In generations past, so-called “experts” have put forth many misguided notions on the path toward understanding the human brain and perceived gender differences in mental health. One of the first and most sexist mental disorder designated to women was called “hysteria” — supposedly caused by what doctors referred to as “wandering wombs” — and was treated through pelvic massage or getting hosed down. Meanwhile, for men, the mental health rule of thumb appeared to be “boys will be boys.”

Effective treatments, eh?

Such ridiculous notions about gender differences in mental health don’t really exist anymore today. Yet, while we may not be operating in the archaic ways mentioned above, more research is certainly needed on the spectrum of what gender means in modern society. Findings in past decades suggest some differences do exist regarding risk factors, symptomatology and prevalence in mental health, from a binary definition along with what illumination may be found in emerging research in transgender and nonconforming identities.

Anxiety and Depression

So, what do recent studies have to say about gender differences in mental health?

The major concern remains the comorbidity and prevalence of anxiety and depression. Over a lifetime, a woman is more likely to experience anxiety or mood disorders than a man as well as a late onset of schizophrenic psychosis. Women tend to ruminate more than men on concerns before engaging in active problem resolution, and anxiety is one of the more common mental health disorders in women.

If left untreated over the long term, anxiety, depression and other mood disorders adversely affects one’s occupational, social and physical health — including a higher rate of mortality.

Depression and anxiety also affect men, especially when they feel like they have to follow the outdated expectation of men avoiding and suppressing their feelings. The severity of symptoms often differs for men and women, with men more likely express their symptoms in the form of irritability or anger, whereas women often express them through sadness.

Men frequently face more sleep challenges than women, as well as the manifestation of physical symptoms such as chest tightening. Men are more likely to visit the doctor out of concern for physical symptoms rather than emotional ones, and they’re also more likely to use lethal means to commit suicide.

Among gender non-conforming and transgender youth, depressive disorder persisted in transfeminine persons at 49 percent and in transmasculine persons at 62 percent. The numbers range four to seven times higher than in cisgender, or binary, populations. Those questioning their identity or facing challenges of acceptance and expression may experience a higher likelihood of having depressive disorder. The numbers also reflected an increased risk of attention deficit disorder.

A Heavy Burden on Minority Mental Health

However, women actually make more attempts than men to commit suicide. Gender interacts with other determinants, and women’s likelihood of experiencing anxiety and depressive disorders at higher rates often comes down to role differences. They are at a higher risk of dealing with crises involving reproduction, child care, finances and the emotional toll of marital problems.

Eating disorders persist in women more than men, and reviews of 40 well-designed, worldwide studies suggest that 25 to 50 percent of women experience physical abuse from men, also known as gender-based violence. Such gender-relevant factors must be integrated into health systems as well as sex-specific burdens of disease and disorder over the course of a woman’s lifetime.

Non-conforming and transgender identities are also identities which must be treated with the same consideration and respect in mental health diagnosis and treatment. Perceptions of self, roles and responsibilities, along with the burdens placed on all gender differential identities, must be accounted for.

Transgender identity was previously (egregiously) considered by the World Health Organization as a mental illness, but that may change in the 2018  ICD-11 approval. This is the WHO’s “International Classification of Diseases” — a book that influences diagnoses across the world. Research impacting this classification shift reveals that gender incongruence didn’t predict individual suffering, but rather violence and social rejection.

Stigmas associated with a diagnosis of anxiety, depression and sexual deviation, among others, happen to real people as health systems fail to account for influential factors in upbringing and role differences. Therapists may discuss these factors in talk therapy, but codebooks and guidelines simply need updating. Unfortunately, that means waiting for emerging research regarding gender differences in mental health.

Although there are clear gender differences in mental health when we look at the classic “male vs. female” dichotomy, we need more info about the mental health risks associated with all gender identities, along with improved access to resources. Those who grow up in a supportive environment and have access to such resources throughout life will naturally be more likely to function healthily and lead fulfilling lives.