Background. It is well documented that females have higher rates of internalizing disorders (anxiety, depression) than males. It is also well known that females have higher exposure to childhood sexual abuse and sexual assault. Recently, it has been proposed that the higher levels of internalizing disorders in females may be caused by their greater exposure to sexual violence.

Method. Data were gathered as part of the Christchurch Health and Development Study. In this study a cohort of 1265 children born in Christchurch, New Zealand, in 1977 have been studied from birth to age 21 years. The measures collected included: major depression and anxiety, childhood sexual abuse and adolescent sexual assault.

Results. Findings confirmed the established conclusion that internalizing disorders are over twice as common in females than males (ORs 2·2–2·7). In addition, it was found that females were exposed to higher rates of sexual violence than males (ORs 5·1–8·4). Statistical control for gender related differences in exposure to sexual violence reduced the associations between gender and anxiety and depression. Nonetheless, even after such control, gender was significantly (P<0·0001) related to both anxiety (OR = 1·8; 95% CI, 1·3–2·4) and depression (OR = 1·9; 95% CI, 1·4–2·3).

Conclusions. Greater female exposure to sexual violence may be a factor that contributes to greater female susceptibility to internalizing disorders. However, even after adjustment for gender differences in exposure to sexual violence it is clear that a substantial relationship between gender and internalizing disorder persists.