When people are looking for a psychotherapist, they often wonder whether to choose a male therapist or a female therapist. For some people, choosing a therapist of the same sex seems the obvious thing to do. Others may simply assume that males work best with male therapists and females work best with female therapists, based on the idea that a therapist of the same sex is most likely to ‘get it.’ On the other hand, you might feel that a psychotherapist of the opposite sex would be the best choice based on your personal history with men or women. People who had abusive or untrustworthy parents of the same sex, or have in general found people of the same sex particularly anxiety-provoking or problematic to deal with, may assume that the best psychotherapist will be of the opposite sex.
In fact, the issue is quite complex, and the best choice for you might even be counter to your assumptions. In choosing a psychotherapist, the most critical factors are feeling safe, and feeling that you can be honest about what you think and feel. Regardless of their gender, you must feel your therapist is nonjudgmental, empathetic, direct, and professional. On this point, research shows that the relationship you develop with your therapist is the most important factor, regardless of the psychologist’s training, gender, theoretical orientation, age, and other factors.
To start with, therapists do not necessarily fit gender stereotypes. A dominant cultural stereotype is that women are more empathetic, understanding, emotional, nurturing, gentle, and intuitive, while men are more direct, intellectual, goal-directed, controlling, and out of touch with their emotions. These stereotypes often don’t hold for men and women in general, and they’re less likely to be true for psychotherapists. Research has shown repeatedly that there tends to be more variation within groups of all men or all women than there is between the two groups.
A therapist of the same sex may have had some experiences in common with you, but there is a risk of over-identification. It’s common to reflexively feel one understands another person’s experience “because we have been through the same thing,” but upon exploration this assumption may be very much off-base. This problem of unchecked assumptions reminds of an experience I had with a patient. I assumed he felt as irritated as I did with a loud banging pipe in my office. In fact, upon exploration, he recalled feeling safer in his grandmother’s house than anywhere else in the world, and his grandmother’s home had banging pipes. Though I assumed the pipe was irritating him, I discovered that he actually found the sound reassuring and cozy. Also, it can be useful for a patient to have to clearly articulate the nature of their experiences to another person because it helps with integration, and helps them feel more grounded in knowing their own story. When therapists and patients assume they understand each other, it may seem less important to articulate feelings.
For people who have issues with the opposite sex but do not find these issues overwhelming, it may be particularly useful to work with a therapist of the opposite sex. Assuming you have a professional therapist who holds clear boundaries, it creates an opportunity to work on these issues as they come up between you and your therapist. In fact, it is possible that having a therapist of the opposite sex could be more helpful and produce insights that a therapist of the same sex couldn’t.
It may be important to consider the gender of a new therapist, but upon reflection, the issue can be complex. In situations where a person has had significant trauma, which may include sexual or physical abuse, a feeling of safety and security is essential and it may be important to choose a therapist who evokes the most trust and security – and this may be a therapist of the opposite sex of the abuser. On the other hand, selecting a therapist whose gender is likely to stir up some of the same feelings you are in therapy to deal with can be helpful. And finally, though it may be tempting to choose a therapist of the same sex out of a sense that they can best understand what it’s like for you, it may also be important not to choose a therapist who seems to automatically understand you, since this could get in the way of thoroughly exploring and articulating subtleties of experience that may be important to address.