Detrimental Impacts of Misogyny on Mental Health

Statement on the Detrimental Impacts of Misogyny on Mental Health

California Association of Marriage and Family Therapists
August 29, 2022


Note: This Statement on the Detrimental Impacts of Misogyny on Mental Health intersects with other important social concerns including the rights of those who identify as transgender and gender nonconforming, the rights of BIPOC women, reproductive rights, and equal access to care. CAMFT is committed to publishing further social policy statements on these and other relevant concerns.

The California Association of Marriage and Family Therapists (CAMFT) recognizes the historical and ongoing effects of gender discrimination, sexism, and misogyny on the mental health of women, nonbinary people, and LGBTQ+ people.

Discrimination on the basis of sex is illegal in the United States, but the dismantlement of legal discrimination is a relatively recent phenomenon. Roughly fifty years ago, marital rape and intimate partner violence was legal in some states, while in some states the possession of birth control by single people was illegal. The legacy of a patriarchal legal system remains powerful; gender inequality persists in the workplace, politics, culture, and most other arenas of American life.

Sexism and misogyny continue to act as a barrier to the full and equal participation of all people, regardless of gender, and to impact the mental health of historically disadvantaged and marginalized groups, especially women, women of color, nonbinary individuals, and LGBTQ+ people. By conceptualizing women’s subordination to men, traditional gender relations, and the gendered division of labor as natural, sexism justifies and reinforces discrimination on the basis of gender and unequal gender relations.

Recent philosophical examinations of misogyny have offered a useful distinction between misogyny and sexism. Whereas sexism works by making social hierarchies appear to be a reflection of the natural order, feminist theorists have proposed that misogyny functions more as “the ‘law enforcement’ branch of a patriarchal order.”1 Specifically, women and girls who violate norms and expectations of feminine-coded behavior are policed and punished; they are subjected to hostile treatment on a spectrum which ranges from blaming and shaming and objectification, to harassment and physical and sexual violence.

For therapists, it is important to recognize that women and girls can face misogynistic punishment in the family, the workplace, and the public arena for failing to conform to gendered expectations. Online and social media platforms, particularly, have emerged key sites for hostile and toxic misogyny. Thus, women and girls who violate expectations of loving caregiving or assert for themselves the right to masculine-coded behavior—for example, by speaking out or occupying a position of power and authority—are frequently subjected to misogynistic policing.

Women’s experiences with sexism and misogyny start at an early age and continue throughout their lives. These day-to-day experiences can often be internalized by women, as a way of coping with discrimination and misogyny. Examples of this phenomenon include selfobjectification, passive acceptance of traditional gender roles, victim-blaming, and even devaluation and distrust of women.2 Internalized sexism is a coping mechanism that is implemented to deal with societal stressors and that further risks women’s mental health.3 Feminist psychotherapists have found a clear relationship between sexism internalization with depression, anxiety, eating disorders, and low self-esteem.4

The normalization of sexism in institutions and societal interactions (interaction at the family level, school, work, etc.) can reinforce the internalization of sexism such that it is passed down to the next generations. Thus, women do not only carry trauma from sexist events throughout their lives, but they might carry the trauma of generations before them. In families in which a parent is a trauma survivor, research based on feminist therapy theory suggests that girls may be more susceptible to inter-generational trauma. (For more on intergenerational trauma, see also CAMFT's statement on racial trauma.) Feminist psychotherapists can use therapeutic strategies to help their patients to recognize and understand the negative impacts of internalized sexism in their lives, and specifically in their mental health.

Misogyny intersects with other mechanisms of oppression and biased ideology; it operates differently on women differently positioned by race, ethnicity, class, age, ability, sexual orientation and gender identity, and so forth. The feminist theorist Moya Bailey coined the term “misogynoir” to describe the anti-black racist misogyny that characterizes Black women’s distinctive experiences.6 For example, the well-documented medical mistreatment of Black women that has resulted in alarmingly and disproportionately high Black maternal mortality rates can be understood, in part, as a case of misogynoir in practice.

