Gender bias in psychiatric texts

Prior research examining gender bias in textbooks used by medical students demonstrated that male models are used significantly more often than female models, raising concerns about the messages conveyed to trainees about patient care. By using a similar paradigm, this study assessed introductory psychiatric texts for gender bias: Five texts were selected for their use by medical students and based upon the presence of illustrative case vignettes. Frequencies with which vignettes featured male or female subjects were obtained. Two earlier versions of the DSM Casebooks were also reviewed for comparison with the most recent edition, to look for longitudinal trends. Male subjects were featured in case vignettes significantly more often than female subjects in the five texts combined; significantly different gender disparities were obtained in three of the five texts examined. The number of vignettes featuring female subjects exceeded those featuring males in one text. Despite repeated revision, each of the three versions of the DSM Casebooks retained a statistically significant predominance of male subjects. The observed gender discrepancies were not an artifact of use of vignettes illustrating disorders with higher prevalence rates among men. In fact, women were featured as subjects in vignettes illustrating disorders with higher prevalence rates among women. The use of predominantly male subjects was incongruent with trends in psychiatric service utilization by men and women. The potential impact of gender bias on medical trainees is discussed.