for “sheeple,” or that mask requirements are unconstitutional, or that masks somehow make you sick. All these claims tie together concerns about personal liberty with beliefs about masculinity, sickness, weakness and conspiracy theories that masks are being used by the federal government to manipulate, dominate or control U.S. citizens, and especially conservatives.

President Trump’s own disdain for masks and reluctance to wear them have helped promote some of these beliefs. Some of these ideas may become less attractive to conservatives if he starts wearing a mask more often in public. However, it is also possible that they have melded together beliefs about illness, personal liberty and hostility toward China in ways that make them self-supporting, even if the president reluctantly starts to dissociate himself from them.

Jen Schneider is professor of public policy and administration in the School of Public Service at Boise State University and co-author of “Under Pressure: Coal Industry Rhetoric and Neoliberalism” (Palgrave Macmillan, 2016)