Gender differences in mental and physical illness: the effects of fixed roles and nurturant roles

A decade ago it was widely assumed that there were no gender differences in mental illness/mental health and that any evidence that suggested that women experienced more psychological distress than men was due to women being more willing to admit to psychological distress, being more willing to seek treatment and/or sex bias on the part of clinicians. Furthermore, although it was widely recognized that on most indicators of physical illness women appeared to have higher rates of morbidity, it was generally assumed that the apparent higher rates of women did not reflect real differences in morbidity, but gender differences in illness behavior. A survey of the recent literature, however, shows that there is now a general consensus among social scientists that women experience more psychological distress than men and that this is largely due to aspects of their societal roles. Furthermore, in the last few years the cumulative evidence indicates that women do in fact have higher rates of morbidity than men and that this probably is also largely a consequence of their social roles. The present paper focuses on two aspects of the roles typically occupied by men and women, namely that the roles of men tended to be more structured or 'fixed' than the roles of women, while women are more likely to occupy nurturant roles than men. It is argued that highly structured or 'fixed' roles tend to be causally related to good mental health and low rates of morbidity. In contrast nurturant roles tend to impose a strain and to impair one's ability to effectively adopt a sick role and as a consequence nurturant roles are linked to poor mental health and the higher rates of morbidity. In short, it is suggested that the fixed role-hypothesis and the nurturant role hypothesis complement each other and together partially explain the higher rates of physical illness and psychological distress among women.