Summary: An international survey of 858 people who received electroconvulsive therapy (ECT) found that women are twice as likely as men to receive ECT and report more adverse effects. Women described higher rates of memory loss, stronger feelings of coercion, and more harmful emotional outcomes, often characterizing the treatment as retraumatizing.
They were also less likely to report mood improvement or to say they would choose ECT again. The results expose systemic gender disparities in psychiatric care and underscore the need for trauma-informed reassessment of how ECT is offered and administered.
Key Facts
- Higher risk for women: Women received ECT approximately twice as often as men in this sample and reported worse outcomes, including both short- and long-term memory loss.
- Lower reported benefit: Only 15% of women said they would undergo ECT again, compared with 29% of men.
- Trauma and coercion: Women reported receiving less information before treatment, experiencing greater pressure or coercion to consent, and reporting experiences that reawakened past trauma.
Source: University of East London
Overview
An international study titled Electroconvulsive therapy and women: An international survey, published in Health Care for Women International and led by Professor John Read of the University of East London, collected responses from 858 ECT recipients across 44 countries. Seventy-three percent of respondents were women, making this the largest survey of its kind to date.
Although ECT is used worldwide—administered to hundreds of thousands to millions of people annually—the survey found that women fared worse than men on nearly every outcome measured. Women were less likely to report improved mood after treatment, and they reported significantly higher levels of harmful effects, including both anterograde (forward-looking) and retrograde (past) memory loss.
The survey also documented that most psychiatrists administering ECT were male—about 81% overall and 88% in the United States—as reported by participants. Respondents indicated they were often given incomplete information about risks and benefits before treatment and that many felt pressured to consent.
Personal accounts and trauma
Beyond the statistics, many women described their experiences in terms of trauma and violation. Reports included being restrained, feeling that the treatment was done to them rather than with them, and having ECT evoke or intensify memories of past sexual or domestic abuse. Several participants described the experience using powerful language, saying it reawakened traumatic memories or left them with a lasting fear of further treatment. For some survivors of sexual violence, ECT was described as “another kind of rape — but of the mind.”
Voices from the research team
Lead author Professor John Read, Professor of Clinical Psychology at the University of East London, commented that the patterns observed are unlikely to be coincidental: “Our findings show that women not only receive ECT more often but are also more likely to suffer its most damaging effects. These patterns reflect systemic biases in psychiatry and underline the urgent need for a trauma-informed, gender-aware perspective on mental health care.”
Three members of the research team are themselves ECT recipients and contributed firsthand perspectives. Lisa Morrison (Belfast, Northern Ireland), a lead author, described how experiences of rape and abuse were treated primarily with psychiatric drugs and ECT, leading to repeated admissions and worsening health. She stressed that informed consent requires full disclosure of risks and criticized the routine use of ECT in situations of trauma: “Responding to abuse with ECT, lack of informed consent and involuntary treatment is another violence against women.”
Co-author Sue Cunliffe (Worcester, England) described being misdiagnosed and mistreated after domestic abuse, saying that psychiatric interventions left her feeling shamed, harmed, and suicidal rather than helped. Sarah Hancock (San Diego, USA) emphasized the disorienting effects of memory loss: losing shared memories and cultural cues undermined relationships and identity, leaving her feeling like a “rudderless ship.”
Co-author Dr Lucy Johnstone (Consultant Clinical Psychologist, Bristol, England) added that prescribing ECT for distress directly related to rape or domestic abuse can retraumatize clients rather than treat them, and she called for an immediate end to such practices.
Key Questions Answered:
A: Survey responses indicate women are roughly twice as likely to be given ECT. The authors attribute this to longstanding biases in psychiatric diagnosis and treatment, particularly in how distress related to trauma, abuse, or gendered experiences is interpreted and managed.
A: Women in the survey reported higher rates of both short- and long-term memory loss, greater feelings of harm, trauma responses, and overall poorer outcomes compared with men.
A: No. Women were less likely to report mood improvement and were much less likely to indicate they would consent to ECT again.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by the editorial team.
- Additional context and clarification were added by staff to reflect the study’s implications for clinical practice and policy.
About this research and reporting on ECT
Author: Kiera Hay
Source: University of East London
Contact: Kiera Hay – University of East London
Image: The image is credited to Neuroscience News
Original research: Open access. “Electroconvulsive therapy and women: An international survey” by John Read et al., published in Health Care for Women International.
Abstract
Electroconvulsive therapy and women: An international survey
An online survey collected responses from 858 ECT recipients in 44 countries. Seventy-three percent of respondents were women. Most psychiatrists administering ECT were reported to be men. Women were less likely than men to report improved mood following ECT and reported worse outcomes across a range of adverse effects, including both anterograde and retrograde memory loss. Fewer women (15%) than men (29%) said they would want ECT again. The authors discuss implications for practice, informed consent, and the need for trauma- and gender-informed approaches to mental health care.