Why Is Agoraphobia More Common in Females?

Repeatedly, scientific research has highlighted gender differences in the incidence of Agoraphobia, with women being up to four times more likely to experience the condition.

Some researchers suggest Agoraphobia is more common in women because of gender stereotypes, while others argue it’s due to biological differences.

Several studies put it down to the effects of physical and sexual abuse.

However, research looking into gender disparities in help-seeking and lack of detection of Agoraphobia in men suggest the current statistics may be inaccurate.

Is Agoraphobia More Common in Females?

Evidence demonstrates that Agoraphobia is more prevalent in females than males. So much so that in 1984, Foa and colleagues described Agoraphobia as a “woman’s syndrome.”

In a 1994 National Comorbidity Survey, it was found that 30.5% of women compared to 19.2% of men experience anxiety disorders.

Two years later, in a 1996 review, it was also reported that women are approximately four times more likely to receive an Agoraphobia diagnosis than are men.

But why is the prevalence higher in females? To answer this, we need to explore the factors potentially at play.

5 Potential Reasons Why Agoraphobia is More Common in Women

Reason #1: Gender Role Stereotyping

In 1974, Fodor proposed that Agoraphobia is more prevalent in females than males because women are taught and permitted to be afraid.

In this study, she describes how females are encouraged to view themselves as inept and incapable without male help.

Fodor believed this was due to societal stereotypes of women, promoting dependency on men for support and protection and, in turn, reducing their independence and skill.

In a 1986 study, Chambless and Mason found that agoraphobic women display avoidance behaviors more often when alone. They also discovered that women scored low on a masculinity sex-role stereotyping scale.

Due to their findings, Chambless and Mason posit that society teaches women to be nurturing and expressive rather than competent, assertive, and instrumental, putting them at a higher risk of phobias.

However, it’s important to note that their study demonstrated that feminine characteristics don’t determine Agoraphobia—research shows no significant association.

Moreover, it’s the lack of masculine traits that appears to increase someone’s risk of having Agoraphobia.

Reason #2: Biological Gender Differences

Prior research demonstrates gender differences in the hippocampus, extended amygdala complex, and the prefrontal cortex—brain regions believed to be related to anxiety.

Furthermore, there may be differences in how males and females biologically respond to stress, with females displaying higher reactivity in blood pressure and pulse than males.

Some research posits that increased anxiety levels in women may be related to hormonal fluctuations due to their reproductive cycle.

For example, anxiety symptoms appear higher during pre-menstruation and the luteal phase of the menstrual cycle.

Therefore, it could be possible that biological factors play a role in the supposedly higher prevalence of anxiety disorders in women.

Reason #3: Experience of Abuse

Evidence suggests that women are more likely to experience potentially traumatic events, including attempted rape, rape, and domestic abuse.

These experiences are associated with anxiety disorders such as PTSD.

A report by Mufson indicates that childhood abuse in women can lead to underdevelopment of the hippocampus, a brain area related to the processing of emotion.

It’s also thought that childhood abuse elicits brain chemistry changes, making these individuals more at risk of developing anxiety disorders.

This could suggest that women are more prone to anxiety disorders like Agoraphobia because of the more frequent experience of abuse.

Reason #4: Gender Differences in Help-Seeking

A recent survey by YouGov discovered that men are:

• Less likely to seek mental health support than are women.
• Less likely to tell their friends or family.

They also found that:

• 33% of women who told a friend/loved one about their mental health problem did so within the first month of its development.
• Only 25% of men did in comparison, while 35% waited over two years.

The prevalence of Agoraphobia may seem lower in males than females because men are less likely to admit their anxiety.

In her review described earlier, Bekker suggested that this is due to the societal expectation of men to be strong and brave.

And there’s evidence to support this. In a 1992 study looking into the question, “Do men lie on fear surveys?” Pierce and Kirkpatrick assessed male and female reports of fear and anxiety when exposed to stress.

When males thought the researchers were monitoring their physiological reactions, their self-reported scores for fear and anxiety were significantly higher, while for females, the scores stayed relatively consistent.

Pierce and Kirkpatrick suggested men lied about their fears to conform to male gender norms.

Reason #5: Agoraphobia Often Goes Undetected in Males

There’s also evidence to suggest that the lack of detection of Agoraphobia in males may warp the statistics.

For example, a study in 1979 found that of 102 people treated for alcoholism, around 32% had highly severe Agoraphobia and/or Social Phobia symptoms. Of these, more were men than women.

Furthermore, it’s also been found that 18% of female outpatient Agoraphobics were alcoholics compared to 36% of males. This evidence could suggest that Agoraphobia in men often goes unnoticed because maladaptive coping strategies like alcohol abuse hide it.

Gender Differences in Panic Disorders and Phobias

Disorder/Phobia	Female Prevalence Rate	Male Prevalence Rate
Panic disorder	5%	2%
Agoraphobia	7%	3.5%
Specific phobia	15.7%	6.7%

Although the research suggests Agoraphobia is more common in females, it’s important to note many of the aforementioned studies date back to the late 1900s.

So what about more recent research?

A 2007 National Comorbidity Survey Replication showed that, between 2001 and 2003, around 0.9% of US adults had Agoraphobia, with a prevalence of 0.9% in females and 0.8% in males.

However, the discrepancy increased when looking at the adolescent sample, with a prevalence of 3.4% for females and 1.4% for males.

As you can see, they found a 3.5% gender difference in 1994, but only a 0.1% difference for adults, and a 2% difference for adolescents, in 2001-2003.

Conclusion

Scientific research suggests that Agoraphobia is more prevalent in women than men. However, the reason for this remains mysterious.

Is this trend the result of socially constructed gender norms or are biological factors at play?

Perhaps women aren’t biologically predetermined to experience Agoraphobia, but instead, it’s the impact of physical and sexual abuse.

Or, maybe, the statistics are inaccurate due to the lower occurrence of male help-seeking behaviors and thus the frequent cases of Agoraphobia going undetected.

We need more research to unpick the true nature of these relationships.