In a previous blog, titled “On Androcentrism in Psychology Research,” I briefly touched on alpha bias in the discipline of psychology and some of the issues it poses for researchers, as well as laypeople. In this article, I’ll be further articulating theories of sexism and patriarchy, as well as some of the ways we can see these concepts manifest as gender disparities in our mental health institutions.
Before getting into sexism in theory and in practice, I’d like to briefly explain the concept of gene/environment-interaction. This will be important later for understanding historical androcentrism, as well as contemporary sexism.
As early as 1958, Cooper and Zubeck bred rats to be “maze dull” or “maze bright” and raised these rats in enriched and impoverished environments. (Cooper, 1958) The purpose of Cooper and Zubecks’ study was to examine the potential genetic x environmental interaction, and to explore the relationship between genetics and environment, rather than perpetuate the historical notion that genetics and the environment are two distinctly separate influences on behavior and cognition. Their research concluded with “dull rats” performing exceptionally well in enriched environments, and did not differ significantly from “bright rats” in performance or cognitive ability.
As I learned about this research, I thought again about sociobiology theory of development and gender differences. Sociobiology theory and evolutionary psychology state that gender differences in psychology are associated with and linked to sex differences and socialized gender roles based on these differences. Sociobiology and evolutionary theories of gender differences are androcentric in nature- but I believe they can be constitutionist with perspective.
Sociobiology theory of gender differences can be constitutionist (the notion that gender is a social construct) rather than essentialist (the notion that gender differences are rooted in biology) if you consider that maladaptive behaviors (such as those that politically and economically cripple women and gender non-conforming individuals) have over time become resocialized as undesirable in a reproductive partner. I believe with further progress in recognizing that gender cannot exist in a cultural vacuum through psychological research, we can continue to work towards equal opportunity and equity in our social institutions.
Cooper and Zubecks’ research shed some more light on how neurobiology isn’t necessarily indicative of cognitive function when environmental influence is accounted for. This research reminded me about sociobiology theory and evolutionary psychology theory of gender differences, and how the argument is commonly made that men and women have different cognitive abilities- an argument that fails to carry its own weight with this research in mind. This argument is commonly cited by proponents of viewpoints that are typically androcentric in nature, which brings us to sexism in theory.
Sexism in theory:
In “Lectures on the psychology of women,” Sandra Bem discusses the historical and contemporary instances of androcentrism and institutionalized sexism in the discipline of psychology. (Bem, 2008) Some examples of what Bem discusses regarding historical and contemporary instances of androcentrism and institutionalized sexism would be the notion that women are less adept than men at certain cognitive abilities- and that these differences in cognitive ability warrant the inequalities women face in institutions such as the workforce. I think socialized, internalized sexism in the hiring process (both overtly and subtly by men, and by others who don’t understand how their socialized and internalized sexism manifests in their belief systems) is an example of how gender differences (rooted in androcentric research) again, do not exist within a cultural vacuum. In some societies, women may appear to be more adept than men at certain tasks, such as “parenting” or “babysitting” because of their “differences in cognition” through characteristics like compassion, which are measured differently in different cultures.
I also see socialization of these gender roles and the way they manifest as benevolent sexism in these concepts. We reward women who want to “perform housewife duties” by giving them jobs that don’t pay well, but that reinforce their gender roles. Or, we give them jobs that pay well, just not the same as they pay men. Then we say “well no that’s not the case, women just take lower paying jobs overall than men do” well, even if that is the case, that’s because the jobs they’re offered by other men, accepted in, and perceived favorably in when they pursue (perception of qualifications, assessment for promotions, etc) are the low paying jobs, or are jobs that have been institutionally crippled by denying access to unionization, etc.. I could really go in on this (the economic acrobatics of sexism) but there will be a place for that discussion in a future post.
I think Johnson’s perspective on patriarchy was exceptional in that it provided some context to the questions I’ve been asking myself since forever- what can I do, a cisgender, heterosexual male, to combat these institutions that affect women and gender non-conforming or gender-fluid individuals? (Johnson, 2004) This is important to me because these individuals suffer greatly psychologically from socialized gender roles. I’ve learned that one way I can actively combat these institutions is to utilize my platform to shed light to these concepts, in addition to amplifying the voices of women who suffer from these institutions.
