Authors: Rhea Manohar, MPH; Mallory Johnson, Dr. Divya Krishnan on behalf of AMWA Gender Equity Task Force
For decades, research has shown that the pain, symptoms, and lived experiences of women are dismissed or minimized in clinical settings. While conversations about gender bias in fields such as cardiology, oncology, and reproductive health have gained traction, mental health remains an area where gender disparities are underrecognized (Al Hamid et al., 2024). The misdiagnosis and overdiagnosis of psychiatric conditions in women remains a significant yet often overlooked public health issue.
According to the World Health Organization (WHO), mental health disorders are among the leading causes of disability worldwide, and the burden of these diagnoses falls disproportionately on women (WHO, 2022). Epidemiological studies consistently report higher rates of depressive and mood disorders among women compared to men. One meta-analysis of 144 independent US-based studies from 1982 to 2017 indicated that not only do women have significantly higher rates of depression diagnoses than their male counterparts, but also that this disparity has remained stable over time (Platt et al., 2021). Yet, the accuracy of these statistics is increasingly contested due to factors including diagnostic bias and gendered assumptions, reporting differences, and skewed measurement tools. This raises concerns that women are more likely to be diagnosed with depressive and anxiety disorders, even when their symptoms overlap with other conditions such as thyroid disease, autoimmune disorders, or chronic pain syndromes (Riecher-Rössler, 2017). Conversely, conditions like ADHD, autism spectrum disorder, and bipolar disorder are historically underdiagnosed and others like schizophrenia have shown to have a later diagnosis in women, (Mowlem et al., 2019; Lai et al., 2015). This diagnostic imbalance–where women are both overdiagnosed with certain psychiatric conditions and underdiagnosed with others–reflects a systemic failure in recognizing the full spectrum of women’s health needs.
Inaccurate diagnoses delay access to effective care, increases emotional distress, and can lead to inappropriate pharmacological treatment. Some sources suggest that the rates of misdiagnosis may be as high as 30-50% for depression alone. On the other hand, overdiagnosis—particularly in women presenting with stress, fatigue, or nonspecific somatic complaints—can lead to long-term dependence on psychiatric medications without addressing the underlying cause (Floyd 1997; Zirnsak et al., 2024). This not only wastes healthcare resources, but can pose significant risks to women’s long-term health and well-being.
The repercussions of diagnostic errors extend beyond the clinic. Women who are consistently misdiagnosed may face years of psychological distress and medical gaslighting. For example, a 2016 Brain Tumor Charity report found that a third of female brain tumor patients had visited a doctor five or more times before receiving a diagnosis, with many experiencing significant delays due to dismissal of symptoms and perceptions of “hysteria”(Dusenberry 2022). These repeated dismissals not only delay life-saving treatment but also erode trust in the healthcare system. For many women, the psychological toll of medical care inequities can induce or worsen mental health symptoms— a cruel irony that deepens existing disparities.
A major contributor to the persistence of gender stereotypes in medical diagnosis lies in archaic clinical training protocols. Clinical training often relies on male-centric prototypes of disease, ignoring how conditions may present differently in women. For instance, ADHD has long been stereotyped as a condition of hyperactivity in boys. Since women are more likely to present with inattentive subtypes and compensatory coping mechanisms, this condition can be overlooked until adulthood (Young et al., 2020). Similarly, women’s mood fluctuations or hormonal changes are more likely to be attributed to depression or anxiety rather than being investigated as part of a broader medical picture (Albert, 2015).
Another factor that contributes to the overdiagnosis of mental health conditions in women is the lack of comprehensive understanding and early symptom recognition in women with chronic disorders. Those with chronic illnesses—such as autoimmune disorders, chronic pain syndromes, or endocrine abnormalities are disproportionately dismissed as “anxious” or “somatizing.” This diagnostic shortcut delays recognition of conditions like lupus, endometriosis, or thyroid disease—illnesses that already face long delays to diagnosis (Trachman 2025; Zirnsak et al., 2024). The result is a double burden: women are undertreated for their physical health while simultaneously overtreated with psychiatric medications, compounding both physical and emotional suffering.
