Although structural sexism in state-level institutions is harmful to women’s and men’s health, less is known about how micro-level structural sexism relates to well-being. Using the 2017 and 2021 Gallup Values and Beliefs of the American Public surveys (N = 1,501 in 2017; N = 1,248 in 2021), we investigate diverse approaches to internalized sexism. Although we find no significant associations with self-rated health, gender traditionalism is linked to greater depressive and anxiety symptoms for women and men, providing the first population evidence for its universal harm in the United States. Although benevolent sexism shows no associations with mental well-being, hostile sexism is linked to greater symptoms among men. A diminished sense of mastery consistently accounts for these relationships, showing promise as a potential mechanism. These findings are suppressed by political conservatism and religious involvement, both of which lead to reporting greater—rather than diminished—well-being.
AddisMichael E.MahalikJames R.2003. “Men, Masculinity, and the Contexts of Help Seeking.”American Psychologist58(1):5–14.
2.
BareketOrlyFiskeSusan T.2023. “A Systematic Review of the Ambivalent Sexism Literature: Hostile Sexism Protects Men’s Power; Benevolent Sexism Guards Traditional Gender Roles.”Psychological Bulletin149(11–12):637–98.
3.
BarretoManuelaDoyleDavid Matthew. 2023. “Benevolent and Hostile Sexism in a Shifting Global Context.”Nature Reviews Psychology2(2):98–111.
4.
BarretoManuelaEllemersNaomiPiebingaLauraMoyaMiguel. 2010. “How Nice of Us and How Dumb of Me: The Effect of Exposure to Benevolent Sexism on Women’s Task and Relational Self-Descriptions.”Sex Roles: A Journal of Research62(7–8):532–44.
5.
BecciaAriel L.AustinS. BrynBaekJonggyuAgénorMadinaForresterSarahDingEric Y.JesdaleWilliam M.LapaneKate L.2022. “Cumulative Exposure to State-Level Structural Sexism and Risk of Disordered Eating: Results from a 20-Year Prospective Cohort Study.”Social Science & Medicine301:114956. doi:10.1016/j.socscimed.2022.114956.
6.
BorgognaNicholas C.AitaStephen L.2020. “Are Sexist Beliefs Related to Mental Health Problems?”The Social Science Journal61(2):405–19.
7.
CalarcoJessica McCrory. 2024. Holding It Together: How Women Became America’s Safety Net. New York, NY: Portfolio/Penguin.
8.
CalarcoJessica McCroryMeanwellEmilyAndersonElizabeth M.KnopfAmelia S.2021. “By Default: How Mothers in Different-Sex Dual-Earner Couples Account for Inequalities in Pandemic Parenting.”Socius7. doi:10.1177/23780231211038783
9.
CarletonR. NicholasThibodeauMichel A.TealeMichelle J. N.WelchPatrick G.AbramsMurray P.RobinsonThomasAsmundsonGordon J. G.2013. “The Center for Epidemiologic Studies Depression Scale: A Review with a Theoretical and Empirical Examination of Item Content and Factor Structure.”PLoS One8(3):e58067. doi:10.1371/journal.pone.0058067.
10.
CasseseErin C.BarnesTiffany D.2019. “Reconciling Sexism and Women’s Support for Republican Candidates: A Look at Gender, Class, and Whiteness in the 2012 and 2016 Presidential Races.” Political Behavior41(3):677–700.
11.
ChaYoungjoo. 2010. “Reinforcing Separate Spheres: The Effect of Spousal Overwork on Men’s and Women’s Employment in Dual-Earner Households.”American Sociological Review75(2):303–29.
12.
ChapmanElizabeth N.KaatzAnnaCarnesMolly. 2013. “Physicians and Implicit Bias: How Doctors May Unwittingly Perpetuate Health Care Disparities.” Journal of General Internal Medicine28:1504–10.
13.
ColemanMax E.AnderssonMatthew A.2024. “Hurt on Both Sides: Political Differences in Health and Well-Being during the COVID-19 Pandemic.”Journal of Health and Social Behavior65(1):94–109.
14.
ConnellyKathleenHeesackerMartin. 2012. “Why Is Benevolent Sexism Appealing?: Associations with System Justification and Life Satisfaction.”Psychology of Women Quarterly36(4):432–43.
15.
ConnorRachel A.GlickPeterFiskeSusan T.2017. “Ambivalent Sexism in the Twenty-First Century.” Pp. 295–320 in The Cambridge Handbook of the Psychology of Prejudice, edited by SibleyC. G.BarlowF. K.New York, NY: Cambridge University Press.