Sexism in practice:
In the text, as described by West, the images of the Mammy, the Jezebel, and the Sapphire are grotesquely racist representations of black women in American society, and serve to socialize and internalize a sense of racism in our social institutions. (Chrisler, 2004) Specifically, an example of social imaging of the Mammy, as black women as asexual servants, would be the appearance of author and psychiatrist John Gray on the Oprah Winfrey show, where he profiled her as “somebody who couldn’t raise her own children because she was raising everybody else’s,” and “America’s Mommy.” This is an example of underlying racism which is internalized in our culture to be acceptable.
As somebody who isn’t a black American, a similar example of representation of the Mammy, Jezebel, or Sapphire didn’t come to mind immediately. This is because I’m privileged in that as a non-black American, I’m not subjected to the same socialized and internalized racism that black Americans, particularly black women, and black transwomen, experience daily. I’m privileged in that my ignorance is due to it not affecting me. I’ll make it a point to find an article that discusses this topic further, written by a black American, that I can learn more from about how I can recognize these racist symbols to speak out against them.
I believe the impact these images have on self-esteem and mental health of black Americans is two-pronged:
1. The internalization of these symbols affects black Americans by: convincing them from a young age that portraying black Americans in generalized, racially prejudiced and sexist images is acceptable, while doing it to white people is not (not because one is outlawed and the other not, but rather because it is the case that in one circumstance, racial profiling and images are culturally accepted- which is apparent in the frequency and emphasis and prevalence of images that portray black Americans, and not images that portray non-black Americans in this manner).
2. The socialization and internalization of these images can lead to identity issues, issues with self-esteem, depression, and suicide. It is not the case that this kind of racism affects every black American the same way- but certainly I can imagine the statistics for disparities in diagnostic rates of specific psychiatric conditions.
A form of sexism I’ve experienced in my personal life would be in the way I’ve personally witnessed, within the discipline of medicine, how women are perceived as less qualified as men. The “hi, when will the doctor be in?” or “wow, YOU’RE the doctor?” are examples of internalized sexism. Why do we immediately assume that, because the medical practitioner is a woman, she is not in a leadership position such as the practice lead or the primary investigator of the case?
I’ve learned how to navigate the history of patriarchy in our institutions in order to understand how I can assimilate my identities as a Muslim with my political identities- this has helped me to be able to discuss these institutions with a perspective that other Muslims may be able to identify with, in order to actively shift the dialog away from extreme traditionalism and fundamentalism in response to American liberalism. It is my belief that social liberalism and traditionalism in Islam are two apples from the same tree. I can go into more detail, but it would require a lot of background information and nuance that would shift the focus of this discussion away from the struggle of black Americans and black women (and women in general).
Under the circumstances of my witnessing sexism manifested, I was young and believed my attending physicians when they (men) would tell me that my symptoms were psychosomatic- my cardiologist now is a woman of color, and I’ve never experienced better quality care and overall concern for my health from another person before. She has grit, brilliance, and a knack for being able to connect symptoms that I don’t even recognize as symptoms. Perhaps she understands the medical gaslighting I went through growing up (which I discuss further here) and works especially hard to make me feel understood, because as a woman of color, she experiences gaslighting on a daily basis in America.
I’m unsure whether I’m qualified to state if one form of sexism is more harmful or dangerous than the other (with regards to hostile or benevolent sexism), due to their widely-misunderstood far-reaching effects on the individual and on society as a whole. I don’t think there is a debate, however, on whether they’re harmful to begin with. It’s clear as day how sexism manifests in ways that cripple our women, especially black Americans and women of color, economically, socially, and politically.
I believe in the premise that all struggle is a manifestation of class struggle. I believe it’s important to acknowledge the intersectionality of socioeconomic class and issues of racism and sexism. I also identify more with Malcom X’s departure from the Nation of Islam to support the Black Nationalist movement than I do MLK’s peaceful demonstration- this is because I recognize that at some point, ideological acrobatics fail to enact real social change, and instead of focusing on identity and what separates us, we should emphasize our common ground and never forget that the source of many of the issues we face in our society is rampant oligarchy and political manipulation and disenfranchisement. Hopefully that provides some context to my perspectives on sexism, racism, and the intersectionality of these concepts with politics. These are very complex issues, but their solutions are clear as day- the first step to enacting real social change is to overcome the cognitive dissonance we face when we realize the reality we’ve enjoyed our whole lives is not the same reality that others live in.
