Battle of the Sexes: Tackling Gender Differences in Suicide

Cultural and societal norms play a large part in defining what it means to be a man or woman. Those definitions then shape our understanding of the behavioral health needs of each gender. However, as men die by suicide at a rate 3.5 times more than women, and women attempt suicide twice as often as men, it's clear that we need to broach and break-down those gender constructs so all individuals can feel supported and comfortable when seeking help.

Illustration of a man and women with their faces looking outward, away from each other
Tayrine Cruz

Pink and blue, Barbies and dump trucks, glitter and grit, Venus and Mars. There are long-standing stereotypes around differences in genders that have been heavily immersed in our social and cultural expectations – and the discrepancies in gender have even made their way into mental health research and care. Research exists that suggests women are more prone to psychological problems, such as depression, thanks in part to how men and women are mentally wired differently – in questionnaire studies, women have greater tendencies to take on the stressors of others around them, have higher reported stress levels than men, develop somatic (sensory feeling) symptoms to stress and overall experience more stressful relationship events. It’s also been reported that mental health disorders range from 20-40% higher in women than men in the United States. So why is it that more men die by suicide than women each year, even though women are more likely to be involved in attempted suicides?

It’s important to remember before we start digging into the “why” behind gender differences in attempted suicide and death by suicide – there is no one-size-fits-all reason, stressor or event that can trigger suicidal thoughts, attempts or completion. There’s also no one single indicator that you or someone you’re close to should seek help or talk to someone. Every person’s mental health is different, but if you feel that you can relate to anything in this article, we don’t want you to hesitate to take care of your health.

To get to the root of the problem, let’s take a look at societal norms and the socially constructed concepts of masculinity and femininity. Traditional male and female gender roles contribute to a multitude of behaviors related to suicide risk, including:

  • whether vulnerability is displayed,
  • suicide methods opted for by the individual,
  • willingness or unwillingness to seek help for mental illness,
  • elevation or reduction of risk.

Social constructs lend additional explanations to male suicide rates, where the social construct of the male gender role places emphasis on being stronger, more independent and decisive individuals with greater earning potentials and more “powerful” job roles than females. This emphasis put on men can cause them to feel more pressure to live up to societal expectations and feel as if there isn’t an outlet to express their feelings because of the expectations set for men to be “emotionally strong.” In contrast, with the social construct of traditional female roles, women are considered more fragile, emotional and expressive – so it isn’t considered as out-of-character for women to visually or audibly show their feelings. Women also tend to be more appreciative of advice from friends and loved ones, valuing interdependence, and are more readily accepting of help from others. Many societies still expect men to hide feelings of vulnerability and weakness, making it socially stigmatizing for many men to seek mental health care.

Regarding health care, there are generalized differences in when and why the genders seek it, including data showing that females consult their healthcare providers more than men do for most health conditions – unsurprisingly, then, females are more likely than males to receive a psychiatric diagnosis and use mental health services. What’s alarming, though, is that society recognizes these higher death by suicide rates in men, yet also continues to perpetuate the myth that a man seeking help or even experiencing pain is categorically “not a real man.” With these social pressures in place, a completed suicide is considered masculine and powerful - whereas surviving an attempt would indicate “failure” and weakness - making men more likely to resort to lethal suicide attempts, evident in their tendency to use guns in suicide attempts that reduce their chances of survival.

The catch-22 of social gender norms is that living and working conditions are shifting for both genders, but this doesn’t translate into a positive shift for everyone. Women are increasingly returning to their jobs after having children; between 1975 and 2015, the labor force participation rate of mothers with children ages three or younger increased by 27.1 percent. Active employment can improve mental health for females, providing additional social outlets and financial independence through their return to the workplace. However, with this positive trend for women comes an inverse change for men, where their traditional gender norms are threatened when they are no longer considered the primary breadwinner or provider for the family, which can lead to loss of self-esteem and an increase in male suicide rates. This loss of self-esteem is thanks in part to how we view masculinity in our society and how much emphasis is placed on “looking up to masculinity;” with the loss of identifying as breadwinner comes a loss of masculinity and can lead to more significant mental health crises.

But when it comes to suicide attempt rates, women are twice as likely to attempt suicide, although men die by suicide at a staggering rate of 3.5 times more than women. There has been an overall tendency – and as a result, lack of additional studying – to assume that attempted suicide in women errs on being non-serious, manipulative and attention-seeking, which feeds into the “emotional” female stereotype. This stereotype, sadly, has been around since 1900 B.C., where Egyptian texts alluded to women’s “hysterical behaviors” and the future “hysteria” illness that was exclusively a “ladies’ disease.” Some studies have suggested that women might intentionally use less lethal suicide methods because they don’t intend to die when attempting suicide, but are trying to draw attention to their mental health needs instead.

When it comes to risk factors, both genders share the same for attempting suicide, including more turmoil in families, increased social instability, and higher levels of sexual abuse among attempted suicide victims, with both genders reporting histories of medical and psychiatric illnesses, including cancers, pulmonary diseases and major depressive disorders. When studying socioeconomic health factors, which include geographic location, income, familial status, family history of health, and more, gender differences become prominent yet again. In one study, men who attempted suicide tended to have lower incomes and were smokers, whereas women in the study who attempted suicide had poor self-evaluated health, lower education levels and drug use. Females who reported having higher somatic symptoms, or physical manifestations of feelings, were more likely to attempt suicide again after their first attempt.

Examining the differences between genders and suicide rates, both attempted and completed, are two-fold. Continuing to look at gender as just a social, economic, or educational characteristic, instead of being considered an influential factor when studying suicide rates, is a major issue.To fully recognize gender disparities in suicide attempts and death by suicide, public health policies moving forward should include gender as an interdependent variable, where gender can influence health-related behaviors and outcomes. As communities and as a society, we can all do our part to help deconstruct gender normative roles so all genders and individuals can begin to change their health behaviors – and seek help if they need it.

If you or someone you know needs help, please contact the National Suicide Prevention Lifeline 1-800-273-8255. All call centers are open 24/7 and calls are confidential. Visit suicidepreventionlifeline.org for more information.