16.
CourtenayWill H.2000. “Constructions of Masculinity and Their Influence on Men’s Well-Being: A Theory of Gender and Health.”Social Science & Medicine50(10):1385–401.
17.
CroftAlyssaSchmaderToniBlockKatharina. 2015. “An Underexamined Inequality: Cultural and Psychological Barriers to Men’s Engagement with Communal Roles.”Personality and Social Psychology Review19(4):343–70.
18.
DoreEmily C.ShrivastavaSurbhiHomanPatricia. 2024. “Structural Sexism and Preventive Health Care Use in the United States.”Journal of Health and Social Behavior65(1):2–19.
19.
DumontMurielSarletMarieDardenneBenoit. 2010. “Be Too Kind to a Woman, She’ll Feel Incompetent: Benevolent Sexism Shifts Self-Construal and Autobiographical Memories toward Incompetence.”Sex Roles62(7):545–53.
20.
EllisonChristopher G.LeeJinwoo. 2010. “Spiritual Struggles and Psychological Distress: Is There a Dark Side of Religion?”Social Indicators Research98(3):501–17.
21.
FischerAnn R.HolzKenna Bolton. 2010. “Testing a Model of Women’s Personal Sense of Justice, Control, Well-Being, and Distress in the Context of Sexist Discrimination.”Psychology of Women Quarterly34(3):297–310.
22.
FroesePaul. (2020). “The Values and Beliefs of the American Public – A National Study, Wave V (2017).” OSF. doi:10.17605/OSF.IO/S5YNU.
23.
FroesePaul. (2024). “The Values and Beliefs of the American Public – A National Study, Wave VI (2021).” OSF. doi:10.17605/OSF.IO/RY8GW.
24.
GlickPeterRabergLiana. 2018. “Benevolent sexism and the status of women.” Pp. 363–380 in APA Handbook of the Psychology of Women: History, Theory, and Battlegrounds, edited by TravisC. B.WhiteJ. W.RutherfordA.WilliamsW. S.CookS. L.WycheK. F.American Psychological Association.
25.
GlickPeterFiskeSusan T.1996. “The Ambivalent Sexism Inventory: Differentiating Hostile and Benevolent Sexism.”Journal of Personality and Social Psychology70(3):491–512.
26.
GlickPeterFiskeSusan T.1997. “Hostile and Benevolent Sexism: Measuring Ambivalent Sexist Attitudes toward Women.”Psychology of Women Quarterly21(1):119–35.
27.
GlickPeterFiskeSusan T.2001. “An Ambivalent Alliance: Hostile and Benevolent Sexism as Complementary Justifications for Gender Inequality.”American Psychologist56(2):109–18.
28.
GlickPeterFiskeSusan T.2011. “Ambivalent Sexism Revisited.”Psychology of Women Quarterly35(3):530–35.
29.
GutierrezNaomi MartinezCribbieRobert. 2021. “Incidence and Interpretation of Statistical Suppression in Psychological Research.”Canadian Journal of Behavioural Science/Revue Canadienne des Sciences du Comportement53(4):480–88.
30.
HammondMatthew D.SibleyChris G.2011. “Why Are Benevolent Sexists Happier?”Sex Roles65(5):332–43.
31.
HarnoisCatherine E.2015. “Race, Ethnicity, Sexuality, and Women’s Political Consciousness of Gender.”Social Psychology Quarterly78(4):365–86.
32.
HarnoisCatherine E.BastosJoão L.2018. “Discrimination, Harassment, and Gendered Health Inequalities: Do Perceptions of Workplace Mistreatment Contribute to the Gender Gap in Self-Reported Health?”Journal of Health and Social Behavior59(2):283–99.
33.
HartChloe GraceSapersteinAliyaMagliozziDevonWestbrookLaurel. 2019. “Gender and Health: Beyond Binary Categorical Measurement.”Journal of Health and Social Behavior60(1):101–18.
34.
HillTerrence D.Christie-MizellC. AndréVaghelaPreetiMossakowskiKrysia N.JohnsonRobert J.2017. “Do Religious Struggles Mediate the Association between Day-to-Day Discrimination and Depressive Symptoms?”Religions8(8):134. doi:10.3390/rel8080134.
35.
HillTerrence D.UpenieksLauraWolfJulia K.CossmanLynneEllisonChristopher G.2024. “Do Religious Struggles Mediate the Association between Neighborhood Disorder and Health in the United States?”Journal of Religion and Health63:202–23.
