- Gender concordance effects in mental healthcare are context dependent, with most studies showing neutral or mixed effects across diagnostic categories.
- Male patients with substance use disorders showed more consistent benefits from gender matching, including better retention, therapeutic alliance and abstinence.
- Literature gaps include limited non-binary representation, insufficient intersectional analysis, and need for more rigorous methods and mechanistic investigations.
BJPsych Open. 2026 Jul 17;12(4):e189. doi: 10.1192/bjo.2026.12036.
ABSTRACT
BACKGROUND: Mental health concerns are common. Despite this, evidence on the impact of patient-provider gender concordance on mental health outcomes remains limited.
AIMS: This review aims to explore the literature on the role of patient-provider gender concordance in mental health across diverse clinical contexts and populations.
METHOD: We conducted a preregistered scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A comprehensive literature search was performed across MEDLINE, PsycINFO, Cochrane Library and Scopus. Study selection and screening were completed using Covidence. Two independent reviewers applied predefined criteria. Data extraction captured study characteristics, demographics, mental health conditions, interventions and outcomes. Given substantial methodological heterogeneity, findings were synthesised narratively and organised by diagnostic category.
RESULTS: This review included 33 studies representing 562 890 patients. Most studies used cohort designs to examine psychotherapy interventions in out-patient settings. Many did not specify diagnoses, although substance use and depressive disorders were common. Results were highly mixed across diagnostic categories. For general mental health, most studies found neutral or inconsistent effects. However, substance use disorder populations showed more consistent benefits, particularly for male patients in gender-matched dyads, who demonstrated improved retention, therapeutic alliance and abstinence.
CONCLUSIONS: This review reveals that gender concordance effects in mental healthcare are context dependent. Whereas male patients with substance use disorders may benefit from gender matching, most evidence suggests neutral or mixed effects. Gaps in the literature include limited non-binary representation and insufficient attention to intersectional factors. Future research should employ more rigorous methods, expand beyond binary genders and investigate the mechanisms underlying observed effects.
PMID:42464623 | DOI:10.1192/bjo.2026.12036
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