A Condensed Look At Women’s Mental Health

Katherine [Katu] Medina-Pineda, MHC-LP

Psychology is a field that has historically served the dual purpose of learning more about the ever-complex mind and of pathologizing perfectly natural responses to oppression to serve the interest of those in positions of power. For instance, between the late 1940s and 1950s lobotomies were considered acceptable treatment for a variety of diagnoses ranging from anxiety to obsessive-compulsive disorder and persistent depression. During that period of time, 60% of lobotomies performed in the United States were on white upper-middle class women, who were overrepresented in the aforementioned diagnostic categories. At the time, women did not have the right to autonomy or an identity outside of being a wife/daughter/mother– who wouldn’t lose motivation or will to live or develop unique coping patterns in response to such dehumanization?

Along similar lines, gay and lesbian people were uniquely threatening to the system given the puritanical understanding of sex as purely reproductive. It was dangerous and threatening to the American empire that people would engage in consensual sex primarily for pleasure. More babies being born, particularly in poor families, ensures a number of exploitable people inside the empire, which is why queerness was pathologized and uteruses continue to be policed by the government. Homosexuality was removed from the Diagnostic and Statistical Manual for Mental Disorders (DSM) in 1973 and the pathologizing of queerness was rebranded in the 1980s as “sexual orientation disturbance” and “ego-dystonic homosexuality” until it was completely excluded from the DSM-IV, published in 2000. 

The same, however, cannot be said for the pathologization of transness. Gender-affirming care for transgender people continues to be made inaccessible by creating a bureaucratic structure that requires evaluation and diagnosis, which forces individuals to justify their identities to access treatments and procedures which are readily available to cisgender people without hesitation. No prior authorization needed for a cis woman to obtain breast implants or extensive psychological evaluations standing in the way of a balding cis man and his hair plugs here! Transness is inherently dangerous to empires because our presence completely invalidates the myth of the existence of two distinct genders, making it harder for governments to categorize, divide, and exploit the working class. Transgender women and femmes experience gender-based violence at alarmingly higher rates than cisgender women, with a 2024 study from The Radiological Society of North America found that trans women are roughly three times more likely to require imaging during emergency hospital visits than cisgender women, and transgender women reported interpersonal violence at higher rates than cisgender women (75% of trans women versus 50% of cis women).

Today, much of the research fails to center or include BIPOC women, particularly transgender BIPOC women. For example, according to the DSM-V, the prevalence of Major Depressive Disorder among women is 10.3% compared to men at 6.2% (APA, 2013). For Generalized Anxiety Disorder, the prevalence in women is 6% as opposed to 3% among men (APA, 2013). A 2014 study on depression among transgender women revealed the lifetime prevalence of depression for transgender women was as high as 62%, whereas the lifetime prevalence for cisgender women was 16% (Hoffman, 2014). While these numbers are helpful to understand a fundamental disparity in mental health among the binary genders, there is a dearth of information to help us understand the nuanced differences in prevalence among Black, Indigenous, and other racialized groups of women as well as femmes that identify elsewhere within the gender spectrum. 

To get a better understanding of the potential risks women and femmes may face within the unique intersections of their respective identities, it is helpful to understand social determinants of health. These include social and community context; access to high quality healthcare; economic stability; access to high quality, individualized education; and the structure and environment of a neighborhood or community. For instance, isolation or limited social support leaves individuals vulnerable and subject to violence and exploitation. It is important that individuals have access to resources that can provide them with a work-life balance, that working class communities have access to affordable and accessible childcare and eldercare, and feel a sense of belonging, acceptance, and safety within society at large. Moreover, access to quality healthcare is paramount for overall quality of life and mental wellbeing of all people. People need access to qualified medical and mental health professionals who are culturally competent within a reasonable distance from their homes. Long waits in underfunded hospitals and clinics paired with being fearful of medical discrimination can be distressing for many, especially if they have previously experienced medical trauma. Financial stressors such as food and housing insecurity, having to work multiple jobs, and limited access to dignified employment opportunities are also known to have an adverse impact on one’s physical and mental wellbeing. All of these determinants of health uniquely impact women, particularly when contextualized in misogyny, fatphobia, anti-Blackness, and classism. 

Conclusion

Women’s mental health has been and continues to be an under-researched area in both the medical and mental health fields. Contextual and environmental factors are essential to obtain a nuanced and holistic understanding of how all women’s mental health and wellbeing are impacted by systemic disparities without pathologizing their responses to oppression, marginalization, and violence. 

Sources:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://odphp.health.gov/healthypeople/objectives-and-data/social-determinants-health

Hoffman B. An Overview of Depression among Transgender Women. Depress Res Treat. 2014;2014:394283. doi: 10.1155/2014/394283. Epub 2014 Mar 13. PMID: 24744918; PMCID: PMC3972927.

Patel , K. and Rocha, T.C. (2024) Study exposes high injury rates in transgender women, RSNA Press Releases. Available at: https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?ID=2537#:~:text=Released%3A%20December%2004%2C%202024&text=Injury%20rates%20among%20transgender%20women,times%20as%20many%20chest%20injuries. (Accessed: 15 March 2025).