Men and Mental Health: Exploring the Gender Gap in Therapy

There is ongoing debate around the factors that may discourage men from seeking therapy (Seidler et al., 2016). Some researchers argue that a primary factor in the avoidance of therapy stems from the socialization of masculine norms that discourage the seeking of mental health support (Affleck et al., 2018) while others argue that it is the lack of accommodation towards male-informed therapy that is to blame (Möller-Leimkühler, 2002). Many descriptive norms that reflect traditionally-masculine traits may promote independence, silence, an avoidance of emotional expression (and emotional processing), which can present a barrier towards seeking mental health support (Mahalik, Burns, & Syzdek, 2007).

While some studies suggest that same-gender client-therapist pairs are not on their own a predictor for an effective therapy (Lambert et al., 2016), clients being able to see a therapist of their preferred gender can be a significant source of feeling understood— when we feel like someone has been in our shoes, we often feel like that person can better understand, relate to, and empathize with what we’re going through. Indeed, Seidler et al’s., (2021) research surveyed 2009 American men to better understand the reasons behind men having a/any preference for their therapist’s gender, and found that the most commonly reported reason behind the men’s preference for either a male or female therapist was a greater comfort in opening due to associations between gender and empathy. While the study found that men’s preference for the therapist’s gender was an almost even split (60% reported no preference; a little over 20% reported a preference for a female therapist; a little under 20% reported a preference for a male therapist), the second most cited reason for gender preference differed depending on the gender preference— men preferring female therapists reported feeling less judged when/if seeing a female therapist, while men preferring male therapist reported feeling a greater sense of being understood and an easier time relating to their therapists. 

As well, Gehart and Lyle’s (2001) research found that the leading reasons for a preference in a therapist’s gender was typically derived from the participant’s desire to obtain either a “male or female perspective” around their concerns. 

The aforementioned studies suggest that the reasons for gender preference are often personal, individualized, and multi-layered. Common themes around therapist-gender preference revolve around seeking a gendered-perspective, seeking empathy, wanting to feel understood, and wanting to avoid stigma and feelings of shame. More research will need to be conducted in order to explore the dynamics between how the desire to be understood can influence internalized shame, shame-avoidance, and in turn influence therapist preference.

For the 20% of men who have a specific preference for male therapists, finding a male therapist can be challenging. A 2021 report published by the Canadian Institute of Health Information (2023) found that 18% of Canadian psychotherapists/counselling therapists were male compared to 82% being female. For the 20% of the clients reported in Seidler et al’s (2021) research, this can present a significant barrier. 

Clients can bring to therapy many issues that they feel would be better understood from a gender-specific perspective. We explored many of the reasons why someone would want a gender-specific perspective: either to avoid potential stigma, to gain insight from a clinical who’s more likely to have had certain lived experiences, or to feel heard and understood amidst their struggles (among many other reasons). Indeed, having difficulty in finding a therapist who embodies a certain gender is only one of the many barriers that may present itself in men obtaining mental health support. Often, the way that therapy is presented/advertised/suggested does not appeal with many male-specific struggles.

To put it simply— some men report that therapy, as commonly marketed or practiced, does not resonate with traditional male experiences. Some men report that therapy can feel abstract, overly focused on emotional disclosure, or lacking in practical and solution-oriented tools. If they’ve had past experiences where they didn’t feel understood (or worse, blamed and shamed) they may disengage altogether. For some men, therapy may feel focused on

validating feelings of being heard and cared for, which might not align with their priorities. For the many men who feel like being heard and loved is secondary to the issues that bring them to therapy, feeling loved without feeling a sense of personal agency can translate to feelings of being trapped, or being pitied for their perceived entrapment. In these cases, some men describe disengaging from therapy when it feels focused on self-validation without sufficient solution-oriented tools, leaving them uncertain about whether therapy is right for them. Some men report a preference for therapies that promote solution-oriented approaches (“doing” in therapy) as opposed to more traditional talk-oriented therapies that focus on emotional processing and reflection (Brownhill et al., 2002). This is not to suggest which type of therapy is superior. Rather, it underscores the need for therapy to respond to the individual client’s values, goals, and ways of being. When therapy defaults to a one-size-fits-all model rooted in tradition rather than attunement, it risks overlooking key aspects of a person— their temperament, their beliefs, their environment, and their autonomy.

If, for example, men ask themselves how will therapy get me closer to my goals? and therapy is touted by others around them as a place to “fix their anger issues” or to “vent their feelings” and men see these problems as issues that are the consequences of other non-emotional struggles (such as frustrations around professional challenges, financial challenges, etc), then of course that person would feel discouraged by the idea of therapy—we’d be asking them to put the (metaphorical) horse before the cart!

The decision to seek support is complex, and not necessarily a matter of pride or reluctance. Lane & Addis (2005) found that men tend to be far more likely to view informal help-seeking methods as more appropriate responses (talking to a partner, parent, or friend) to issues such as depression and substance use, as opposed to more formal help-seeking methods (such as speaking with a psychologist, a doctor, or a religious minister). As well, researchers have also found that men tend to exhibit worse symptoms of depression before getting to the point of considering therapy (Shi et al., 2021).

As previously mentioned, many potential clients may feel discouraged by the aformentioned barriers to men finding appropriate mental health and institutional support. Specifically, a mistrust of the systems and institutions have been noted by various researchers, such as concerns about biases against male-identified issues and the seeking of treatment (Shepherd  et al., 2023), concerns that men will be stigmatized by mental health practitioners (Seidler et al., 2021) as well as a lack in institutional support for male-specific issues (Lysol & Dim, 2025). When men view formal methods of help-seeking as the last line of support (Lane & Addis), the weight of the concern that a person will be let down by these support systems may be amplified. Combined with any concern that a gender-bias within a mental health professional risks their pleas being ignored, invalidated, or even pathologized, many men see silence as the most peaceful way to suffer.

Reports have shown that several male-specific issues have little to no institutional support, such as male victims/survivors of intimate partner violence (Lysol & Dim, 2025), male survivors of sexual assault in the UK (Langdridge et al., 2023), relationship break-ups (Oliffe, 2022), depression (Ogrodniczuk, et al., 2021), as well as services for men who identify as being a sexual minority (Mental Health Commission of Canada, 2022). A lack of emotional literacy can mean that many men who are experiencing symptoms of depression may not be aware that their symptoms are mental-health related— instead attributing their suffering to a physical illness (Seidler et al., 2016). For many men, getting the right help is not always a question of will or intention, but often requires the person to identify their suffering as something that can be adequately supported through a mental-health professional, as well as also knowing where to go to find the support that they need.