Gender and Age Differences in Psychotherapy Use Among U.S. Adults With Depression and Anxiety

This study aimed to determine whether psychotherapy use varies by gender and age among U.S. adults with depression or daily anxiety.

Data were from the 2021-2023 National Health and Nutrition Examination Survey. The sample included adults ages ≥18 who screened positive for depression (Patient Health Questionnaire-9 score ≥10, N=728) or reported daily anxiety symptoms (N=1,708). Psychotherapy use was defined as self-reported receipt of therapy from a mental health professional in the past year. Survey-weighted logistic regression estimated associations between gender and psychotherapy use within age strata, and the margins produced predicted probabilities and gender gaps. Secondary analyses examined differences by race-ethnicity.

When the full analytic sample was considered, psychotherapy use was higher among women than men for both depression and anxiety. For depression, the gender gap was largest among adults ages 18-25 (22 percentage points), smaller for ages 26-49 (12 points), and reversed at ages ≥50 (-1 point); young men had the lowest use (27%). For anxiety, gender gaps were 13, 12, and 4 percentage points for ages 18-25, 26-49, and ≥50, respectively. Men in the youngest and oldest age groups had the lowest psychotherapy use (24% and 23%, respectively). Mexican American adults had the lowest psychotherapy use for both depression (19%) and anxiety (27%).

Gender disparities in psychotherapy use are greatest among younger adults, particularly for depression, and are less pronounced for anxiety. Young men show especially low use. Findings highlight opportunities for targeted outreach, referral pathways, and service models tailored to men, especially younger men, and to Mexican American adults to reduce underuse of psychotherapy.