Addressing gender disparities in behavioral health: What employers need to know.

Addressing gender disparities in behavioral health: What employers need to know.


July 17, 2025

Addressing gender disparities in behavioral health

Tags

Behavioral Health
Health Equity
Improving Outcomes


Men and women experience, express, and engage with behavioral health care differently. Ignoring these distinctions puts employees at risk of misdiagnosis, disengagement, and ineffective treatment.

We've learned that cardiovascular disease often presents differently in women1than in men—a fact that has led to catastrophic diagnostic delays. We must acknowledge similar differences in behavioral health. From depression to ADHD, anxiety to substance use, the clinical picture often varies by gender, with real implications for outcomes, especially in the workplace.

Understanding these nuances is key to building a smarter, more inclusive benefits strategy.

Depression: Beyond sadness.

A stark gap in depression outcomes suggests that men are falling through the gaps.

  • Women are nearly twice as likely as men to be diagnosed with depression.2
  • Men are almost four times more likely than women to die by suicide.3

Societal norms, atypical symptoms, and underdiagnosis contribute to men having more severe outcomes.

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Traditional masculine ideals.

+ Traditional masculine ideals.

Men are conditioned to emphasize stoicism, self-reliance, and emotional control. This can lead them to suppress typical symptoms of depression, such as hopelessness.4

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Atypical symptoms.

+ Atypical symptoms.

When men experience depression, they are more likely to have symptoms like anger, risk-taking, and substance abuse.5 In a workplace setting, these behaviors may be interpreted as performance issues or burnout, rather than signals of deeper emotional distress.

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Incorrect diagnosis.

+ Incorrect diagnosis.

Healthcare professionals looking for typical symptoms of depression may misdiagnose men who show atypical symptoms and mask typical ones. Furthermore, some men may perceive getting care as a threat to their masculinity, so they don’t seek help from behavioral health professionals.

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Undertreatment.

+ Undertreatment.

Without the proper diagnosis, men with depression go without the treatment they need, resulting in worsening depression and tragic outcomes.

This combination of factors contributes to the higher suicide rates among men, highlighting the need for gender-sensitive approaches to behavioral health assessment and intervention.5

Anxiety: The silent struggle.

Women struggle with anxiety disorders at a higher rate than men, and these disorders often affect a woman’s physical health.

  • Women are more than twice as likely to develop an anxiety disorder as men.6
  • Anxious women have significantly more ER, urgent care, and doctors’ visits,
    compared to women without anxiety.7
  • Women with anxiety miss an extra day of work per month compared to non-anxious peers.7

The disease burden of medical visits and missed work may be due to the physical toll that anxiety takes on women.

Physical symptoms of a panic attack include a racing heart, chills, trouble breathing, chest pain, and nausea.8

Societal norms, hormones, and biological differences are thought to play a role in the disparity between women and men with anxiety.9 Employers can support a more equitable and productive workforce by providing gender-specific, whole-person care for behavioral health.

ADHD: The overlooked diagnosis.

Attention Deficit Hyperactivity Disorder (ADHD) is more likely to be diagnosed in boys than girls. However, research suggests that the disorder affects both sexes equally.10 The difference in diagnosis rates is likely due to the different ADHD symptoms that boys and girls experience.

This means that many women with ADHD aren't diagnosed until adulthood, often after years of quietly struggling in school or the workplace. Employers can help these women be happier and more productive by offering specialized care, accommodations, and awareness.

When gender isn’t just a factor – it’s a driver.

Men and women misuse substances at different rates and for different reasons.11 Understanding these nuances allows providers to give better care.

Substance use: Different paths, same risks.

+ Men use illicit drugs more.

Men are more likely to use almost all illicit drugs than women. However, there are some exceptions. An illicit drug is any illegal substance or the misuse of a prescription medication.

+ Illicit drug use has serious consequences.

Illicit drugs can threaten the life of any user. However, men are more likely than women to overdose or visit an emergency department due to illicit drugs.

+ Women use stimulants for different reasons.

Research shows that women start using stimulants like cocaine and methamphetamine at a younger age than men. Furthermore, women are much more likely to start stimulants in order to lose weight.

+ Opioid misuse affects everyone.

Opioid abuse is on the rise for both men and women across the United States, but is rising faster for women. However, men are more likely to die from an opioid overdose.

+ Men use more alcohol, with one exception.

Men typically use and abuse alcohol more than their female counterparts of the same age. However, females aged 12 to 20 years are more likely to misuse alcohol than males in the same age range.

Substance use: Different paths, same risks.

Two types of disorders—eating disorders and post-traumatic stress disorder (PTSD)—disproportionately affect women, and it’s likely due to gender.

  • Approximately 9% of the U.S. population will experience an eating disorder in their lifetime.12
  • Women account for nearly 70% of eating disorder cases.13
  • 10–12% of women will experience PTSD in their lifetime compared to 5–6% of men.14

These disparities reflect the outsized burden of interpersonal trauma and gender-based harms to which women are exposed. Often, care systems are not designed to recognize or respond effectively to how these experiences shape behavioral health. These conditions don’t just present differently; they highlight the urgent need for better workforce education and support.

What employers can do now.

Employers don’t need to overhaul their entire benefits strategy to close the gender gap in behavioral health care, but they do need to be intentional. Here are six actions that can help build a more equitable, responsive, and results-driven approach.

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Train managers.

+ Train managers.

Equip management with the knowledge to identify gender-specific symptoms, such as irritability or withdrawal in men and somatic complaints in women. Then, give them the tools to escalate support appropriately.

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Offer options.

+ Offer options.

Offer virtual behavioral health care through a reputable partner like MD Live by Evernorth, giving employees faster access to board-certified clinicians, along with added privacy, flexible scheduling, and the ability to easily switch providers if needed.15

  • 15

    Patients may switch providers up to two times following their first appointment, but may not exceed three providers total.

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Use data.

+ Use data.

Audit benefits utilization data by gender in a compliant, privacy-focused fashion to uncover hidden disparities in access, engagement, or outcomes. Use those insights to fine-tune communications and benefit offerings.

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Break the stigma.

+ Break the stigma.

Normalize early mental health care-seeking by creating stigma-free messaging that speaks directly to the different barriers men and women face.

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Empower the workforce.

+ Empower the workforce.

Invest in gender-aware, whole-person care models that improve health equity, reduce absenteeism, and support long-term workforce resilience.

These steps will take time to implement, but each of them plays a role in creating an atmosphere that’s more inclusive and supportive of everyone’s behavioral health.

Supporting behavioral health with MD Live.

Behavioral health equity isn’t just good medicine: It’s good business. Through MD Live, employers can invest in their workforce with highly personalized behavioral health care that can improve employee well-being, reduce absenteeism, and boost resilience across their workforce.

The MD Live platform empowers members to:

  • Select a provider that best fits their preferences -- including gender, specialty, and approach.
  • Easily change therapists if they aren’t connecting to ensure they find the best possible fit.
  • Develop personalized strategies to self-manage conditions like depression and anxiety between provider visits using MD Live Well-being Tools.
  • Access holistic, whole-person care with behavioral health integrated across MD Live Primary and Urgent Care services.

The result? Greater engagement, earlier intervention, and better mental health outcomes across your workforce.

Curious to learn more? Watch this short demo to see our behavioral health solution in action.