36.
HomanPatricia. 2019. “Structural Sexism and Health in the United States: A New Perspective on Health Inequality and the Gender System.”American Sociological Review84(3):486–516.
37.
HomanPatricia. 2024. “Health Consequences of Structural Sexism: Conceptual Foundations, Empirical Evidence and Priorities for Future Research.”Social Science & Medicine351:116379. doi:10.1016/j.socscimed.2023.116379.
38.
HomanPatriciaBurdetteAmy. 2021. “When Religion Hurts: Structural Sexism and Health in Religious Congregations.”American Sociological Review86(2):234–55.
39.
JostJohn T.2019. “A Quarter Century of System Justification Theory: Questions, Answers, Criticisms, and Societal Applications.”British Journal of Social Psychology58(2):263–314.
40.
JostJohn T.GlaserJackKruglanskiArie W.SullowayFrank J.2003. “Political Conservatism as Motivated Social Cognition.”Psychological Bulletin129(3):339–75.
41.
KingTaniaPeralesFranciscoSinghAnkurGurrinLyleCrammondBradley. 2022. “Traditionalism vs Egalitarianism: Is There an Association between Gender Attitudes and Mental Health?”Australian & New Zealand Journal of Psychiatry56(7):844–51.
42.
KingTaniaPeralesFranciscoSutherlandGeorgina. 2022. “Why We Need Population Data on Gender Norms, and Why This is Important for Population Health.”Journal of Epidemiology and Community Health76(6):620–22.
43.
KnightCarly R.BrintonMary C.2017. “One Egalitarianism or Several? Two Decades of Gender-Role Attitude Change in Europe.”American Journal of Sociology122(5):1485–532.
44.
KriegerNancy. 2012. “Methods for the Scientific Study of Discrimination and Health: An Ecosocial Approach.”American Journal of Public Health102(5):936–44.
45.
KriegerNancy. 2020. “Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm—An Ecosocial Analysis.”Annual Review of Public Health41:37–62.
46.
LemonakiElenaMansteadAntony S. R.MaioGregory R.2015. “Hostile Sexism (De)Motivates Women’s Social Competition Intentions: The Contradictory Role of Emotions.” British Journal of Social Psychology54(3):483–99.
47.
Martínez-MarínMaría DoloresMartínezCarmenRódenasIrene. 2023. “The Effect of the Benevolent Experienced Sexism and the Sexual Myths on Women’s Health.”Psychological Reports. doi:10.1177/00332941231180440.
48.
MasserBarbara M.AbramsDominic. 2004. “Reinforcing the Glass Ceiling: The Consequences of Hostile Sexism for Female Managerial Candidates.”Sex Roles51(9):609–15.
49.
MontezJennifer KarasBeckfieldJasonCooneyJulene KempGrumbachJacob M.HaywardMark D.KoytakHuseyin ZeydWoolfSteven H.ZajacovaAnna. 2020. “U.S. State Policies, Politics, and Life Expectancy.”The Milbank Quarterly98(3):668–99.
50.
MonzaniDarioVerganiLauraFrancescaSilviaPizzoliMariaMartonGiuliaMazzoccoKettiBailoLucaMessoriChiaraPancaniLucaCattelanManuelaPravettoniGabriella. 2020. “Sexism Interacts with Patient–Physician Gender Concordance in Influencing Patient Control Preferences: Findings from a Vignette Experimental Design.”Applied Psychology: Health and Well-Being12(2):471–92.
51.
NapierJaime L.BettinsoliMaria LauraSuppesAlexandra. 2020. “The Palliative Function of System-Justifying Ideologies.”Current Opinion in Behavioral Sciences34:129–34.
52.
NapierJaime L.JostJohn T.2008. “Why Are Conservatives Happier than Liberals?”Psychological Science19(6):565–72.
53.
NapierJaime L.ThorisdottirHuldaJostJohn T.2010. “The Joy of Sexism? A Multinational Investigation of Hostile and Benevolent Justifications for Gender Inequality and Their Relations to Subjective Well-Being.”Sex Roles62(2010):405–19.
54.
OswaldDebra L.FranzoiStephen L.FrostKatherine A.2012. “Experiencing Sexism and Young Women’s Body Esteem.”Journal of Social and Clinical Psychology31(10):1112–37.
55.
PacilliMaria GiuseppinaSpaccatiniFedericaGiovannelliIlariaCentroneDeliaRoccatoMichele. 2019. “System Justification Moderates the Relation between Hostile (but Not Benevolent) Sexism in the Workplace and State Anxiety: An Experimental Study.” The Journal of Social Psychology159(4):474–81.
