Enhancing adolescent social and emotional well‑being

2. How do social and emotional well-being outcomes differ between adolescent boys and girls?

The recent decline in adolescents’ social and emotional well-being has been characterised by stark gaps between boys and girls. For example, girls consistently report lower levels of life satisfaction, and the post-COVID decline in this area was steeper for them than for their male peers (Marquez et al., 2024[12]) Broader measures of adolescent mental well-being, such as the WHO‑5 Well-Being Index,1 point to similarly large gaps: According to 2021-2022 data, 44% of girls aged 11 to 15 report poor mental well-being, compared with 23.5% of boys (OECD Child Well-being Data Portal).

This section provides an overview of the differences between boys and girls observed across three dimensions of social and emotional well-being: mental well-being, mental health, and resilience. Additionally, while social and emotional well-being is a broad term ranging from positive well-being and happiness to distress and mental ill-health, this section focusses on negative outcomes in social and emotional well-being to discuss the key challenges faced by boys and girls in adolescence. These challenges are critical as low social and emotional well-being in this period of life negatively affects long-term health and well-being, for instance through mental health issues and risk-taking behaviours, including suicidality, delinquent activity, and interpersonal conflict.

2.1 Life satisfaction is declining among adolescents, especially for girls

Despite significant variation across OECD countries, highly consistent patterns in adolescents’ subjective assessment of their emotional states (or mental well-being) emerge, indicating a decline in recent years. In the OECD, the percentage of 11‑, 13‑ and 15‑year‑olds who report low satisfaction with their lives overall (scoring 4 or below on a 0 to 10 scale) has increased by 40% from 2013-2014 to 2021-2022 on average (see Figure A.1 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). According to data from the Health Behaviour in School-aged Children (HBSC) World Health Organization Collaborative Cross-National Survey, the share of children who report having felt low, irritable or nervous more than once a week in the past six months has seen an increase of over 50% since 2013-2014, and represented 26% of 11‑, 13‑ and 15‑year‑olds in 2021-2022. This decline was particularly marked for girls (World Health Organization, 2023[13]).

Girls fare worse than boys across several indicators of mental well-being. Figure 2 illustrates that girls are around twice as likely to experience low life satisfaction than boys in all countries in 2021-2022 (a factor between 1.65 and 2.5). Girls are also more likely to have felt low, irritable or nervous more than once a week in the past six months (36%) compared to boys (17%). PISA data confirm substantial gaps between boys and girls when assessing the share of 15‑year‑olds who feel sad, miserable, scared or afraid (Campbell, Bann and Patalay, 2021[14]). Girls are between 55% and 155% more likely to report low frequency of positive affects such as feeling “cheerful and in good spirits” or “active and vigorous”, in all OECD countries with available data (see Figure A.2 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). Girls also feel lonelier than boys: in all 28 OECD countries with available data, girls were around two to three times more likely to report having felt lonely most of the time or always during the past 12 months (22% compared to 10%, on average, see Figure A.3 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en).

Figure 2. More girls than boys report low life satisfaction

11‑, 13‑ and 15‑year‑old school children who report low life satisfaction, 2021-2022

Note: *The difference between boys and girls is statistically significant at the 5% level. **The OECD average includes all countries depicted in the figure except Belgium and the United Kingdom.

11‑, 13‑ and 15‑year‑old school age children were asked “Here is a picture of a ladder. The top of the ladder “10” is the best possible life for you and the bottom ‘0’ is the worst possible life for you. In general, where on the ladder do you feel you stand at the moment?”. Data refer to the percentage responding “4” or below. “11‑, 13‑ and 15‑year‑old school children” refers to children aged 11, 13 and 15 attending mainstream schools.

Source: OECD Secretariat calculations based on the Health Behaviour in School-aged Children (HBSC) World Health Organization Collaborative Cross-National Survey 2021‑2022, https://hbsc.org/about/.

2.2 Girls’ mental health issues tend to be internalised, whereas boys struggle more with externalising behaviours

Adolescents are also experiencing worsening mental health and increasing signs of ill-being, including elevated levels of stress, trauma, anxiety, and depression, with again significant differences between boys and girls observed across several indicators (OECD, 2025[4]). The onset of most mental health conditions is more frequent during adolescence than in early and middle childhood or adulthood, and the risk of developing a first mental health condition is highest at around age 15 for both boys and girls (McGrath et al., 2023[15]; Kessler et al., 2007[16]). However, girls are more often diagnosed with internalising mental health problems and symptoms (i.e. directing distress and negative emotions inward, for example anxiety, depression, self-harm, and low self-esteem symptoms), whereas boys are at higher risk of developing externalising issues (i.e. to express their negative emotions or thoughts through destructive behaviours directed at others or their environment, such as conduct disorders and antisocial behaviours2).

