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Adolescence

How to Close the Mental Health Gender Gap for Girls

The highest achievers are also the most worried about others' approval.

Key points

  • Progress in psychology can be stalled by following misleading studies, or when illuminating studies are lost.
  • The current crisis in teen girls' mental health suffers as researchers ignore key findings.
  • Social media increases pressure but does not change the dilemmas girls face at the crossroads of adolescence.
  • Changing expectations as girls enter adolescence will ease their mental health crisis.

Some studies obscure rather than illuminate the human mind, yet nevertheless become embedded in developmental theory. For example, Anna Freud's claim that adolescents want to divorce their parents, psychologically speaking, somehow remains in place alongside overwhelming evidence that what teens want is to revitalise, maintain, and update relationships with parents. [1] What is less well known is how understanding of human development is also impeded when some seminal studies fade from view, as though they never existed.

The Inexplicable Loss of Useful Knowledge

Over and over we hear about the crisis in the mental health of girls. The gender gap is noted, but the work that could help frame the issue is forgotten. Maggie Jones, writing last week in The New York Times, notes that:

“the numbers of teenagers—in particular, girls—who are in despair about their lives is surging. Three out of five teenage girls felt persistent ‘sadness or hopelessness’ in 2021, the highest rate in a decade, according to a Centers for Disease Control and Prevention survey released this year... Experts don’t understand why the numbers have been rising... Some blame social media.” [2]

This common, casual, and lazy attribution of blame to social media is so widespread that it seems reasonable to assume that researchers do not really care about the gender gap in mental health.

Seeing the Need and Losing Sight of What We Have

A recent piece in the Journal of Child and Adolescent Mental Health [3] speaks eloquently to the need to explain the gender gap in common mental health difficulties, but ignores the significant body of work that does just that. Instead of exploring past research, the authors ask, “Why do we not care about the gender gap in common mental health difficulties?”

This is a pity because in so many ways the authors clearly grasp the approach needed. They challenge any “tendency to treat [the gender gap in mental health] as inevitable” or essential or based on biology. They believe it is likely linked to “the context in which boys and girls grow up and are socialized.” They note that “a key component of research in this area must be engagement with women themselves… [and] if we as mental health researchers made more effort in asking girls and women about their experiences… it will likely lead to many possible avenues to examine.”

Disappointingly, however, the authors claim that “we have little empirical evidence delineating the drivers of this gender gap.” Yet empirical evidence is precisely what we already have in a rich body of research that is ongoing and highly cited but inexplicably ignored by many now at the coalface of teen mental health.

Reviving Key Research

I am of course referring to the work of Carol Gilligan’s ten-year research project on “Strengthening Healthy Resistance and Courage in Girls” in which she showed—long before iPhones and social media—that teen girls face a psychologically costly dilemma: They are challenged to silence themselves in order to keep peace with others, and when they resist, they are punished, warned, or excluded. [4] Young teen girls learn they can either say what they really think and be unacceptable to others, or they can cover their gut resistance to the female norms into which they are being initiated and remain acceptable to their parents, teachers, and friends.

These findings remain pertinent today. Girls are told they can do anything, and be anyone they want, but to do so they have to succeed according to social rules and educational standards. Social media comes in only as it adds more watchers to police girls’ looks, words, and actions, but the laws are the same. Girls are still taught to put others’ needs before their own, to “look nice” and “speak nicely.” Those who believe that teen girls don’t care about the approval and acceptance of grown-ups—parents, teachers, neighbours—should think again.

Teen Girls Seem Self-Confident But Fear Conflict

In 2019, alongside education charity The Female Lead, I interviewed teen girls in the UK about their aims, desires, and fears. The girls set high goals for academic achievement and careers, and in many ways represent the feisty, thriving teens we want to see. But as they spoke they revealed Gilligan's dilemma. What they feared most was conflict with others. What they admired most in others was “courage” or the ability to speak out and hold one’s ground. [5]

More recently in the U.S., a large-scale survey found that 46 percent of girls reported that “they don’t say what they are thinking or disagree with others because they want to be liked.” [6] Even more shocking is that when girls satisfy traditional measures of success, such as attaining a high grade point average, that percentage rises to 62 percent.

As Tara Christie Kinsey from the Hewitt School (who is partnering with Gilligan in a new study of girls) says, “The highest achieving girls in the U.S. are the most concerned with the outside approval of others. Pressed to choose between having a voice or having relationships, many girls stay silent, going along to get along with a crowd whose behavior, beliefs, and values may not align with their own.”

Covering one’s real voice is widely recognised as a costly cognitive load. That is why some therapists are able to help, especially when therapy involves meeting them “where they are and [taking] them at their word” [7] Gilligan’s research can help girls before their difficulties become clinical. The only thing educators, therapists, and parents need to do is re-discover the framework, theory, and practice they have lost sight of.

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References

1. Anna Freud. 1958. The Psychoanalytic Study of the Child. Vol 13, issue 1: 255-278; Terri Apter. 2022. The Teen Interpreter. W.W.Norton.

2. Maggie Jones, How Do You Actually Help a Suicidal Teen? The New York Times. May 17, 2023.

3. Lucienne Spencer and Matthew Broome. 2023. Debate: Don’t Mind the gap – why do we not care about the gender gap in common mental health difficulties? Child and Adolescent Mental Health. Vol 28, Issue 2: 344-346.

4. Carol Gilligan and Lyn Mikel Brown. 1993. Meeting at the Crossroads: Girls' Development and Women's Psychology. Harvard.

5. Terri Apter. 2019. Disrupt Your Feed. The Female Lead

6. L. Winkelman. 2017. The Girls' Index: New Insights into the Complex World of Today's Teens. Columbus, OH: Ruling Our eXperiences, Inc.

7. Layne Filio, quoted in Maggie Jones, How Do You Actually Help a Suicidal Teen? The New York Times. May 17, 2023.

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