Social stressors affecting women’s mental health
Women have had to face higher social stressors that impact their mental health because of their unequal role in society. A voluminous research literature on mental health has shown that symptoms of depression and anxiety, psychiatric disorders, and psychological distress are more prevalent among women than men. 7 One in five women in the United States has a mental health problem such as depression, post-traumatic stress disorder (PTSD), or an eating disorder. When trying to explain these patterns of mental health disorders in women, multidimensional poverty8 and isolation are associated with poor mental health outcomes in numerous research findings. 9

The unequal distribution of unpaid work has caused women to be exposed to high-level stress situations. Women spend a disproportionate amount of time carrying out care and domestic activities than men. Studies have estimated that women carry out three-quarters of the world’s unpaid work.10 The lack of time for leisure, self-care, and socializing can ultimately lead to physical and emotional distress, depression and anxiety. 11 For women in the labor force, the unequal distribution of unpaid domestic work imposes a double burden. Studies have found that household stress seems to affect women more than men, and women’s disproportionate share of housework has contributed to sex differences in depression. 12 Overall, the research shows a link between more unpaid work hours and a higher depression for women than men.

Oppressive practices produced by misogyny and sexism have led women to experience domestic violence and other forms of gender-based violence. Before the pandemic, the World Health Organization estimated that globally one in seven women ages 15-49 had experienced physical and/or sexual violence from an intimate partner or husband. 13 Thus, women do not only have to deal with the experienced abuse, but they also have to cope with its mental health consequences: emotional distress, depression, anxiety, and post-traumatic stress disorder (PSTD). 14 Studies have shown that women experiencing abuse are at greater risk of mental health disorders. However, there is also a bi-directional effect; mental health conditions make women more vulnerable to abuse. 15

Women's level and experiences of social stressors vary across race, ethnicity, sexual orientation, gender identity, and socioeconomic background. In short, the prevalence of poor mental health differs across groups of women. For instance, research has shown that Latina and Black women in the US are more likely than white women to have depressive symptoms. 16 Women, especially BIPOC women, have higher rates of poverty than men, and studies have demonstrated a relationship between poverty and poor mental health. 17 Finally, Black and Latina adults have less access to mental health services, which exacerbates poor mental health. Only 8.7 percent of Black adults and 8.8 percent of Latino adults in the US received mental health services in 2018, compared to 18.6 percent of White adults.18 A higher prevalence of psychiatric morbidity and psychological distress in women is also associated with situations of powerlessness and oppression.

Among other social and economic inequities that have mental health impacts on women is access to education. Although overall, women have higher rates of college completion than men, low-income women with low levels of education are at higher risk of poor mental health. Moreover, they are less likely to seek mental health care services – due to stigmatization or inaccessibility.19

This status quo in which women are chronically facing social stressors and are left to cope with the impacts on their mental health is perpetuated by the lack of women’s representation in leadership positions and lawmaking entities. Unequal representation has often contributed to a simplistic interpretation of policies to address women's mental health issues, misogynistic and discriminatory attitudes in the mental health practice field, omission of gender considerations in the training of mental health professionals, and lack of funding for policy implementation. 20 Essentially, when women are underrepresented, decision-making bodies dominated by men often overlook women's needs and allocate resources to areas that they consider more "urgent.” This disregard of women's needs could disrupt women's access to mental health services.

Women's representation in leadership and policymaking could enable access to mental health care services tailored to women's specific mental health needs. It can ensure that services do not replicate inequalities that stereotype and disempower women. 21 Research has shown that female legislators are more likely to introduce bills on gender equality and to consider how any policy reform will impact women. 22 Furthermore, the inclusion of women in leadership positions across the mental health care field can ensure that women's perspectives and experiences are included in collective decisions, protect their interests, and promote an intersectional approach. 23 For instance, feminist mental health professionals have developed alternative services in which the social realities of women's lives are considered, and the therapeutic relationship becomes more egalitarian and women-centered.24

The impacts of COVID-19

The impacts of the COVID-19 pandemic in women’s mental health have not only demonstrated the urgency to ensure equal access to mental health services, but have also shown the need to understand and consider the continuing social stressors women face that trigger poor mental health outcomes. The pandemic has exacerbated poor mental health outcomes among women who were already vulnerable.