Adolescent girls are more likely to develop internalising mental health disorders, including anxiety and depressive disorders. Anxiety disorders are among the most frequent mental disorders among adolescents and usually develop in adolescence (McGrath et al., 2023[15]; Costello, Copeland and Angold, 2011[17]). Anxiety disorders encompass feelings of fear and anxiety that persist over months and are usually accompanied by avoidance behaviour and other symptoms such as feeling irritable, having trouble sleeping or concentrating. Estimations of clinically diagnosed severe anxiety disorders vary significantly between OECD countries, from less than 7 cases per 1 000 individuals aged 10‑ to 19‑year‑olds in Japan to 35 in Ireland (see Figure A.4 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). Across the OECD, they are nearly twice more common among girls than boys, and girls are more likely than boys to suffer from an anxiety disorder in all OECD countries. Depressive disorders, characterised by a prolonged period of pervasive low mood, low self-esteem and loss of interest or pleasure in normally enjoyable activities, are twice as frequent among girls compared to boys in OECD countries (Figure 3). Depression rates become more frequent among girls than boys during adolescence, a difference that persists until middle adulthood (Merikangas, Nakamura and Kessler, 2009[18]).

Other internalising disorders and behaviours are eating disorders and self-harm, which are also significantly more frequent in adolescent girls than in boys. Eating disorders encompass several different diagnoses, including anorexia nervosa, bulimia nervosa and binge eating disorders, and show the strongest difference by sex across the OECD. Girls aged 10 to 19 are on average over three times as likely as boys to develop an eating disorder (see Figure A.5 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). While they are much less prevalent than other mental health disorders, eating disorders are also the mental illness with the highest death rate (Treasure and Alexander, 2013[19]). Deliberate self-harm is most often an attempt to relieve negative affects and includes behaviours like cutting, poisoning, hitting or burning oneself, as well as ingesting toxic substances and illegal drug-taking (Gillies et al., 2018[20]). In most countries, more girls than boys are estimated to engage in acts of deliberate self-harm (see Figure A.6 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en), and trends may be increasing along with the deterioration of adolescents’ mental health. Recently collected data for hospitalisations for self-harm in some countries suggests a rise in self-harming behaviour by girls in recent years (OECD, 2026[3]). For example, in France, between 2010-2019 and 2021-2022, the rate of hospitalisations for self-harm rose by +71% for girls aged 10 to 14 and by +44% for girls aged 15 to 19 (Hazo et al., 2024[21]). Despite the observed gaps in self-harm estimates for boys and girls, it should be noted that self-harm can be hidden and underreported, potentially more so in boys as they may more often engage in acts of self-harm that are considered an accident or the consequence of a fight (Mental Health Foundation, 2022[22]).

Figure 3. Adolescent girls are at greater risk of developing depressive disorders

Estimated prevalence of depressive disorders, rate per 1 000, 10‑ to 19‑year‑olds, 2024

Note: Data refer to the estimated proportion of children and young people (10‑ to 19‑year‑olds) in the given country and year with depressive disorders, including major depressive disorder and persistent depressive disorder (dysthymia). No prevalence assumed before age 3. The IHME Global Burden of Disease (GBD) data are standardised modelled estimates built on data from a range of sources, including vital records (e.g. births, deaths), population and household surveys, national censuses, hospital records, and academic research.

Source: Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Risk-taking behaviours also differ between boys and girls, but the patterns are nuanced and vary across activities, so it cannot be assumed that boys are systematically more likely than girls to engage in such behaviours (Molinaro et al., 2024[23]). For example, self-reported data from European countries show that nearly one in three students (31%) reported heavy episodic drinking in the past 30 days. In 18 out of 37 countries, differences by sex were statistically significant, with higher rates among boys in eight countries and among girls in the remaining ten. Overall, 7.9% of students reported daily cigarette smoking in the past 30 days, with only small differences by sex when combining cigarette and e‑cigarette use (14% for girls versus 12% for boys). Among those who consumed alcohol, drinking occurred on average 5.4 times in the past month, with boys generally reporting higher frequency than girls. The most pronounced gap between boys and girls is observed in gambling: in 2024, 5.7% of students reported behaviour indicative of excessive gambling, and among those who had gambled in the past year, the share of excessive gamblers was substantially higher among boys than girls (28% versus 10%).

