Summary: Qualitative interviews were conducted to examine the dynamics of gender roles, tradition, culture, and parental expectations, often influenced by Confucian values, of Korean American first-born or only sons. Theories of stress, identity, and acculturation may inform how gender and status affect outlook on life, relationships, duties, career, and mental and physical health. Method: 47 Korean Americans, ages 18-40, of whom 35 were first-born or only sons, were interviewed. For corroborative data, 12 siblings (five younger brothers and seven sisters) were also interviewed. A semi-structured, open-ended, 25 question guide was used for interviews which were then recorded and transcribed. Results: Common themes emerged. First-born or only sons had privileges (e.g. more attention and respect) but there were stressors, burdens, sibling conflict, and duties tied to their roles. Traditional Korean cultural expectations were contrasted with " American" equivalents observed by participants in their non-Korean peers. Some perceived their role burdens as outweighing their privileges. Despite these burdens, however, many Korean American males were proud of the accomplishments that resulted from the pressure. They appreciated their parents' hard work to provide and to support their education and felt obligated to repay them by caring for them in old age. They also learned the value of family loyalty to care for family members. Some expressed gratitude for parents having high academic and career standards. Conclusions: Dynamics of tradition, culture, parental expectations, respondents' realization, acknowledgment, and acceptance of roles, are important to understand for the overall health of Korean American first-born or only sons and their families. Roles include privileges and burdens. Yet, among immigrant families, role expectations can result in a clash between traditional Korean values and American values in terms of what sons want and what parents expect. Given high expectations of first-born sons, an imbalance in the dynamics of burden/pressure vs. privilege/support may create stress. However, burdens and expectations can be mediated by status, respect, privilege, achieving success and pride when fulfilling parental expectations. This study highlights how assimilation and acculturation may be complicated among second generation immigrants when expectations of the old country are different from the new.