The impact of therapist gender on the treatment of bulimic women

A number of recent therapists and researchers have shown that the gender of the therapist can have a substantial effect on treatment. This is especially true in treating eating disorders, which involve many gender-related issues (such as body appearance and gender identity) and occur in primarily one sex (females). Here we discuss four areas in which transference and countertransference issues are greatly influenced, depending upon whether the therapist is male or female: (1) problems of body image; (2) the patient's overinvolvement with her mother; (3) the patient's ambivalence about gender identity; and (4) her need for a role model. The ways in which a female and male therapist work differently in these four areas are illustrated by two clinical vignettes with female bulimic patients.