Externalising disorders and behaviours are more common in boys, including conduct disorders, which involve repetitive and persistent patterns of antisocial behaviours (such as delinquent behaviours, bullying, fighting, or stealing, see Figure 4). Externalising behaviours affect a range of outcomes in adolescence, including interpersonal abilities and enjoyment in school, and have long lasting consequences, for instance when academic performance is affected or when interpersonal conflicts arise. Conduct disorders are related to future offending behaviour and victimisation, general mental and physical health status and poorer academic achievement (Rice, Purcell and McGorry, 2018[24]). On average, 32 out of 1 000 10‑to‑19‑year‑old boys develop a conduct disorder, compared to 18 girls, a homogenous prevalence across OECD countries. Additionally, conduct disorders tend to manifest in different forms of destructive or challenging behaviours in adolescent boys and girls. Guidance from the American Psychiatric Association (2013[25]) emphasises that boys diagnosed with a conduct disorder are more likely to engage in physical and relational aggression, including stealing, physical fighting, vandalism and theft, whereas diagnosed girls more frequently exhibit relational aggression such as lying or running away. This aligns with the finding that adolescent boys across the OECD are more likely than girls to perpetrate interpersonal violence. In all countries, boys aged 11, 13 and 15 reported more often than girls to have been involved in physical fights (14% against 6% on average, see Figure 6). In all countries, boys are also more likely to state that they have bullied others at school in the past couple of months (21% against 13% on average, see Figure A.7, Panel A in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). Boys also report participating in cyberbullying more frequently than girls (14% against 8% on average in the OECD, respectively, see Figure A.7, Panel B in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en).

Figure 4. Boys are more likely to be diagnosed with conduct disorders

Estimated prevalence of conduct disorder, rate per 1 000, 10‑ to 19‑year‑olds, 2024

Note: Data refer to the estimated proportion of children and young people (10‑ to 19‑year‑olds) in the given country and year with conduct disorder. No prevalence assumed prior to 5 years of age or after 18 years of age. The IHME Global Burden of Disease (GBD) data are standardised modelled estimates built on data from a range of sources, including vital records (e.g. births, deaths), population and household surveys, national censuses, hospital records, and academic research.

Source: Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

Mental health disorders are a significant risk factor for suicide among young people (OECD, 2025[4]). Suicidality, which encompasses suicidal ideation, planning, and attempting and completing suicide, is a salient concern for adolescents. In EU countries, suicidal behaviour is the second leading cause of death among people aged 15‑29, and suicide deaths as a proportion of all deaths has increased for this age group, while it decreased in older adults over the same period (Eurostat, 2024[26]; OECD, 2025[4]). While girls tend to be more at risk of self-harm and attempting suicide, boys are nearly three times (2.76) more likely to die from suicide across the 11 OECD countries with available data (see Figure A.8 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en). The risk factors for suicidality in adolescents and young people may also vary by sex, with specific risk factors being, for example, depressive symptoms and interpersonal violence for girls, and conduct problems, hopelessness, and access to means for boys (Miranda-Mendizabal et al., 2019[27]). While some reasons for the gap in suicide mortality between boys and girls have been identified, such as differences in the means used to attempt suicide (which tend to be more lethal and violent in boys) and genetic, developmental and hormonal differences (Mai et al., 2024[28]), the reasons for this disparity are not yet fully understood. Data on 10‑19 year‑olds from the United States between 1975 and 2016 indicate that this gap might be closing in the United States, with a steeper increase in mortality from suicide for girls over this period (Ruch et al., 2019[29]).

2.3 Adolescent girls report lower resilience against life stressors than boys, making them more vulnerable to low social and emotional well-being

Social and emotional well-being in adolescence depends on adolescents’ capacity to cope with the disruptions of many physical, cognitive and psychosocial changes that characterise this developmental stage. Findings from the OECD Survey on Social and Emotional Skills highlight important differences by sex that tend to widen with age. At age 15, boys report higher levels of emotional regulation – particularly stress resistance – as well as greater energy, trust, and sociability, with gaps in stress resistance already visible by age 10. In contrast, girls tend to report higher levels of tolerance, achievement motivation, empathy, and responsibility (OECD, 2024[30]).

At the same time, evidence suggests that adolescent girls may face particular stressors and barriers to developing the skills needed to navigate these challenges. Personal skills such as high levels of self-efficacy, a growth mindset, perseverance, and stress-resistance enhance adolescents’ resilience and can lessen the likeliness of negative outcomes such as mental health issues (Tang, Upadyaya and Salmela‐Aro, 2020[31]; Bae, Zhang and Lee, 2024[32]). These individual features are particularly important due to the many stressors met in adolescence, such as interpersonal difficulties and academic pressure, which have a significant impact on social and emotional well-being. Additional stressors are increasingly highlighted, such as the growing role of digital environments – associated with a diverse range of negative experiences – as well as concerns about climate change and global conflicts (OECD, 2026[3]). While these factors are frequently cited by clinicians and policymakers, further research is needed to better understand the extent to which they shape adolescents’ social and emotional well-being.

