Gender differences in post-traumatic symptomatology among refugees: a systematic review and meta-analysis

Background: Armed conflicts and persecution force millions of people to flee their countries, exposing them to severe pre-, peri-, and post-migration stressors that can negatively affect mental health. Post-traumatic stress disorder (PTSD), anxiety, and depression are common among forcibly displaced populations, and evidence suggests that gender may influence these outcomes.Objective: This systematic review and meta-analysis examined gender differences in mental health among refugees displaced by armed conflict, focusing on: (1) the odds and frequency of individuals presenting post-traumatic symptoms, (2) common comorbid conditions such as anxiety and depression, and (3) gender-based differences in exposure to traumatic events.Methods: Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus, and Science Direct (December 2024). Two independent reviewers screened and extracted data according to PICOS criteria, and study quality was evaluated using the Newcastle-Ottawa Scale. Twenty-five studies met inclusion criteria, and 14 provided quantitative data for meta-analysis. Random-effects models were computed in R to estimate gender-based effect sizes for PTSD and related outcomes.Results: Women showed higher odds and frequency of PTSD symptoms, as well as increased levels of anxiety and depression, although differences in PTSD symptom severity were not consistently significant. Gender differences were also observed in exposure to traumatic events: women reported higher rates of sexual violence, whereas men were more likely to have been kidnapped or imprisoned. Longitudinal findings indicated a chronic trajectory of PTSD symptoms for both genders, likely shaped by post-migration stressors.Discussion: These findings highlight the relevance of gender in post-traumatic mental health among refugees. Higher symptom levels in women may reflect disproportionate exposure to gender-based violence and unequal access to support resources. Addressing these disparities is essential for designing gender-sensitive interventions and policies. Further research is needed to clarify long-term trajectories, standardize assessment tools, and identify effective strategies for diverse refugee populations.