40 Therapists Reveal The Differences They’ve Observed Between Their Male And Female Clients

As a therapist, I’ve noticed that men and women are all individual, unique human beings who can’t be pigeonholed based on gender.

Men will whisper “I’m not sure if I’m allowed to feel sad” after getting hit by a metaphorical train. Women will apologize to the train.

I was a therapist for people with psychosis and schizophrenia if that counts?

Men were more likely to have God delusions. (I am god, or God speaks to me)

Women were more likely to have romance delusions. (Michael Jackson speaks to me, I'm Mary and I'm pregnant by a miracle)

Both had pretty equal amounts of dissociative issues. (This world isn't real, humans are being replaced by zombies, you aren't my mom).

Older men will often complain of physical pain when they really have depression.

Men frequently schedule their first appointment because their wife or girlfriend strongly encouraged it. It’s more rare for them to reach out of their own volition.

Twenty years ago gender differences in therapy was an area I researched.

A couple of general differences was a tendancy for males to under-represent - so they'd say they weren't feeling as bad as they were, or that they were satisfied with the therapist when they weren't - or happy with them when only moderately satisfied. The other very general point was that males presented less verbally than females.

Alexithymia was also much more common in males - that inability to identify emotions and therefore to explore them without professional support was absolutely crippling for many. (This was observed in session rather than as part of traditional/ structured research).

Men tend to have smaller support systems, if any at all.

Female patients usually apologize for crying, male patients usually apologize for having emotions at all.

For me, men opened up faster. The first visit or two might be super limited and then the floodgates open all at once. The women are more open at the start, but drop big details ways slower.

My male clients come to therapy wanting solutions, action, structure, and for me (a woman) to tell it like it is. Over time, we almost always end up going very psychodynamic (lots of talking, open ended guiding questions, raising awareness of relational/childhood stuff, behavioral patterns) and processing the deeper stuff that they didn't think was relevant or no one gave them space to talk about before.

My female clients are very h**h performing, controlling, perfectionist, burned out, and trying to perform therapy and healing in a perfect way. Over time, we end up working on self acceptance, processing anger, boundaries, values-driven action, self image, and raising consciousness on gender roles and capitalism. And actually *feeling* the emotions in addition to labeling and analyzing them.

Edit: to add, my female clients are often very self aware when they meet me. They know their experience, their emotions, they know how to talk about it. What they need help with is a safe relational connection (a therapist) who can gently challenge them to really be honest with themselves. Growth doesn't happen without some discomfort, so we build tolerance for really looking at the self and barriers to change.

Therapy intern here! One of the biggest differences I've noticed is how anger is presented.

Many women I work with often feel this repressed anger that they deny themselves until it explodes out from them or they're completely unaware that they have an anger problem. They may also deny the expression of anger for fear of being labeled "sensitive" or "hysterical"

Men, on the other hand, are conditioned that anger is the ONLY emotion that they are allowed to present so they often deny the depression, anxiety, and other negative emotions that inform that anger. Or they're so afraid of becoming like the other angry men in their lives that they deny themselves the expression of anger at all.

I have learned that men need support and encouragement to thrive. Constant criticism is hard on a man, it causes him to lose his confidence and in that situation he has a hard time relating to his partner.

Women on the other hand need attention. They need to feel seen and heard. They don't need to be understood as much as they need to feel heard. Women don't usually accept excuses. They want acknowledgment. When a woman is not feeling seen or heard. She doesn't feel loved and has a hard time relating to her partner.

In most couples i saw as a therapist, the woman wants to feel emotionally safe while the guy wants to be appreciated for what hes doing

Also most men dont seem to identify getting angry easily as emotional and only think crying is emotional.

More men asked if they could be put on medication and women preferred talk therapy.

Hope someone sees this, it's been a few hours!

Clinical psychologist here! I work with trauma, anxiety, depression, eating disorders and sleep disorders in adults and older teens.

I do find the differences to be fairly consistent with gendered socialization- the men I work with often need a lot more coaxing to allow emotion into the room, rather than keeping things intellectual, theoretical, or prolem-solving. They tend to freeze up when strong emotion appears, and very often I can tell their default relationship with strong emotion is shame, or general "DO NOT WANT." Working through that relationship to emotion has to come frst.

I find that with many of my female clients, too, but always with a history of trauma. Oh, you had to absolutely go flat or else your drunk father would pick a fight with you? Cool, no wonder it's hard for you to emote in session. With the men, it's just their default, trauma or not.

I think that tells us a lot about what society teaches little boys from an early age. It makes me think of that bell hooks quaote (Im' paraphrasing): "The first act of violence boys must do in patriarchy is self-mutilation of the emotional self."

In addition, the trend absolutely holds that the women in my practice tend to be more anxious and more self-doubting, and more concerned with weight, shape, and general likeability. They look to others' opinions to define their worth, or even their own opinions. Again, some men are this way too, but typically after a more explicit trauma from a male caregiver. Their default is more confidence. For women, I see this crippling sense of not being good enough nearly across the board.