Women were suddenly spending a greater number of hours performing domestic labor, child and elder care, including homeschooling for mothers of younger children. They had to reduce working paid hours and adapt their job schedules to carry the increased burden of unpaid work. Studies have found that these changes were associated with women experiencing more significant psychological distress, anxiety, and depression than men. Not surprisingly, more negative impacts of the pandemic were seen in groups of women who were already coping with higher social stressors, such as poverty, isolation, unemployment, etc.25 Furthermore, lockdown restrictions caused isolation, decreased access to social services, and increased exposure to intimate partner violence, exacerbating the disproportionate effect of the pandemic on women’s mental health and quality of life.

Marriage and Family Therapists, as relational experts, have unique training to work on the gender equity issues discussed in this statement. It is best practice for therapists to be intimately familiar with the issues impacting women coming into the therapy room, in order to advocate in a trauma-informed way for the well-being and health of our clients. Likewise, it is critical that MFTs and all mental health practitioners understand the intersectionality between gender inequality, racial inequality, income inequality, sexual orientation inequality, and other systemic injustices, and how these dynamics impact mental health.

This statement was created in collaboration with the Gender Equity Policy Institute (GEPI) for publication at Individual contributors to the development of this statement include:

  • Nancy L. Cohen, Mona Shaw, and Natalia Vega Varela from the Gender Equity Policy Institute (GEPI)
  • Joy Alafia, Executive Director, and Holly Daniels, Managing Director of Clinical Affairs, CAMFT; and
  • Robin Andersen, Juan Gavidia, Ronald Mah, and Lisa Romain, CAMFT Social Policy Task Force.

Any correspondence or inquiries regarding CAMFT Social Policy Statements should be addressed to Additional information about GEPI can be found at

The CAMFT Board of Directors has prioritized the publishing of Social Policy Statements to raise understanding and awareness about the impact of social and systemic issues on mental health and well-being, and to emphasize the importance of culturally responsive training for mental health clinicians

CAMFT develops these positions and responds to social issues relevant to the practice of psychotherapy, mental health policy, and social concerns impacting the mental health of individuals, families, and communities in California in order to guide the profession, amplify the voices of marriage and family therapists, educate the public, and influence decision makers.

CAMFT is aware that social justice issues are dynamic developmental processes responsive to evolving social, political, economic, and other world circumstances, as well as clinical, ethical, and legal considerations. This statement is both a commitment on the part of CAMFT to address these issues and intended to provoke discourse and evolution in recognition of the realities of members of all communities.



1Kate Manne, Down Girl: The Logic of Misogyny (New York: Oxford University Press, 2017), 63

2See Szymanski, D. M., & Feltman, C. E. (2014). Experiencing and coping with sexually objectifying treatment: Internalization and resilience. Sex Roles, 71(3-4), 159–170 and Rahmani, Syeda, "WOMEN'S EXPERIENCES OF INTERNALIZED SEXISM" (2020). Dissertations. 451.

3Rahmani, Syeda, "WOMEN'S EXPERIENCES OF INTERNALIZED SEXISM" (2020). Dissertations. 451.

4Szymanski, D.M., Gupta, A., Carr, E.R. et al. Internalized Misogyny as a Moderator of the Link between Sexist Events and Women’s Psychological Distress. Sex Roles 61, 101–109 (2009).

