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 pat ient cave. By using a similar paradigm, this study assessed introductory ps ychiatric 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 ob tained. Two earlier versions of the DSM Casebooks were also reviewed for co mparison with the most recent edition, to look for longitudinal trends. Mal e subjects were featured in case vignettes significantly move often than fe male subjects in the five texts combined; significantly different gender di sparities were obtained in three of the five texts examined. The number of vignettes featuring female subjects exceeded those featuring males in one t ext. Despite repeated revision, each of the three versions of the DSM Caseb ooks retained a statistically significant predominance of male subjects. Th e observed gender discrepancies were not an artifact of use of vignettes il lustrating 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 in congruent with trends in psychiatric service utilization by men and women. The potential impact of gender bias on medical trainees is discussed.