This paper seeks to advance the debate that considers critical realism as an alternative approach for understanding gender and mental health and its relatedness to mental health research and practice. The knowledge base of how ‘sex’ and ‘gender’affect mental health and illness is expanding. However, the way we conceptualize gender is significant and challenging as quite often our ability to think about ‘gender’as independent of ‘sex’ is not common. The influences and interplay of how sex (biological) and gender (social) affect mental health and illness requires consideration. Critical realism suggests a shared ontology and epistemology for the natural and social sciences. While much of the debate surrounding gender is guided within a constructivist discourse, an exploration of the concept ‘gender’ is reflected on and some key realist propositions are considered for mental health research and practice.\ud This is achieved through the works of some key realist theorists. Critical realism offers potential for research and practice in relation to gender and mental health\ud because it facilitates changes in our understanding, while simultaneously, not discarding that which is already known. In so doing, it allows the biological (sex) and\ud social (gender) domains of knowledge for mental health and illness to coexist,without either being reduced to or defined by the other. Arguably, greater depth and\ud explanations for gender and mental health issues are presented within a realist metatheory
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