5Miriam L. Vogel, “Gender as a Factor in the Transgenerational Transmission of Trauma,” Women & Therapy 15, no. 2 (May 15, 1994): 35–47,

6Moya Bailey and Trudy, “On Misogynoir: Citation, Erasure, and Plagiarism,” Feminist Media Studies 18, no. 4 (July 4, 2018): 762–68,

7See Mental Health Disparities: Women's Mental Health. Division of Diversity and Health Equity: American Psychiatric Association, 2017 or Mary-Jo DelVecchio Good. “Women and Mental Health”, UN Women, 1997.

8Multidimensional poverty comprehends various deprivations such as poor health, lack of quality of education, inadequate living standards, disempowerment, poor quality of work, unsafety, and vulnerability to environmental hazards from Oxford Poverty and Human Development Initiative (

9Seedat S, Rondon M. Women’s wellbeing and the burden of unpaid work BMJ 2021; 374 :n1972 doi:10.1136/bmj.n1972

10Langer A, Meleis A, Knaul FM, et al. Women, and health: the key for sustainable development. Lancet2015;386:1165-210. doi:10.1016/S0140-6736(15)60497-4 pmid:26051370

11Seedat S et al. (2021)

12See Mortensen J, Dich N, Lange T, et al. “Job strain and informal caregiving as predictors of long-term sickness absence: a longitudinal multi-cohort study.” Scand J Work Environ Health2017;43:5-14. doi:10.5271/sjweh.3587 pmid:27556905. Also: Peristera P, Westerlund H, Magnusson Hanson LL. “Paidunpaid working hours among Swedish men and women in relation to depressive symptom trajectories: results from four waves of the Swedish Longitudinal Occupational Survey of Health.” BMJ Open2018;8:e017525. doi:10.1136/bmjopen-2017-017525 pmid:29880559

13World Health Organization, on behalf of the United Nations Inter-Agency Working Group on Violence Against Women Estimation and Data (2021). Violence against women prevalence estimates, 2018. Global, regional, and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women.

14Giulia Ferrari, Roxane Agnew-Davies, Jayne Bailey, Louise Howard, Emma Howarth, Tim J. Peters, Lynnmarie Sardinha & Gene Feder (2014) Domestic violence and mental health: a cross-sectional survey of women seeking help from domestic violence support services, Global Health Action, 7:1, 25519, DOI: 10.3402/gha.v7.25519

15Ferrari (2014)

16Bromberger JT, Harlow S, Avis N, Kravitz HM, Cordal A. Racial/ethnic differences in the prevalence of depressive symptoms among middle-aged women: The Study of Women's Health Across the Nation (SWAN). Am J Public Health. 2004 Aug;94(8):1378-85. DOI: 10.2105/ajph.94.8.1378. PMID: 15284047; PMCID: PMC1448459

17Belle, D. (1990). Poverty and women's mental health. American Psychologist, 45(3), 385–389.

18Carratala, Sofia and Maxwell, Connor. "Health Disparities by Race and Ethnicity.” Center for American Progress (2020).

19Lopez, V., Sanchez, K., Killian, M.O. et al. Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. BMC Public Health, 646 (2018). and Srivastava, Kalpana. “Women and mental health: Psychosocial perspective.” Industrial psychiatry journal vol. 21,1 (2012): 1-3. doi:10.4103/0972-6748.110938

20Karen Newbigging, Chapter 12 - Mainstreaming Gender Equality to Improve Women’s Mental Health in England, Editor(s): M. Pilar Sánchez-López, Rosa M. Limiñana-Gras,The Psychology of Gender and Health, Academic Press,2017,Pages 343-361.

21Newbigging, 2017.

22Brechenmacher, Saskia. "Tackling Women's Underrepresentations in U.S. Politics: Comparative Perspectives from Europe.” Carnegie Endowment for International Peace: 2018.

23Dena Javadihttps, Jeanette Vega, Carissa Etienne, Speciosa Wandira, Yvonne Doyle & Sania Nishtar (2016) Women Who Lead: Successes and Challenges of Five Health Leaders, Health Systems & Reform, 2:3, 229-240, DOI: 10.1080/23288604.2016.1225471

24Newbigging, 2017.

25Seedat S et al. (2021)