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As the number of women therapists increases, the study of the effects of the sex of the therapist on treatment becomes meaningful. Patients may choose, and mental health agencies may assign therapists of either gender, yet there are no guidelines for such pairing.
Meltzoff and Kornreich (1970), in reviewing the literature on sex-pairing in psychotherapy, conclude: “At present there is no clear basis for preferential assignment of a patient of either sex to a therapist of either sex. No statement can be made with confidence about the relative benefits of selected sex pairing with given types of patients.” More recently, a small, consistent body of literature has developed that permits some definitive statements about how patients differentially perceive, experience, and behave according to the therapist's gender.
It is clear from the literature that patients and analysts are susceptible to sex-linked stereotyped ideas that critically affect treatment decisions. Given freedom of choice, patients almost invariably choose men as therapists (Fuller, 1963; Chesler, 1971), and a recent survey shows that the clients of women therapists are primarily women (Pendergrass, 1974). Two explanations are possible: patients are disproportionately attracted to male therapists, or they actively avoid female therapists. Reasons patients give for seeking male therapists support both explanations: feeling greater respect for and confidence in a man's competence and authority, feeling more comfortable with and relating better to men, discomfort with women, fear and mistrust of women as authorities, embarrassment about discussing sexual matters with women (Chesler).