Gender differences in the prevalence of psychiatric disorders, with higher prevalence of mood and anxiety disorders among women, have been the focus of much debate. In Iran, the adoption of the construct of Bipolar Spectrum Disorder (BSD) and of the concept of “soft bipolarity” has been associated with a large gender difference in rates of diagnosis. This paper discusses the gendered meanings of the diagnosis of BSD in Iran. In this qualitative study, we conducted 25 in-depth semi-structured interviews with prominent psychiatrists and university professors (7 female and 18 male) at six different universities in Iran and 37 in-depth semi-structured interviews with patients (23 female and 14 male, 18–55 years of age) who had received bipolar spectrum disorder diagnosis and treatment, excluding Bipolar I. Findings suggest that the high rate of diagnosis of bipolar spectrum disorder (i.e., subthreshold or soft bipolar disorder) among women in Iran is influenced by gender, sociocultural, political, and economic factors, as well as the diagnostic practices of biomedical psychiatry. The dominant biological psychiatry system in Iran has led many psychiatrists to frame sociopolitically and culturally rooted forms of distress in terms of biomedical categories like soft bipolarity and to limit their interventions to medication. This bioreductionist approach silences the voices of vulnerable groups, including those of women, and marginalizes discussions of problematic institutional and social power. To understand the preference for biomedical explanations, we need to consider not only the economic interests at play in the remaking of human identity in terms of biological being and the globalization of biological psychiatry, but also the resistance to addressing the sociocultural, political, and economic determinants of women’s mental suffering in particular contexts.

精神疾病患病率的性别差异，女性情绪和焦虑症的患病率较高，一直是许多争论的焦点。在伊朗，采用双极谱系障碍 (BSD) 的概念和“软双极”概念与诊断率的巨大性别差异有关。本文讨论了伊朗 BSD 诊断的性别含义。在这项定性研究中，我们对伊朗六所不同大学的著名精神病学家和大学教授（7 名女性和 18 名男性）进行了 25 次深度半结构化访谈，并对患者进行了 37 次深度半结构化访谈（23 女性和 14男性，18-55 岁）接受过双相谱系障碍诊断和治疗，不包括双相 I。研究结果表明，伊朗女性双相谱系障碍（即阈下或软性双相障碍）的高诊断率受性别、社会文化、政治和经济因素以及生物医学精神病学诊断实践的影响。伊朗占主导地位的生物精神病学系统导致许多精神病学家根据软两极等生物医学类别来构建社会政治和文化根源的痛苦形式，并将他们的干预限制在药物治疗上。这种生物还原主义方法压制了弱势群体的声音，包括女性的声音，并将对有问题的制度和社会权力的讨论边缘化。要了解对生物医学解释的偏好，