This makes perfect sense to me- in patriarchy, women are not granted equal rights, equal ability to earn and maintain wealth independently, or the ability to engage in civic life and contribute to outcomes for their society. So women have, generation over generation, depended on others (men) liking them for sheer survival, or to have any control whatsoever about their circumstances. Finding a partner to marry and reproduce with, or at least a group to accept you, would have been a matter of life and death, or at least of being impoverished or not. So the effort to be attractive to others, especially men, is a matter of ingrained survival, not just "being shallow." I see that surviving to this day, even in women who otherwise, intellectually, hold feminist values. Or who, in their current life, could actually build wealth without a man. But jsut because it's changed for this generation does not erase the cultural teachings and epigentics that have been handed down through the generations. It tears these otherwise smart, loving, capable women apart to be constantly bombarded with thoughts about not being good enough, pretty enough, safe enough, etc, when they wish they could be more focused on other things.

In line with that, I see a trend (but not a rule) that women are much more likely to blame problems on themselves, and fear, guilt, and shame are primary to show up in interpersonal conflict. With men, anger tends to show up first. I assume this is in part because boys and men have typically not been permitted to be vulnerable (I'm thinking of one of my most beloved clients right now, with whom I've discussed his experiences of shaming at the hands of all of his caregivers for signs of weakness.) I think it's ALSO, at times, because men do truly feel more confident and more entitled to their own opinions, as society treats them as full human beings with their own complex, important thoughts. This has often been condescendingly stripped away from girls at an early age, who have been othered, put in a box, objectified, or outright belittled. So women are less likely to jump to anger, because they question themselves too much. How can you be angry if you're not srue you're right, or if your opinion even makes sense?

There are more, but this is what just came to mind! A bit rambly. Happy to answer any more specific questions.

I work with foster kids aged 2 - 18, therapeutic mentoring and placement stabilization

Up until like 9/10/11, there are no discernable differences. Preteen girls are more likely to seek control by refusing to see me or talk to me, preteen boys are usually thrilled that I'm taking them out of the house. Meanwhile, teen girls are usually thrilled to have someone actually listen to what they have to say and are very open, while teenage boys will seek control by trying to make me uncomfortable (they get weirdly sexual, make inappropriate jokes, or are mean).

Gendered problems are quite common among my clients - or at least feature heavily in their clinical needs.

I've seen women whose life problems are frequently attributable to beliefs, events, and relationships that are derived from patriarchal society. Or women who struggle with making friends because they find it difficult to deal with the prevalence of social aggression in female friendships (particularly autistic women). Some also tend to overgeneralize their (reasonable) fear of what dangers men pose to them into avoidance of men even when they want to be in a relationship. Some struggle with the attractiveness expectations towards women, either by failing to meet them and having the body image/self-esteem consequences, or by succeeding and then finding it difficult to navigate the consequent objectification by men (and women) in their lives.

In men, I've seen problems related to loneliness (lack of meaningful friendships), difficulties/disinterest in expressing emotions (to friends/partner), callousness in romantic relationships and views of women (likely encouraged by the manosphere internet), and fears of being a burden on society and their families (often reinforced by their wives or girlfriends' pressure on them). Some men's overgeneralized negative views of women (e.g., "they're too stupid/materialistic/shallow") lead to their problems in relationships across their families, friends, and partner.

So this is nothing we haven't already seen on the internet. But these gender wars play out in the therapy room too. It's unfortunate because it's obvious how the systems in place create these problems, but there's not much we can directly do as therapists to treat the source. All we can do is help the individual develop skills and attitudes that buffer them against the worst of this.

I work with kids in play therapy. The boys will have a lot more aggressive and competitive play, sword fights, battles, and games. They are more comfortable showing angry feelings. Girls will have more nurturing, and relationships play like doll house, babies, and family scenarios. They are more likely to show sadness. And other genders will have a combination of both. Though, I have not worked with many non binary kids in therapy.

Not a therapist but i give Mental Health Assessment.
Mostly, men are not intuned with their emotions and it would take some time for them to acknowledge said changes and some would even deny it while women are more aware and would readily acknowledge and accept it.

I work with a lot of college students and guys always take break-ups much harder and are more likely to cry about them .

I am a therapist who specializes in attachment trauma and I use a style of therapy called internal family systems/parts work (imagine the Pixar movie Inside Out but instead of emotions vying for control they're different 'parts' of you). As some have said above, there are often less differences than one might assume, but a big difference I see in parts work is how comfortable people are interacting with different parts. With my caseload I see my female clients doing a great job of showing love to the youngest version of themselves (3-6 year olds) but really struggling to show curious compassion to their parts once their parts are in their teens and early 20s especially if sexual abuse is involved. With my male clients, they struggle to accept that their young parts need love and attention, but are a bit better at listening to the needs of their teen parts. But this is a big generalization and every case and client is different.