Understanding the Gender Differences in Post-Traumatic Stress Disorder
Helena Huynh
October 2024
Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition typically following exposure to a traumatic event, with symptoms impacting day-to-day functioning, causing the person to re-experience their traumatic event, and affecting overall cognition and mood.[1] According to the World Health Organization, over half of the global population–a shocking 70% of people–will experience a potentially traumatic event in their lives, with a minority of that population (5.6%) going on to develop PTSD.[2] However, women are much more likely to develop PTSD, with lifetime prevalence rates being almost three times as frequent for women than for men.[3] Why does this happen?
Types of Trauma
Women are much more likely to experience high-impact trauma, including sexual-related trauma and sexual assault. The CDC National Intimate Partner and Sexual Violence Survey conducted in 2010 found that 18.3% of women in the United States experienced rape at some point in their lives.[3] That equates to an alarming rate of about 1 in 5 women. Exposure to sexual violence are associated with higher rates of PTSD.[2] Additionally, women are also more likely to experience sexual abuse at younger ages compared to men.[3] Trauma in early childhood has a strong impact on overall neurobiological development[4] and also serves as a risk factor increasing the likelihood of developing PTSD.[1]
Physiological Responses
Prior research has found several differences when it comes to psychobiological reactions to PTSD[4]. For one, hormonal responses can potentially play a role in regulating trauma responses. The hypothalamic-pituitary-adrenal (HPA) axis, a neuroendocrine system within the body that regulates responses to stress, has been found to be more sensitive to stress and trauma. Additionally, studies have found that testosterone may possibly work to reduce HPA reactivity.[5] On top of that, studies have found that women with PTSD are more likely to experience a reduced fear-extinction during the mid-luteal phase of their menstrual cycle, when oestradiol and progesterone levels are lowest.[5] These hormones are related to cognitive-emotional processes relating to PTSD, and in trauma-exposed women without PTSD, researchers actually found the opposite result.[5]
Understanding PTSD Symptoms and Comorbidities
When it comes to PTSD symptom expression, males and females tend to experience PTSD in a similar way.[3] A study found that male and female veterans were about equally likely to report different PTSD symptoms on the PTSD Checklist[3], a self-report measure looking at PTSD symptoms. However, when it comes to comorbidities, women are much more likely to experience internalizing disorders, including mood and anxiety-related disorders. Men, on the other hand, were much more likely to experience externalizing disorders, including substance abuse.[3]
Overall, previous research has established a number of differences in the development and prevalence of PTSD in males and females. Given that much of the early research surrounding our knowledge of PTSD revolves around male war veterans[3], we must continue adding to the literature. Increasing our understanding of why these gender differences develop can inform targeted interventions to ultimately help those who need it.
References
[1] U.S. Department of Health and Human Services. (n.d.). Post-Traumatic Stress Disorder. National Institute of Mental Health.
https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd
[2] World Health Organization. (2024, May 27). Post-traumatic stress disorder. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder
[3] Vogt, D. (2007, January 1). Va.gov: Veterans Affairs. Research on Women, Trauma and PTSD. https://www.ptsd.va.gov/professional/treat/specific/ptsd_research_women.asp#four
[4] Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: An update. European Journal of Psychotraumatology, 8(sup4).
https://doi.org/10.1080/20008198.2017.1351204
[5] Christiansen, D. M., & Berke, E. T. (2020). Gender- and sex-based contributors to sex differences in PTSD. Current Psychiatry Reports, 22(4).
