Depending on age and the diagnostic criteria employed, some researchers fi nd that more men than women have ‘schizophrenia’ while others fi nd there is no difference (Bogren et al. 2010; Jablensky 2009; Kirkbride et al. 2006). More importantly, there are defi nitely some clear differences between men and women with this diagnosis. These differences are so pronounced that they have been summarized in terms of men having ‘typical schizophrenia’ and women ‘atypical schizophrenia’ (Lewine 1981). Recently, reviewers reported that ‘Sex differences in schizophrenia are one of the most consistently reported aspects of the disease’ (Abel et al. 2010: 417). These differences remain something of a mystery. In this chapter we suggest that a psychosocial approach might provide some answers in an area where the bio-genetic paradigm has been particularly unproductive.