Anti-male gender bias in the mental health system

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I have Borderline Personality Disorder and Asperger's. The former is far more destructive to my life than the latter, but it was very hard to get it recognized for a long time. Why? Because I am stereotypically male in a lot of ways. I do not create drama or talk to others about my self-harm (except on WP). The few times I've been in therapy (once against my will), it went terribly because I have alexithymia & disassociate from emotions.

It seems to be a bias in the mental health system that only those who "act out" and are open with their emotions and problems are likely to get help. This is something that overwhelmingly disfavors men, which is why our suicide rates are extremely high. A lot of this has to do with the biases of the mental health system itself; some of it has to do with other cultural biases that teach men to be "strong" and keep their problems to themselves. I follow these cultural stereotypes very well.

Instead of acting out and getting help, we just suffer in silence and usually isolate ourselves because we have no one to talk to who will take our problems seriously. This is why suicide rates among men are far higher than suicide rates among women, according to multiple studies.

http://en.wikipedia.org/wiki/Gender_dif ... in_suicide

I agree with the OP. That has actually been a problem for me, too.

Even if you try to talk about your problems, some people actually disapprove of your being weak. So rather than getting help you get ridicule/criticism/punishment for it. And a man cannot even cry in front of people because it's considered as shameful or embarrassing. Really in many situations we have no escape and I can see why men have much higher suicide rates in most countries. In addition men are still often expected to accept unfavorable treatment in many situations, even legally, in this age of "equality". I really think something needs to be done for men's well-being. I know there is an organization in Sydney that actively promotes men's mental and physical well-being and I'm hoping to contribute to their activities in some way.

I wonder if it's the DSM that has the inherent in-built gender bias. Outward expression of symptoms is a really really terrible way to diagnose and treat diseases, especially when 50% of the population is trained from birth to hide these symptoms.

Most conditions--Asperger's, Borderline, and even depression--can be determined objectively through hormone tests and even brain scans (especially BPD). There was a blood test for a type of depression called Melancholia that was 100% accurate but still rejected from the DSM V because it didn't fit with the approach of traditional psychology (the article appeared in the New Yorker a few months ago).

When I finally got diagnosed with my real thorn in the flesh--Borderline Personality Disorder--it was determined that I met 8/9 criteria (5 needed). It was a major shock. I thought I barely had it, if at all, because it hadn't been recognized. Then, there are women who barely meet 5 of the criteria (to put it generously) who get diagnosed with BPD routinely and then get help for it.

There's definitely a gender-bias in a lot of diagnostic criteria or at least in the way psychologists or psychiatrists perceive certain symptoms to manifest themselves. Cultural conditioning can be one factor that shapes how symptoms look like while the psychiatrist's own lense and bias colors his perception.
Here's an article about BPD in men: overlooked, misdiagnosed
This is one study about something similar:
Gender Patterns
This is about cultural influence: cultural history
This is a study about gender bias in PD diagnosis: Gender Bias in Diagnostic Criteria
As is this one: Social stereotypes
Here's one that looks at different PDs and concludes that there's a bias in BPD diagnosis: Four PDs
This one is specifically about cluster b disorders: gender expectations

So there do exists studies about this. Another probably overlooked disorder in males would be anorexia nervosa.

Well...you could also view this issue from a different perspective. It seems to me that one of the reasons you get help if you "act out" is that this behavior is considered unhealthy and so in need of treatment, whereas if you "keep it together" you are considered healthy and not in need of treatment. The logical conclusion to this view is that (extreme) female behavior is seen as sick and male behavior as sound. That is in fact an anti-female view - not anti-male. So it cuts both ways.

In some ways this bias - whatever we call it - is as bad for both genders, because it's a narrow-minded and superficial view of humanity. Instead of being open to the fact that everyone express themselves differently and react in unique ways to their condition, we have professionals that try their best to fit people in to Procrustean beds of imagined categories that not necessarily reflects reality at all. One of the weaknesses of the tradition of behavioral psychology that is so dominant in the Western world is that observation is key, but actually listening to people isn't considered important. So - no drama equals nothing to observe equals no help.

I am in no way trying to belittle any man's problems with this, on the contrary. Although I am female I have had similar experiences with both health professionals and social services, as I am in no way conforming to the "normal" female stereotype. I have had doctors blatantly deny that I cold possibly be in a lot of pain (physically), purely because I stated my experience calmly instead of screaming and bawling my eyes out. I value my dignity highly, and will not succumb to drama, just to satisfy someones (selfish) need for acting all motherly and compassionate. I am not in need of commiserations - I deal with my emotional crises best alone - but sometimes I do need practical help (medicine, money, information) but can't seem to get one without the other. It's humiliating. I'm the one who needs help, but they won't give it unless I give them something first, namely a reason to feel pity for me and hence good about themselves for helping this piteous creature before them. Blech! It's a disgusting habit, and imo highly unprofessional. Sorry for ranting.