The realities of overdiagnosis and misdiagnosis of mental health conditions in women cannot be separated from the broader social and economic realities faced by women. Women are more likely to experience poverty, caregiving burdens, and intimate partner violence—all potent risk factors for mental distress (WHO, 2022). Despite broader awareness of these risk factors, clinical responses often pathologize women’s distress as an individual psychiatric issue rather than recognizing the structural determinants at play. By diagnosing normal responses to inequitable social conditions as medical conditions, the healthcare system inadvertently reinforces gender-based stigma and silences broader calls for systemic change (McLean et al., 2018).
Addressing gender disparities in mental health diagnosis requires multifaceted solutions, beginning with formative and continuing medical education. Training programs must move beyond male-normed diagnostic criteria and incorporate gender-specific presentations of mental illness. Clinical case examples and board examinations should reflect diverse patient populations to normalize recognition of atypical presentations. Additionally, greater integration between psychiatry, primary care, and subspecialties can help clinicians identify when psychiatric symptoms are secondary to underlying medical conditions. Collaborative care has demonstrated success in reducing misdiagnosis, reducing disease burden, and ensuring more holistic treatment (Balasubramanian et al., 2017).
Research efforts must prioritize sex- and gender-based analyses. Historically, women have been underrepresented in clinical trials, leading to evidence gaps that perpetuate misdiagnosis (Global Data Healthcare 2023). Increased investment in inclusive research is essential to build more equitable care models. Beyond the clinic, mental health must be reframed as a public health issue shaped by social inequities. Policies that address gender-based violence, workplace inequities, and caregiving support are as essential to mental health as psychiatric medications. A holistic approach that addresses social determinants alongside clinical care can reduce the mislabeling of women’s distress and promote long-term health equity.
The misdiagnosis and overdiagnosis of mental health conditions in women is not simply a clinical error—it is a public health failure. By pathologizing women’s symptoms without considering the interplay of biology, lived experience, and structural inequities, the healthcare system perpetuates gender disparities that carry lifelong consequences. Correcting this imbalance requires a cultural shift in medicine: one that validates women’s experiences, broadens diagnostic frameworks, and addresses the social inequities that shape mental health. Until then, too many women will continue to carry the burden of conditions they do not have, while waiting years for recognition of those they do.
References:
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About the Authors
Rhea Manohar, MPH, MS3
Rhea Manohar is a third year medical student from St. George’s University. She has a Masters in Public Health with a concentration in Maternal and Child Health from George Washington University Milken Institute of Public Health and a Bachelors of Science in Microbiology, Immunology, and Public Health from the University of Miami. She served as Co-VP of OB/GYN Education for St. George’s University’s Women in Medicine chapter in St. George, Grenada where she developed and implemented hands-on workshops to further reproductive health issues and bolstered medical students abilities to navigate physician-patient communication. Prior to medical school, she was a Research Associate for Fors Marsh Group, where she led qualitative and quantitative public health research and campaign development for federal agencies (e.g., CDC, NIH, DHHS, CPSC). She is also a member of the Gender Equity Task Force and Reproductive Health Coalition within the American Medical Women’s Association. When she is not pursuing medicine, you can find her reading, exploring artistic passions, and spending time connecting with friends and family.
Mallory Johnson, MS4
Mallory Johnson is a fourth-year medical student from St. George’s University. She holds a Bachelor of Science in Forensic Science and a Bachelor of Science in Chemistry from Tiffin University. She worked as an Analytical Chemist at P&G and KAO before medical school. She is passionate about giving back to vulnerable communities and providing equal access and opportunity to medical care. She is a member of the Domestic Violence and Music in Medicine Committees within the American Medical Women’s Association. When she’s not doing schoolwork, you can find her playing her cello, reading cozy mysteries, and playing with her poodles, Gertie and Maple.
Divya Krishnan, MD
Dr. Divya Krishnan obtained a medical degree with honours at the University of Medicine and Health Sciences, St. Kitts. She is passionate about preventative medicine and community medicine. She believes that we can only begin to move towards good health for all patients, with health equity and consistent community education led by healthcare workers. When not working in the medical world, she spends her spare time learning outdoors (hiking, rock climbing, gardening), learning indoors through reading books, and studying to brainstorm creative ideas for how to improve her practice as a whole- for her patients and for her co-workers.