The catchy title of the best-selling relationship self-help book, Men Are from Mars, Women Are from Venus (Gray, 1992) implies that in at least some ways males and females are “alien” to each other. The metaphor became part of popular culture to validate the general population’s observations about common yet profound differences between men and women, many of which have become scientifically validated in evolutionary psychology (e.g., Miller, 20021; Buss, 2017).
The primary concern of this article is how the trend in clinical psychology of predominantly female clinicians will impact the psychological understanding and psychotherapeutic treatment of males. Callahan et al. (2018) reported that, compared to the U.S. population at large:
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female doctoral psychology students are “far overrepresented” (78 percent vs. 49 percent)
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students who identified as transgender were normally represented (.006 percent vs. .003 percent)
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students who identify as male are significantly underrepresented (22 percent vs. 51 percent).
Arguably, this imbalance is unlikely to change given no apparent efforts by the American Psychological Association to increase the recruitment and retention of males into graduate programs in clinical psychology.
Does Clinical Psychology Educate Therapists About Male Psychology?
The female/male imbalance in its own right may not be a problem. And I am not necessarily advocating perfectly equal male representation among clinical psychologists (although I briefly address this below). Instead, I suggest the following template be considered.
In recognition of the fact that therapists, as a group, did not reflect the cultural/racial diversity of the U.S. population at large nor those seeking treatment, the American Psychological Association accreditation process mandated diversity training as a profession-wide competency, based upon the idea that it is crucial for practitioners to better understand and effectively serve clients from diverse backgrounds by equipping them with the knowledge and skills to navigate cultural nuances and provide culturally competent care. If you read a journal or attend a conference, you will witness the explosion of articles and presentations on these topics.
Yet I wish to point out here that the largest discrepancy in the representation of clinical psychologists to the population at large is the male-female divide (Callahan et al., 2018). Therefore, increasing the training of therapists in the psychology of men (e.g., Liddon & Barry, 2021) seems warranted, in the spirit of diversity training that is already in practice for circumstances where the therapist’s personal qualities and beliefs may be out of sync with the patient they are working with. (Male therapists would of course benefit from training specifically focused on female psychology; however, this therapist “mismatch” is less likely to occur given the preponderance of female therapists.)
Unfortunately, this does not seem to be on the radar of clinical psychology training. In reviewing APA’s Division of Clinical Psychology recorded CE Webinars and the APA’s 2025 Convention CE workshops, I found that there were no training opportunities focused on working with cisgender men. Based on the provided titles, there appeared to be seminars focused on adapting evidence-based treatment to individuals of different races, cultures, and ages (children, adolescents, older adults), as well as transgender people, gay people, and women—but none that focused on males alone.
This is of major concern for the reasons noted above and, in my view, is counter to APA’s own guidelines. One of the nine profession-wide competencies required for training clinical psychologists is preparing them to work effectively with diverse clients. Diversity is defined in the Standards of Accreditation (APA, 2018) as follows: “Doctoral students are expected to demonstrate (1) an understanding of how their own personal/cultural history, attitudes, and biases may affect how they understand and interact with people different from themselves; and (2) knowledge of the current theoretical and empirical knowledge base as it relates to addressing diversity in all professional activities including.”
In my reading of these criteria, it seems that, for female therapists, working with men should be included as a diverse group (i.e., people different from themselves). Some people may even argue that the greatest differences lie not in people from different races, ethnic groups, cultures, socio-economic groups, etc (where most of the diversity training is focused)—but instead between the sexes. Certainly the field of evolutionary psychology provides an empirical basis of human nature that suggests the answer to this question is “yes” (Miller, 2001; Buss, 2017).
Does Clinical Psychology Deny or Ignore Innate Sex Differences?
Perhaps underlying the lack of attention to innate sex differences may be the underlying belief that they do not exist. While on the surface, the American Psychological Association’s (APA) acknowledgment of the necessity to release Guidelines for Psychological Practice With Boys and Men (2018) appears to reflect the understanding that there are aspects of men that are inherently different from women, it instead backfired by overestimating the cultural influence on masculinity (masculinities are constructed based on social, cultural, and contextual norms). Indeed, the following quote exemplifies this contention: “When researchers strip away stereotypes and expectations, there isn’t much difference in the basic behaviors of men and women (Pappas, 2019).
In addition, the Guideline was criticized for broadly denigrating the nature of traditional masculinity: “Traditional masculinity—marked by stoicism, competitiveness, dominance, and aggression—is, on the whole, harmful”; Pappas, 2019) without truly highlighting the potential upside of some of these traits (e.g., stoicism, competitiveness, self-reliance), especially when exhibited at an appropriate level, presumably because these are not aligned with current socio-political ideologies that dominate psychology (see Ferguson 2023 for a detailed critique). At some level, these guidelines suggest that masculinity should be deconstructed.
Why Should Clinical Psychologists Care?
Currently, women are providing the bulk of treatment as a result of their overrepresentation in the field of clinical psychology. But without appropriate diversity training, several iatrogenic consequences may occur, such as misunderstanding or ignoring men’s issues, failing to address the pressures of masculinity that may underlie psychopathology, the tangible consequences of dismantling masculinity, and negative stereotyping of men (or male qualities) presenting for therapy.
This may lead to men prematurely dropping out of therapy—or not pursuing therapy at all. Indeed, one possible negative impact of the accelerating disproportionate representation of women to men in the field is it may unwittingly give the message to men that emotions and therapy are for women. That may prohibit the necessary help-seeking behavior in men.
One may argue there is not much that can be done to change the trajectory of men’s and women’s career choices in this field. However, if that is the case, as noted above, training female therapists in male psychology seems essential to providing quality psychotherapeutic care.