I wouldn't want anyone to be unfairly discriminated against, however it is ironic that on an Aspie board...where us females have often pointed out the gender bias towards males in the AS diagnostic criteria, males are claiming they are the ones being unfairly discriminated against in MHS because of being male...

I suppose it is ironic, coming from an Aspie message board where girls are under-diagnosed, but gender bias depends on the context, and in this case the "acting out" tends not to favor men who need a diagnosis but are also supposed to keep it together and have everything under control at all times.

@Whirlingmind, our liberal utopia celebrates irony without even understanding what it is. Discrimination against males--and white conservative, Christian males in particular--is the ONLY type of discrimination socially sanctioned. In fact, it has been legally memorialized with affirmative action. Against what other group is discrimination written into the law and official policy?

Having said this, and though it is not socially or legally sanctioned, I think all aspies are discriminated against because of our inability to deal with people. As a result, I have given up on doctors. Unlike officially recognized Preferred Victim Groups, aspies really do have to try twice as hard, and be twice as good. It's simply a matter of recognizing a bias toward the likeable and against those who are less personable.

It's not an anti-male gender bias, its a different diagnoses have different stereotypes which include gender.

Autism is male.

BPD is female.

Aside from "gender roles" affecting treatment or diagnosis (such as men suppressing emotions/actions, or women expressing emotions/actions), the human culture side of the coin, there is the scientific side of the coin where certain disorders/diagnoses are linked to a gender based on brain activity (ASD being Extreme Male Brain, and Schizophrenia being Extreme Female Brain, supposedly). Those two in particular are supposed to be based on behavior viewed in males and females, but that doesn't mean they are limited to a male/female diagnosis only, but they are biased to a specific gender by nature of difference in brain function. It isn't a fool proof designation, but a typical one. I think the issue comes out when culture and science collide on this point.

Do you have data on this? Because from what I've seen, it's the opposite problem.

Women have a higher rate of suicide attempts (men more often complete suicide, but that's because men more often use guns). Also, across the board we tend to find internalizing disorders (depression, anxiety, etc) more common in females and externalizing disorders (aggression, delinquency, etc) more common in males.

Externalizing people are more likely to get noticed as having a problem, however there's an unfortunate tendency to think the problem is best dealt with by punishment. In contrast, internalizing people are more often overlooked entirely, but when they do get recognized as having a problem, it tends to be better treated.

And either gender tends to get underrecognized when they have a gender-atypical psychological problem. For example, BPD men are often underdiagnosed because BPD is seen as more of a female condition. (I'm not sure if it actually is more common in girls, but even if it is, the gender bias is exaggerated by under and over diagnosis.)

I would agree with everything but the anti-mail bias...

I have driven the transport for several different mental health clinics... The attendees to the clinics (and this was all over the US) were 3 to 1 male...

That being said... I have dealt with mental health professionals being unwilling or unable to accept that I was capable of the things I was concerned about. (Documented rage issues, but was NEVER violent towards a person unless they started the violence)... My control was slipping and they argued with me... stating that "If you are cognizant of the issues, then you won't do it."

When one of them told me "You aren't capable of that kind of violence. You just don't have the temperament for it." (being told what I am capable of or how I am feeling is one of my triggers)... My mate had to grab my hand before I pinned his hand to his desk with a letter opener... No rage, just an object lesson.

Psychiatrists (due to the conflict of interest clauses) pretty much have to be NTs... NTs are not capable of certain thought modes and emotional stress responses... NTs also ASSUME that if they are not capable of a specific behavior... of course no one else is... This makes it difficult for most of us to get proper diagnosis...

Maybe that's why with so many females with AS being misdiagnosed some of them are misdiagnosed with BPD when it should have been AS.

It's funny how perceptions are. I would have thought that males would be more likely to be recognised as having conditions because they are more likely to be violent and aggressive (or more expected to be), whereas females will more often cry when they are feeling a variety of negative emotions.

I agree with Ettina's point. Women are supposed to be the caregivers, the nurturers etc. so the expectations on them make them suppress a lot of what they are feeling. I also wonder, whether if there is overdiagnosis of AS it is more overdiagnosed in males than females because doctors are quicker to put moodiness, bluntness, social awkwardness down to AS than another condition that has similar traits.

As a female with autism I know what it's like to have my condition not be recognized because of my gender. I don't think that is bias against men/women, though. It's gender stereotyping. Women are supposed to be more like the BPD profile, men more like the autism profile, and anyone who doesn't fit doesn't exist.

Statistically, women are likely to seek medical aid. Also, the suicide rates for men are higher in countries with limited access to firearms, not just in the US, the land of the free to shoot each other.