In most OECD countries, adolescent girls report lower levels of resilience and are more likely to report high levels of perceived stress than boys. Both factors can indicate a higher vulnerability to poor mental well-being in adolescence.

Adolescent girls are less likely to report high levels of self-efficacy, i.e. to have high confidence in their capacity to exercise control over important things in their lives. For example, on average across the OECD, 53% of 11‑, 13‑ and 15‑year‑old girls report managing to do the things they decide to do most of the time, compared to 62% of boys. This difference is statistically significant in all 27 OECD countries with available data, except Spain. Similarly, 57% of girls and 66% of boys across the OECD state that they find a solution to a problem if they try hard enough most of the time. Only in Israel and Spain is the pattern not statistically significant.

Additionally, girls are less likely to report aspects of resilience such as a growth mindset (the belief that an individual’s abilities are not innate but can be improved through effort, learning, persistence and perseverance) (Walker and Jiang, 2022[33]; Gouëdard, 2021[34]; Jiang, Fang and Mueller, 2023[35]). On average across the OECD, 20% of 15‑year‑old girls present high relative levels of a growth mindset compared to 24% of boys at the same age. Perseverance (e.g. remaining interested in a started task, not giving up easily when confronted with a problem) is also less high in 15‑year‑old girls than in their male peers (OECD averages of 21% and 24%, respectively). This pattern is statistically significant in most OECD countries.

Finally, adolescent girls report high stress resistance less often than boys (Figure 5). While 39% of 15‑year‑old boys across the OECD report high values on the PISA Index “Stress-Resistance”, only 14% of girls do. The index is derived from adolescents’ agreement with statements such as “I panic easily” or “I can recover quickly after something bad has happened”. When asked questions about their ability to navigate life and cope with their personal problems recently, over half of 13‑ and 15‑year‑old girls (55%) indicate high levels of perceived stress, whereas for boys the share lies at 35% (see Figure A.9 in the additional data that can be found clicking on the Support materials tab of the paper at this link: https://doi.org/10.1787/00ebd3dd-en).

Figure 5. Adolescent boys report they are more resistant to stress than girls

15‑year‑old students with high relative values on the PISA Index “Stress Resistance”, 2022

Note: *The difference between boys and girls is statistically significant at the 5% level.

Data refer to the percentage of 15‑year‑old students with values on the PISA Index “Stress resistance” that are among the highest 25% across all OECD countries with available data. (For students in non-OECD countries, those with values at a level equivalent to the highest 25% across all OECD countries with available data). The PISA Index “Stress resistance” is a derived multi‑item scale, constructed using Item Response Theory scaling and within-construct matrix sampling design. It is based on students’ agreement with the following statements: “I get nervous easily”, “I am more relaxed than most people I know”, “I worry about many things”, “I panic easily”, “I am able to work under pressure”, “I remain calm under stress”, “I feel nervous about approaching exams”, “I can recover quickly after something bad has happened”, “I handle stress well” and “I am afraid of many things”. Some items were reverse‑coded prior to scaling. For more details on index construction, see the PISA 2022 Technical Report: https://doi.org/10.1787/01820d6d-en. “15‑year‑olds” and/or “15‑year‑old students” are used as shorthand for the PISA target population.

Source: OECD Secretariat calculations based on the OECD Programme for International Student Assessment (PISA).

Notes

← 1.  Data refer to the percentage of 11‑, 13‑ and 15‑year‑old school age children scoring below 50 on the percentage score of the World Health Organization-Five Well-Being Index (WHO‑5), where 0 represents worst possible mental well-being and 100 represents best possible mental well-being. The WHO‑5 Well-Being Index asks respondents to indicate for the following five statements which is closest to how they have been feeling over the last two weeks: 1) ”I have felt cheerful and in good spirits”, 2) ”I have felt calm and relaxed”, 3) ”I have felt active and vigorous”, 4) ”I woke up feeling fresh and rested” and 5) ”My daily life has been filled with things that interest me”. For each of the five statements, the response options “All the time”, “Most of the time”, “More than half of the time”, “Less than half of the time”, “Some of the time” and “At no time” are assigned scores of decreasing value, which are then summed into the overall Index. For more details on index construction, see https://www.who.int/publications/m/item/WHO-UCN-MSD-MHE‑2024.01. “11‑, 13‑ and 15‑year‑old school children” refers to children aged 11, 13 and 15 attending mainstream schools.

← 2.  Antisocial behaviours are commonly understood as behaviours, both criminal and non-criminal, that cause harm or nuisance to others, including threats, harassment, drug use, and vandalism (Government of the United Kingdom, 2023[192]).