56.
PearlinLeonard I.BiermanAlex. 2013. “Current Issues and Future Directions in Research into the Stress Process.” Pp. 325–40 in Handbook of the Sociology of Mental Health, edited by AneshenselC. S.PhelanJ. C.BiermanA.New York, NY: Springer.
57.
PearlinLeonard I.MenaghanElizabeth G.LiebermanMorton A.MullanJoseph T.1981. “The Stress Process.”Journal of Health and Social Behavior22(4):337–56.
58.
PearlinLeonard I.RadabaughClarice W.1976. “Economic Strains and the Coping Function of Alcohol.”American Journal of Sociology82(3):652–63.
59.
RadloffLenore Sawyer. 1977. “The CES-D Scale: A Self-Report Depression Scale for Research in the General Population.”Applied Psychological Measurement1(3):385–401.
60.
RaoAliya Hamid. 2020. Crunch Time: How Married Couples Confront Unemployment. Berkeley: University of California Press.
61.
RappKristen SchorppVolpeVanessa V.HaleTabitha L.QuartararoDominique F.2022. “State-Level Sexism and Gender Disparities in Health Care Access and Quality in the United States.”Journal of Health and Social Behavior63(1):2–18.
62.
RidgewayCecilia L.MarkusHazel Rose. 2022. “The Significance of Status: What It Is and How It Shapes Inequality.”RSF: The Russell Sage Foundation Journal of the Social Sciences8(6):1–25.
63.
RuckerDerek D.PreacherKristopher J.TormalaZakary L.PettyRichard E.2011. “Mediation Analysis in Social Psychology: Current Practices and New Recommendations.”Social and Personality Psychology Compass5(6):359–71.
64.
SalomonKristenBurgessKaleena D.BossonJennifer K.2015. “Flash Fire and Slow Burn: Women’s Cardiovascular Reactivity and Recovery Following Hostile and Benevolent Sexism.”Journal of Experimental Psychology: General144(2):469–79.
65.
Sánchez-LópezMaría del PilarCuellar-FloresIsabelDreschVirginia. 2012. “The Impact of Gender Roles on Health.”Women & Health52(2):182–96.
66.
ScarboroughWilliam J.SinRayRismanBarbara. 2019. “Attitudes and the Stalled Gender Revolution: Egalitarianism, Traditionalism, and Ambivalence from 1977 through 2016.” Gender & Society33(2):173–200.
67.
SchlenkerBarry R.ChambersJohn R.LeBonnie M.2012. “Conservatives Are Happier than Liberals, but Why? Political Ideology, Personality, and Life Satisfaction.”Journal of Research in Personality46(2):127–46.
68.
SearRebecca. 2021. “The Male Breadwinner Nuclear Family Is Not the ‘Traditional’ Human Family, and Promotion of This Myth May Have Adverse Health Consequences.” Philosophical Transactions of the Royal Society B: Biological Sciences376:20200020. doi:10.1098/rstb.2020.0020.
69.
ShepherdMelissaErchullMindy J.RosnerArynTaubenbergerLeslieForsyth QueenEmilyMcKeeJenna. 2011. “‘I’ll Get That for You’: The Relationship between Benevolent Sexism and Body Self-Perceptions.”Sex Roles64(1):1–8.
70.
ShuXiaolingMeagherKelsey D.2018. “Beyond the Stalled Gender Revolution: Historical and Cohort Dynamics in Gender Attitudes from 1977 to 2016.” Social Forces96(3):1243–74.
71.
SpaccatiniFedericaRoccatoMichele. 2021. “The Palliative Function of Sexism: Individual Sexism Buffers the Relationship between Exposure to Workplace Sexism and Psychological Distress.”Sexuality & Culture25(3):767–85.
72.
UmbersonDebraMontezJennifer Karas. 2010. “Social Relationships and Health: A Flashpoint for Health Policy.”Journal of Health and Social Behavior51(S):S54–66.
73.
UpenieksLauraLouiePatriciaHillTerrence D.2023. “Welcome to the Dark Side: The Role of Religious/Spiritual Struggles in the Black–White Mental Health Paradox.”Society and Mental Health13(2):151–68.
74.
WongY. JoelRingo HoMoon-HoWangShu-YiMillerI. S. Keino. 2017. “Meta-analyses of the Relationship between Conformity to Masculine Norms and Mental Health-Related Outcomes.”Journal of Counseling Psychology64(1):80–93.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
