Gender

Gender

  • Women are more likely to experience common mental health conditions than men (NHS Digital, 2014). This discrepancy is greatest in the 16 to 24 age group, in which women are almost 3 times more likely to have a common mental health condition. Women have higher rates of post-traumatic stress disorder (PTSD), self-harm, eating disorders and suicidal ideation than men (Abel & Newbigging, 2016). It has been estimated that 75% of people who have eating disorders are women (Beat, 2023).
  • Two thirds of people who die by suicide are men (Appleby et al., 1997).
  • Trans and non-binary people face very high rates of mental ill health, suicide and self-harm (Bachmann & Gooch, 2018) . Young trans people are more likely to plan or attempt suicide than their peers (McDermott et al., 2018).

Figure 22: Proportion of trans and non-binary people who report having the following mental health issues in the past year. Data source: (Bachmann & Gooch, 2018)

Local population

The number of people whose are trans, non-binary or whose gender identity is otherwise different from their sex registered at birth varies across Cambridgeshire and Peterborough. It is highest is Cambridge and Peterborough (Office for National Statistics, 2022b). Note that a significant proportion of people did not answer this question on the census, which suggests that this may be an underestimate of true numbers.

Figure 21: The number of trans and non-binary people, and all those whose gender identity is different for the sex registered at their birth, in C & P in 2021. Data source: (Office for National Statistics, 2022b)

Risk factors for poor mental health 

  • Higher rates of mental health conditions in women are likely to be linked to the social conditions of their lives, including higher levels of poverty, caring responsibilities and experiences of sexual and physical violence (Abel & Newbigging, 2016).
  • Over half of young women and girls (aged 11 to 21) in the UK do not feel safe when they are outside by themselves; and around 1 in 5 do not feel safe in school (Girlguiding UK, 2022).
  • 1 in 4 women in Britain will experience physical violence from a partner by the age of 50 (Sardinha et al., 2022). Domestic violence has a strong impact on mental health.
  • Around 1 in 20 women in England has experienced extensive physical and sexual violence and abuse across their life (Scott & McManus, 2016). These women are at high risk of poor mental health (Scott & McManus, 2016):
    • Over half have a common mental health condition.
    • 1 in 3 have attempted suicide.
    • 31% have alcohol use issues.
  • Perimenopause and menopause can be risk factors for poor mental health:
    • Changes in mood, such as depressive symptoms, are frequently reported during perimenopause and menopause (Hogervorst et al., 2022).
    • Some evidence suggests that people with pre-existing mental health conditions such as depression and schizophrenia can be at greater risk of relapse during the perimenopause or find that psychiatric medications become less effective (Behrman & Crockett, 2023).
    • One large study found that rates of major depressive disorder (1.2 times more likely) and mania (2.1 times more likely) increased during the perimenopause, compared to the years prior (Shitomi-Jones et al., 2024).
  • Trans and non-binary people face a range of risk factors for poor mental health, including discrimination. Over a quarter of trans people in a relationship have experienced domestic abuse in the last year (Bachmann & Gooch, 2017).
  • Many trans people are LGBQ+, hence large overlap with Sexuality section below. There is limited mental health research exploring the intersectionality of race and gender identity (Bignall et al., 2019).

Access

Some groups face specific barriers to accessing mental health services, including:

  • Structural barriers: 37% of trans people and 44% of non-binary people have avoided medical treatment due to fear of discrimination (Bachmann & Gooch, 2018).
  • Healthcare system barriers: men are less likely to be referred to, and to access, NHS Talking Therapies (previously known as IAPT) than women (NHS Digital, 2021).
  • Individual barriers: some women can be reluctant to seek mental health support due to fears of having their children removed from their care, particularly women from marginalised groups (Department of Health & Social Care, 2018).

Experience

  • Mental health services do not always consider or take into account the specific needs of women (Department of Health & Social Care, 2018). For example, there is a lack of services which are able to make the links between gender-based violence, trauma and poor mental health (Department of Health & Social Care, 2018).
    • Around 1 in 5 adult women and 15% of young women admitted to mental health services are physically restrained (Agenda, 2017). This can be re-traumatising (Agenda, 2018).
  • Many young women feel that they are not taken seriously by healthcare professionals when seeking support for their mental health, with one national survey finding that a third were asked if they were ‘overthinking things’ and 1 in 5 were told that they were being dramatic or were asked if they were on their period (Hussen, 2023).
  • Trans and non-binary adults report poorer experiences of primary care, including being half as likely to report that their needs were met in their last GP appointment (Saunders et al., 2023).
  • A large-scale national survey found that (Bachmann & Gooch, 2018):
    • 40% of trans people report having experienced difficulties accessing healthcare because of their gender identity.
    • 1 in 3 trans people have experienced unequal treatment by healthcare professionals, with 16% having experienced unequal treatment within the last year.
    • 62% of trans people had experienced a lack of understanding of specific trans health needs by healthcare professionals.

Outcomes

There are similar rates of recovery following NHS Talking Therapies (previously known as IAPT) between men and women (NHS Digital, 2021).

Additional resources

References 

Full list of references is included at the end of this chapter.

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