Therapist-client gender match: How much does it matter?

Written by: Dan Mortenson, PhD

Dan, the Man

Some time ago, I discovered that I’m a bit of an anomaly in my field: a male psychologist.  For whatever reason, mental health providers tend to be predominantly female and I found myself to be in the minority which put me in a unique position when starting therapy with clients.  Often I would hear during initial phone calls comments such as, “I think my son would really connect with you because he’s never met with a male provider before.”  Or sometimes, in contrast, “I’m not sure my teenage daughter would be the best match since you’re a guy.”

Does gender-match matter? It depends!

I’ve been with Chicago CBT Center for over thirteen years and after seeing hundreds of people for therapy from all ages and backgrounds it got me thinking, “How much does my gender matter when considering goodness of fit with someone?”  The standard psychologist answer to questions like this is often “It depends!” but I wanted to be honest and consider what the factors are that determine a good match.

When does gender-match not matter?

In all honesty, in the vast majority of cases I’ve found that my gender doesn’t make as much of a difference as I would think.  Instead it seems that my experience, familiarity with the issues at hand, and general personality match are the most important factors in determine how well I click with someone in therapy.

When does gender-match make a difference?

However, there are some specific cases where my gender can be an important factor to consider.  The first type of issue that comes to mind is trauma and if my being a male therapist could be triggering due to previous abusive behavior a client has experienced from another male.  In this case, it’s completely understandable that client comfort level may be higher with a female provider when exploring such delicate issues.  That being said, I’ve also seen some instances where, although off putting at first, learning to be around a male therapist and how to manage difficult emotions that may come up can also be part of the healing process for some.  In these examples, it’s important to explore the unique needs of the individual to see how my gender may play a role over the course of treatment and have an ongoing dialogue as to how this may impact engagement and overall efficacy of therapy.

One of the most common referrals I get is often young males because it’s assumed that I would click with them due to my ability to validate male developmental experiences.  Often, I have found this to be true. And it can enhance rapport building when there is an implicit understanding that I may have also experienced some similar themes growing up.  Or other times it may be the novelty of me being different from female therapists that he’s met with before that can help jostle new skill building or perspective taking on an issue.

Another factor to also take into consideration is how my gender identity matches up with those identifying as non binary or transgender.  Similarly, I’ve found that my exact presentation is less important and what really matters is my ability to have an open perspective on the fluid nature of gender identity and expression.  Although I will of course take into account how my specific gender presentation may impact the care of someone seeking treatment, quality care often comes down to my core abilities as an emphatic therapist educated in care for those of all variants of gender in our society.

What is most important?

Overall, I’ve felt that other factors often eclipse the gender variable in making connections with people: empathy and openness.  Empathy is most important in building therapeutic connections with others regardless of any demographic factor.  I’m often reminded of something I remember hearing from some of my colleagues who work with veterans.  They often reported struggling with how they could build rapport with their patients when they themselves may have never experienced military conflict firsthand.  They’ve informed me that it’s not about directly sharing this experience, but understanding how to recognize and best treat relevant symptoms and, most importantly, being able to listen and be open to understanding their experience.  I may never have known military combat, but mental illness I know well. Similarly, I’ve also found that my having gender-specific personal experiences is less relevant than my being open to hearing and validating the narratives of others even if it’s different than my background.  Although there are times when having a match can open up some parts of therapy, the most common secret ingredient is the openness to understanding someone’s experiences with open arms and without judgment.