Publication date

Sex and gender differences in help-seeking of patients with somatic symptoms.

Ballering, A., Olde Hartman, T., Verheij, R., Rosmalen, J. Sex and gender differences in help-seeking of patients with somatic symptoms. Journal of Psychosomatic Research: 2022, 157, 110823


Women are reported to consult general practitioners (GPs) more frequently than men. However, previous studies on sex differences in help-seeking behaviour for somatic symptoms do not distinguish between sex and gender, do not account for sex differences in presented symptoms, and are often conducted in clinical settings, automatically excluding non-help seekers.

Therefore, we assess the independent associations of sex and gender with primary care help-seeking for somatic symptoms in the general

Records from the longitudinal population-based Lifelines Cohort Study were linked to routine electronic health records from GPs. We applied generalized linear mixed-effect models to assess whether participants' sex and gender, operationalized by a novel gender index, were associated with consulting GPs, while adjusting for participants' presented symptom(s), age, presence of chronic disease and educational level. In post-hoc analyses we assessed whether gender-related variables, such as mean

Of the 20,187 individuals with linked data, 8325 participants (67.5% female; mean age = 44.5 [SD = 12.9]) reported at least one new-onset somatic symptom and 255 (3.1%) hereof consulted the GP. Female sex was positively associated with consulting the GP (OR = 1.78; 95%CI = 1.13–2.80), whereas feminine gender was not significantly associated with this (OR = 0.67; 95%CI = 0.39–1.16). More paid working days negatively associated with help-seeking (OR = 0.95; 95%CI = 0.91–0.98).

The results suggest that female sex rather than feminine gender associated with primary care help-seeking behaviour for somatic symptoms. Nevertheless, clinicians should be aware that gender-related variables, such as mean paid working days may associate with help-seeking behaviour.