Gender differences in Mental Health:
To begin: the facts on mental health disparities in our society.
Women are much more frequently diagnosed with mental disorders than men. Women are prescribed psychotropic drugs 2x as often as men, and doctors are more likely to think women’s physical illnesses have psychological components.
With regards to major diagnoses applied to women:
Depression: 16% of people in the US are diagnosed with depression over the course of their lifetime. Women are 1.5-3x more likely than men to be diagnosed with depression and it’s the leading cause of disability among women around the world.
Eating disorders: with regards to anorexia, one out of every one hundred women are diagnosed with anorexia, and 90% of all cases are female. With regards to bulimia, 1.1 to 4.2% of women are diagnosed with bulimia, 90% of cases are female, and it occurs 5x more frequently than anorexia.
Anxiety disorders: 2x as many women suffer from specific phobias than men. Panic disorders affect 2.4 million adult Americans, and they’re 2x as prevalent in women. Generalized Anxiety Disorder affects 4 million Americans, and twice as many women than men. Women are more likely than men to be diagnosed with PTSD, and 12% of women meet the criteria for diagnosis.
With regards to suicide, although men succeed 4x as often as women at suicide attempts, women attempt suicide twice as often as men, and it’s the second leading cause of injurious death among women. Six thousand women annually, aged fifteen and older, commit suicide. In addition to this, depression is linked to suicide stronger in women, while alcohol and substance abuse is linked to suicide more so in men. Self mutilation is also twice as common in women, and these individuals represent 4-13% of the nonclinical population. Women are also more likely to be diagnosed with histrionic personality disorder, dependent personality disorder, and 75% of all borderline personality disorder diagnoses are women.
Some contemporary issues in diagnosis: Labels put focus on the individual rather than on social context, and gender stereotypes shape what is considered normal behavior. Due to reporting bias, under the same levels of physiological stress, women report more anxiety. Men may also deal with anxious feelings by suppressing with drugs/alcohol (versus expressing them directly).
Women are prescribed psychotropic drugs 2x as often as men (doctors are more likely to think women’s physical illness has a psychological component, and commercial ads are aimed at women more than men). In addition to this, men don’t seek help as often as women, women report more emotional symptoms, and substance abuse masks symptoms in men.
Some alternative perspectives on why these disparities exist in our mental health include the following theories:
Sex-role theory predicts that women encounter more stressors in their daily lives that can promote depression.
Learned helplessness theory states that female gender roles have low status and power, which leads to silencing of voices, and suppression of anger.
Rumination theory says the way women are reared fosters excessive worry, which makes them more likely to blame themselves and feel helpless, as well as more likely to focus on causes and consequences (men are more likely to escape).
Over-eye-theory purports the inner voice that judges women against what is “good” and “right” condemns their authentic self, leading to poor mental health outcomes.
Attribution styles- women are more likely to attribute success to luck and failures to inabilities.
Interpersonal styles- many women become overly involved in the problems of their frineds, partners, etc, which can contribute to neglecting their own needs and feeling responsible for making sure relationships go well.
Sexual and physical assault- women are more likely to be victims of traumas. This accounts for as much as 35% of sex differences in adult depression.
Economic inequality- the feminization of poverty, lower salaries, double shifts, and single parent headed households leads to poor outcomes. Poverty is one of the single most consistent correlates of depression, and women and children comprise nearly 75% of US residents living in poverty.
In Denmark’s analysis, they provide a background on historical diagnosis and treatment of mental illness in women, as well as some ideas as to why women are diagnosed more frequently than men. Denmark states, in the section titled “The Double Standard of Labeling and Diagnosis,” that “applying labels to a diagnosis can be inherently problematic. (Denmark, 2016) Labels have the effect of putting the spotlight on the individual with the condition rather than on the social context that may have given rise to the disorder. Denmark goes on to explain how labeling groups individuals into broader categories, which ends up exacerbating their similarities and obscuring the unique aspects of their personalities. Since women are already subject to more stigmatization than men, and many labels carry a stigma, that means that women diagnosed with mental disorders are also the targets of discrimination. An additional issue with regards to labeling would be the fact that there’s significant gender differences in the diagnosis of some mental disorders, and that gender stereotypes influence what is determined to be “normal behavior” for men and women. Personality traits such as rationality and independence are equated with mental health and are usually used to describe men- meanwhile, characteristics such as being emotional, conforming, or submissive, are considered pathological, which is an issue because these characteristics are more commonly found in women.
