Mental illness affects women differently than men – not only in prevalence and symptoms, but also in how it’s perceived, diagnosed, and treated. Women are twice as likely as men to experience depression and anxiety, yet the discrepancies run far deeper.
One global study found that women are nearly twice as likely as men to suffer from mental illness, and this gender disparity significantly correlates with social inequality and gender inequality.
A Swedish study found that women are 44% more likely to be diagnosed with depression and 31% more likely to take antidepressant medication than men. Even after controlling for higher rates of mental health conditions in women, women still receive disproportionate numbers of mental health diagnoses and mood-altering drug prescriptions. This suggests that gender stereotypes continue to influence clinical judgment in ways that may either lead to overdiagnosis in women or underdiagnosis in men.
A Belgian study of adolescents found consistent gender differences in psychological distress, anxiety, and depression, with girls reporting significantly higher scores than boys across multiple measures. This pattern begins early in life and persists through adulthood, indicating that gender disparities in mental health emerge during critical developmental periods.
A shocking fact that underlies many contemporary disparities is that women were largely excluded from scientific healthcare research before 1990 and weren’t required to be included in National Institutes of Health-funded studies until 1993. This decades-long exclusion created research gaps that continue to affect women’s care today.
Research conducted in Germany confirmed that while approximately one in three women and one in four or five men receive a diagnosis of a mental disorder annually, the nature and presentation of these disorders differ significantly by gender. Women show higher rates of internalizing disorders like major depression and eating disorders, while men show higher rates of externalizing disorders such as substance abuse.
Breaking Down the Factors
The disparities women face in mental health include biological, psychological, and social factors. The World Health Organization recognizes that health outcomes are unequal for women across their lifespan. Numerous factors contribute including lower rates of schooling and employment, lower pay for similar jobs, underrepresentation in leadership positions, and higher levels of psychosocial stressors due to caregiving burden and intimate partner violence.
Additionally, women experience unique stressors that men typically don’t face. Although the pay gender gap is slowly narrowing, recent research indicates that in 2024 women earned an average of 85% of what men earned. This creates additional financial stress that compounds mental health challenges. Research shows that cost is the greatest barrier to accessing mental healthcare for women, creating a vicious cycle where those in need of care can’t afford it.
Furthermore, gender bias affects how women’s pain is interpreted and treated, which has mental health consequences. In emergency care settings, women are 13% to 25% less likely than men to receive opioid medications and they wait longer to see doctors, even after controlling for age, race, class, and pain scores. This often contributes to anxiety and depression as untreated pain takes its toll.
Contemporary Challenges and Persistent Biases
Healthcare providers, despite good intentions, carry implicit biases that affect patient care. Studies show medical practitioners are susceptible to the same unconscious biases as their non-physician peers. Research indicates that women’s symptoms are sometimes perceived as emotional or psychosomatic rather than clinical, which can delay or complicate treatment.
Systemic gender bias in the management of chronic health disorders results in women receiving less medical support and more incorrect diagnoses, leading to avoidable damage to their mental health. This pattern extends beyond mental health into physical conditions, creating a healthcare environment where women’s concerns are often minimized or attributed to psychological factors.
Lessons from a Dark Past: The Lobotomy Era
The history of psychiatry offers profound lessons about gender bias in mental health treatment. For example, lobotomies, which are now recognized as one of medicine’s most heinous treatments, were performed disproportionately on women. While most institutionalized patients in the 1940s were men, most lobotomy patients were women.
By 1942, 75% of the lobotomies performed by pioneers Freeman and Watts were carried out on women. These procedures weren’t just about treating mental illness-they were also used to control behavior that was viewed as socially unacceptable. Women were lobotomized for being “too assertive” or for failing to conform to what were considered traditional feminine roles. Cultural expectations of gender have dangerously influenced medical practice for decades, with surgeries that made female patients more “docile and compliant” being seen as beneficial.
Moving Forward: Lessons for Better Care
The history of lobotomies and ongoing gender biases in mental healthcare teach us crucial lessons about the importance of being aware of both overt and subtle forms of gender bias. Rising suicide rates among young women remind us that despite medical advances, women still face unique mental health challenges requiring thoughtful, bias-aware approaches.
Healthcare providers must recognize unconscious bias and acknowledge that gender stereotypes can influence clinical judgment. Taking women’s reports of symptoms seriously is essential. We must also consider biological differences such as hormonal influences and stress responses unique to women, in order to provide a more comprehensive approach to care.
The Path Forward
As we move beyond outdated mental health approaches, we must continue to monitor for both overt and subtle forms of gender bias in mental healthcare. Good intentions without proper oversight and awareness of bias can lead to tragic outcomes.
By learning from past mistakes while embracing evidence-based, gender-informed care, we can work toward a future where mental health treatment truly serves all people. The goal isn’t just to avoid the horrors of the past, but to actively create a more just and effective system of mental healthcare for all.