Gender Gaps in Teen Mental Health Differ by Region

TOPLINE:

Gender inequalities in depressive symptoms emerged earlier and increased more rapidly among youths in London vs Tokyo, with the annual rate of increase in symptoms being four times steeper among girls in London than among those in Tokyo, a study showed. By 16 years of age, the gender gap in London was twice as large as that in Tokyo.

METHODOLOGY:

• Researchers conducted a longitudinal cross-cohort study and analysed responses to the Short Mood and Feelings Questionnaire (SMFQ) by 7100 children (50.5% boys) aged 11-16 years from the Tokyo Teen Cohort (TTC; n = 2813) and London-based Resilience, Ethnicity, and Adolescent Mental Health (REACH; n = 4287) cohort.
• Mean trajectories of the SMFQ among boys and girls overall and in each cohort were estimated and compared. Higher SMFQ scores indicated increased symptoms of depression.

TAKEAWAY:

• A combined cohort analysis revealed strong evidence of gender differences in SMFQ in the starting level (mean difference, 0.71; 95% CI, 0.42-0.95) and in the rate of change (mean difference, 0.73; 95% CI, 0.62-0.82), with higher scores observed in girls than in boys.
• In the REACH cohort, girls showed higher SMFQ scores than boys at the age of 11-12 years (mean difference, 0.75; 95% CI, 0.25-1.25).
• In the TTC, girls showed higher SMFQ scores than boys at the age of 11-14 years (mean difference, 0.52; 95% CI, 0.40-0.65).
• The annual rate of increase in SMFQ scores was about four times greater among girls in the REACH cohort (mean, 1.1; 95% CI, 0.9-1.3) than among girls in the TTC (mean, 0.3; 95% CI, 0.2-0.4).

IN PRACTICE:

“We found strong evidence suggesting that gender inequalities in depressive symptom trajectories between adolescent boys and girls are larger, and might emerge earlier, in London than in Tokyo,” the authors wrote. “Against a backdrop of high and rising rates of emotional health problems among young women and girls in many countries, there is an urgent need to understand the contexts and conditions that enable young girls to thrive,” they added.

SOURCE:

This study was led by Gemma Knowles, PhD, ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom, and Daniel Stanyon, MSc, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan. It was published online in the April 2025 issue of The Lancet Child & Adolescent Health.

LIMITATIONS:

This study was limited by including only three waves of data, which restricted the analysis to linear trajectories. Measurement invariance tests could not detect systematic underreporting across all items. The TTC and REACH cohort were location-based and not designed to be nationally representative, limiting generalisability beyond these localities. Low-income households might be underrepresented in the TTC, which could have potentially led to an underestimation or overestimation of the gender mental health gap. Finally, the views of the young people involved may not reflect those of the broader youth population as the groups were small and localised.

DISCLOSURES:

This study was funded by the Japan Society for the Promotion of Science, UK Economic and Social Research Council, and European Research Council. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.