Reporting bias also plays a role in the topic of mental health and gender differences. For largely understood reasons, male social roles dictate that they’re supposed to be “stronger” which leads to less self-reporting on their behalf. In addition, men are less likely to seek treatment, leading women to have higher rates of diagnoses than men. Denmark also points out that, through social role theory, we understand that due to exposure to poverty and violence, and double duty in the workplace and at home, women experience higher levels of mental distress. Women’s overall lower social and economic statuses, in conjunction with other factors, lead to emotional and cognitive strain in women.
Reporting bias seemed to be the most accurate perspective to me- until I realized that I was looking at it from an androcentric viewpoint. Initially, I thought “well, that makes sense, because if everybody’s cognitive and emotional distress could be measured objectively, perhaps the gender differences would be severely less emphasized.” However, social role theory more closely aligns with my constitutionist beliefs regarding gender. Social role theory takes into account the specific experiences of individuals, and accounts for the added stresses resulting from biases and discrimination against demographics such as lesbian and ethnic minority women.
I think one thing Denmark et. al are missing are how gender differences in psychology begin with the gene x environment interaction and how these concepts intersect. Social role theory incorporates what we understand from developmental psychology with our comprehension of gender differences and androcentrism in our research and institutions. These concepts are relevant because developmental psychology tells us that the environment largely shapes gene expression, and a “resource poor” environment would lead to issues such as poor resilience, or the development of poor self-image over time versus an individual in a “resource rich” environment with the same genetic make-up. Hopefully my understanding of these concepts makes sense.
In Dana Jack’s essay, she explains how diagnostic criteria for mental disorders such as depression are rooted in self-evaluation, and that the moral language used by women may contribute to higher rates of diagnosis. (Jack, 1991) Jack explains that, regardless of the theoretical perspective you view gender differences through, observers find “a female morality attuned to relationships and affection, and a male morality based on abstract principles expressed in laws and rules.” Jack also argues that despite longstanding observations between male and female ethical orientations (Gilligan explained that women are more orientated towards relationships and interdependence), and the clear connection between self-evaluation and diagnosis of depression, there is no systemic analysis of the morality in depressed women’s dialog. Because of this and other cultural factors, Jack states that it’s imperative to research women’s experience of depression through their moral language.
I do believe many contemporary issues in gender disparities in mental health can be attributed to social factors such as perceived experienced harassment. The normalization and internalization of sexism can lead to self-image that, even when effectively communicated, doesn’t admonish women of their impact. Time and time again, I’m reminded of the intersectionality of environment, genes, culture, and perception, with regards to gender differences in psychology and our institutions.
Bem, S. L. (2008). Transforming the debate on sexual inequality: From biological difference to institutionalized androcentrism. In J. C. Chrisler, C. Golden, & P. D. Rozee (Eds.), Lectures on the psychology of women (p. 3–15). McGraw-Hill.
Champagne, F. A., & Mashoodh, R. (2009). Genes in context: Gene–environment interplay and the origins of individual differences in behavior. Current Directions in Psychological Science, 18, 127-131.
Chrisler, J. C., Golden, C., & Rozee, P. D. (2004). Lectures on the psychology of women. Boston: McGraw-Hill.
Cooper, R. M., & Zubek, J. P. (1958). Effects of enriched and restricted early environments on the learning ability of bright and dull rats. Canadian Journal of Psychology/Revue canadienne de psychologie, 12(3), 159.
Denmark, F., Rabinowitz, V. C., & Sechzer, J. A. (2016). Engendering psychology: Women and gender revisited. Psychology Press.
Jack, D. C. (1991). Silencing the self: Women and depression. Harvard University Press.
Johnson, A. G. (2004). Patriarchy, the system. Women’s lives: Multicultural perspectives, 25-32.
Lewis, J. A. (2018). From modern sexism to gender microaggressions: Understanding contemporary forms of sexism and their influence on diverse women. In C. B. Travis, J. W. White, A. Rutherford, W. S. Williams, S. L. Cook, & K. F. Wyche (Eds.), APA handbooks in psychology®. APA handbook of the psychology of women: History, theory, and battlegrounds (p. 381–397). American Psychological Association. https://doi.org/10.1037/0000059-019