The History of Women's Mental Health and Why It Matters
Part One of a Two-Part Series for Women’s History Month
Mental health is shaped by a variety of social, biological, and cultural factors, but history has shown that women and female-identified individuals have often been misunderstood, overlooked, and mistreated in mental healthcare. From being labeled as "hysterical" to being systematically excluded from medical research, the experiences of those identifying as women have long been shaped by bias, stigma, and a fundamental misunderstanding of gendered mental health needs.
This two-part series for Women’s History Month explores the history of women's mental health and its implications. In this first installment, we examine how mental healthcare for women has evolved, the ways in which gender bias has shaped treatment, and why addressing this history matters. The second part of this series will focus on the present-day challenges facing female-identified individuals in mental healthcare and what needs to change for a more equitable future.
Sex, Gender, and Mental Health: An Intersectional Lens
Before delving into the history, it is crucial to acknowledge the difference between biological sex and gender. Sex refers to biological characteristics such as chromosomes, hormone levels, and reproductive anatomy, while gender is a social and cultural construct that influences identity, roles, and expectations.
Mental health exists at an intersection where biological, social, and cultural factors interact. While cisgender women have historically been the primary focus in discussions of women’s mental health, it is important to include transgender, nonbinary, and gender-nonconforming individuals in the conversation. The exclusion of female-identified people from healthcare studies, as well as the stigmatization of traditionally "feminine" emotions such as sensitivity and vulnerability, has negatively impacted all who identify as women, regardless of their assigned sex at birth.
A Troubled Past: Women and Mental Healthcare Throughout History
The "Hysteria" Diagnosis and Early Misconceptions
For centuries, women’s mental health struggles were misattributed to their reproductive systems, leading to the diagnosis of "hysteria." The term, derived from the Greek word for uterus, hystera, was used as a catch-all label for any behavior deemed socially unacceptable. Women exhibiting symptoms of depression, anxiety, or even strong emotions were diagnosed with hysteria and subjected to treatments ranging from bed rest to forced institutionalization.
In the 19th century, Dr. Silas Weir Mitchell introduced the "rest cure," which prescribed complete isolation, bed rest, and forbade intellectual activity for women experiencing psychological distress. This practice famously failed writer Charlotte Perkins Gilman, who documented her experience in The Yellow Wallpaper, a haunting account of medical misogyny that still resonates today.
Institutionalization and the Pathologization of Femininity
The early 20th century saw widespread institutionalization of women, many of whom were placed in asylums for reasons unrelated to mental illness. Women who defied societal norms—those who sought divorce, displayed sexual independence, or rejected traditional gender roles—were often committed against their will. Psychiatric diagnoses frequently pathologized femininity itself, reinforcing restrictive gender roles and punishing deviation.
Women were subjected to inhumane treatments such as electroconvulsive therapy (ECT) and forced sterilizations, particularly those from marginalized backgrounds. The intersection of gender, race, and class played a significant role in who was institutionalized and what level of care (or lack thereof) they received.
The Exclusion of Women from Mental Health Research
One of the most pervasive issues in mental healthcare has been the exclusion of women from research. Until the 1990s, women were frequently left out of clinical trials due to concerns about hormonal fluctuations "complicating" study results. This exclusion meant that medical treatments, including psychotropic medications, were primarily developed and tested on men. As a result, women’s unique physiological responses to medications were overlooked, leading to ineffective or even harmful treatments.
The long-term effects of this exclusion are still evident today, with gaps in understanding how mental health disorders manifest differently across sexes and genders. For instance, conditions like autism and ADHD have historically been underdiagnosed in women because research and diagnostic criteria were developed based on male presentations of these disorders.
Feminism and the Mental Health Movement
The feminist movements of the 20th century played a crucial role in reshaping the landscape of women’s mental healthcare. The second-wave feminist movement of the 1960s and 70s highlighted the ways in which women’s emotions and struggles were dismissed as "personal problems" rather than systemic issues. Books such as Betty Friedan’s The Feminine Mystique shed light on "the problem that has no name"—the widespread dissatisfaction and depression experienced by many housewives who were expected to find fulfillment solely through domestic life.
Feminists also fought against the overprescription of psychiatric medications to women, particularly tranquilizers like Valium, which was marketed as a cure for women’s emotional distress. The activism of this period pushed for more holistic and empowering approaches to mental health care, laying the groundwork for contemporary feminist psychology.
Why This History Matters
Understanding the history of women’s mental healthcare is not just an academic exercise—it has real consequences for mental health treatment today. The legacies of medical misogyny, exclusion from research, and the pathologization of femininity continue to shape how female-identified individuals experience and receive mental health care.
The Lingering Effects of Stigma
While "hysteria" as a diagnosis is no longer used, its legacy remains in the way women's emotions are often dismissed or minimized. Women expressing anger, sadness, or anxiety are still more likely to be labeled "dramatic" or "overreacting." This stigma discourages many from seeking the mental health support they need. Additionally, it impacts folks who identify as male due to the negative connotation of expressing emotions labeled as “feminine,” impacting those they are in relationships with, preventing them from accessing the support, or even getting the treatment that they need.
Ongoing Gaps in Mental Health Research
Despite progress, mental health research continues to center men as the default. Women and female-identified individuals often receive misdiagnoses or inadequate treatment due to a lack of understanding of their specific needs. Additionally, the mental health experiences of LGBTQ+ individuals, particularly transgender women, remain underrepresented in research and care models.
Barriers to Care
Access to mental healthcare remains unequal, with marginalized women—especially women of color, LGBTQ+ individuals, and those in lower-income communities—facing the greatest barriers. The cost of therapy, lack of culturally competent providers, and systemic discrimination all contribute to disparities in mental health outcomes.
Looking Ahead: Toward a More Inclusive Future
While progress has been made, there is still much work to be done in ensuring that mental healthcare is equitable, inclusive, and responsive to the needs of all who identify as women. The second installment of this series will explore contemporary issues in women’s mental health, including:
The impact of reproductive healthcare policies on mental well-being
The overpathologization of women’s pain and distress
How gender-based violence influences mental health outcomes
The importance of intersectional and trauma-informed care
By examining both history and current realities, we can work toward a future where mental healthcare truly serves all women—honoring their experiences, needs, and autonomy.
Stay tuned for Part Two of this series, where we’ll discuss the current challenges in women’s mental healthcare and how we can advocate for change.