Male or female therapists for eating-disordered adolescents: guidelines suggested by research and practice

The question of whether male or female therapists are best for female patients has sparked controversy for decades. This paper explores which therapist-patient gender matches facilitate the most patient growth and avoid detriment to female patients. There is little research on this subject related to eating-disordered female adolescents. Thus, an attempt was made here to distill relevant variables from the literature on eating disorders, adolescence, transference and countertransference, and psychotherapy, as well as the author's own practice, to suggest guidelines for effective matches. Although no consistent evidence pointed to a particular match as being most effective in this population, situations are noted in which assignment of one gender offers the chance of better therapeutic alliance. Therapist and patient preferences, the patient's traumatic experiences, enmeshed versus disengaged patient relationships, patient resistance, and therapists' comfort with both their male and female sides are variables related to preferred assignment. Advantages and disadvantages for male and female therapists are discussed, and suggestions made for variables to be used in future studies.