By Charvi Koul
Member, Creative team
Everyone’s thoughts and decisions are influenced by the biases present in society. Even clinicians and therapists are not immune to them. They especially need to make a conscious effort to acknowledge these biases and not let them affect mental health diagnoses and treatment. One such factor that needs to be acknowledged is the effect of a person’s gender on the onset, symptoms, underlying mechanisms and response to treatment and the gender bias, and gender-blindness that exists in mental health diagnosis.
A facilitator of gender bias in therapy is the traditional DSM approach and models which act in a gender-blind manner. The DSM does not take into account how a patient’s symptoms may be related to societal gender processes or that the diagnoses may be gender-biased. Behaviour patterns expressed by one gender may be deemed suitable but the same patterns displayed by the other gender may be declared problematic. Behaviours exhibited by a person that goes against the traditional gender norms can especially be seen as abnormal. For example, women who are “uncooperative” or “resistant” would have a higher chance of being seen as problematic rather than men. This can be very harmful when giving out a mental health diagnosis.
For instance, women are more likely to be diagnosed with histrionic personality disorder, a disorder where a person’s symptoms include being seen as seductive, attention-seeking and dramatic. Society is quick to stereotype women into this role rather than men. Similarly, eating disorders often go underdiagnosed and unseen in men because the prevalent view is that these are disorders of teenage girls and women. Women are 2-3 times more likely to be depressed or have anxiety than men and 8 times more likely to have an eating disorder. On the other hand, men are more likely to suffer from alcoholism, antisocial behaviours and suicide. However, these effects of gender are often ignored by clinicians while screening and diagnosing people.
Being gender blind also leads to an assumption that the symptoms of a particular disorder will manifest themselves in the same manner across genders, which can be very misleading. Mental health issues often manifest differently across genders. For example, men suffering from eating disorders are known to indulge in overexercising whereas women are more likely to diet or purge their food.
Current mental health professionals, as well as future budding mental health advocates, are also consumers of such stereotypes and assumptions. This makes it important for them to be informed of such tendencies and biases. To work upon the gender bias in the diagnosis of mental health issues, we must first acknowledge and educate clinicians and therapists on gender differences and their implications on mental health. From there on we need to assess whether certain diagnostic criteria are skewed towards a certain gender. It is important for clinicians to question their decisions from a gendered perspective before making a diagnosis and prescribing therapy or any sort of treatment. In the end, mental health professionals are human but they must make sure that their biases do not interfere with them being able to help their patients to the best of their abilities.
Macfarlane, M. M., & Knudson-Martin, C. (2003). How to avoid gender bias in mental health treatment. Journal of Family Psychotherapy, 14(3), 45-66. https://doi.org/10.1300/j085v14n03_04
Rojas, E. G. (2016). Gender Bias and Clinical Judgment: Examining the Influence of Attitudes Toward Women on Clinician Perceptions of Dangerousness [Doctoral dissertation]. https://doi.org/10.7916/D8WQ043B
Featured Image: “Hysterical Woman Screaming”, Photo by Albert Londe 1890. Via Pinterest