Does Picking the Gender of Your Therapist Matter?
Myth versus reality
Writing this third post on men’s mental health has been challenging.
I thought I knew the story: Men and masc people struggle to open up to other men, so they prefer to have a woman as their therapist. That was the assumption when I set out to write this post. I assumed the masculine-identifying clients I see are part of the small group who go against the trend. But when I dug into the research, that narrative fell apart. I realize now that the men I work with are not the exception. Far from it. They are the rule, and the research backs it up repeatedly.
For example, one study of over 2,000 men found that about 60% had no preference at all regarding their therapist’s gender. The rest were a coin toss, with about 20% preferring a female and 20% preferring a male. It turns out, most men just want someone who can listen, show some empathy, and provide some expertise.
Going deeper
Is the gender of your therapist something you've considered before, for yourself or someone important in your life?
Let’s push past the easy assumptions. Let’s take a look, through the lens of gender, at some of the influences on decision making in help-seeking. Consider this a chance for reflection on what your needs are from a therapist, and whether or not you are open to viewing those needs differently.
To match or not to match
Because there is no one-size-fits-all rule, the right choice depends on your identity and your unique needs in the moment. The statistics for male clients are pretty consistent—in addition to the study mentioned earlier, another one found that 58% of had no therapist gender preference. However, multiple studies also show that the pattern looks very different for women. Over and over, we see a trend where most women prefer to work with women. When the primary issue is explicitly about gendered concerns (such as post-partum depression), the rates of preference for a woman-to-woman match approach 100%.
In fact, presenting problems matter across the board. It seems that the more severe a man’s depressive symptoms are, the more likely he is to prefer seeing a female therapist. It’s speculated that while many men are comfortable discussing less emotionally charged situations with other men, severe depression clashes with stereotypes of “traditional” masculinity, turning vulnerability into a point of shame among male peers.
While the general pattern shows men are open to any gender, there are distinct trends in the remaining camps:
Male-male matches: Guys often want a therapist who simply “gets it” from a shared lived experience.
Male-female matches: Gender stereotypes, for better or worse, come into play, with some clients viewing emotional work as a more natural domain for women.
Yet another perspective is the potential “opposites attract” dynamic. Some older research found that women sought therapists with more stereotyped masculine traits like confidence or directness while men sought therapists with more feminine traits like gentleness or a nurturing demeanor. I think we should take these ideas with a massive grain of salt. That being said, if we look at therapy as a practice of restoring equilibrium when life feels out of balance, then there may be something corrective, for some people, in such an approach.
Importantly, these patterns shouldn't be mistaken for exclusively binary rules about men and women. People's experiences along the spectrum of gender are complex and unique to each person.
Knowing what you need versus room for flexibility
That brings us to an important consideration: Sometimes, good therapy is about challenging ourselves a little. Sometimes, we need a kind but opposing opinion that’s hard to swallow. Sometimes, we need called out on our bullshit.
Likewise, there is evidence that partnering with a therapist who doesn’t share your identity markers acts as a catalyst for growth. These catalysts can take many forms:
Maybe you’re a woman used to emotionally unhealthy men, and you could benefit from a safe male presence in the therapy space.
Maybe you're a masc person who typically prefers disclosing to women, but the real healing lies in pushing outside your comfort zone to practice opening up to another men (a journey I’ve encountered in my practice more than once).
On the other end, perhaps you grew up with an overly critical mother, and you need a supportive, corrective relationship with a female therapist.
Perhaps, regardless of identity, you would benefit from the intersectional perspective of a non-binary therapist who is prepared to have deep discussions about, say, cultural gender pressures.
The examples could go on indefinitely. But to be clear, the most important part is almost always the strength of the therapeutic relationship itself, regardless of identity markers.
That said, the results are pretty unambiguous that if there is a strong preference for the gender of your therapist, measurable post-therapy outcomes are significantly better if you get the match you are looking for. And if that’s you, that’s completely okay. Again, the point here is to reflect on what’s best for your needs. If you have flexibility, consider making the choice that doesn’t feel like the easy one, yet could be the more rewarding path. If your line in the sand is one you won’t cross, great! You’re exercising your autonomy and have already identified a crucial component for your healing.
Hopefully, this offers some useful food for thought if you’re considering reaching out for help. If you’re already in therapy, maybe this can spark a conversation about the role that cultural-level gender dynamics play in your life. Whatever you’re journey, I hope you take the step that’s needed, in whichever direction it’s needed, to get help when it’s necessary.
If reading reminds you of someone you love
Send it to them. Sometimes the right words from the right place is the tipping point.
Matthew Sooby, MS, is a therapist at InPowered Therapy in Lincoln Square, Chicago. He is accepting new clients, in-network with BCBS and Aetna, and offers a free 20-minute phone consultation. Reach out at inpoweredtherapy.com.
Full citations for article available by request.
