Childhood and adolescence are sensitive periods in the development of an individual’s personality, understanding of relationships, and emotional health. Moreover, adolescence is a period of vulnerability for the development of mental disorders because of the physical, emotional, and social changes it witnesses. According to WHO data, one in seven adolescents (14%) aged 10–19 years has a mental disorder (Organización Mundial de la Salud. La salud mental de los adolescentes [Internet]. 2024 [cited 2025 Mar 28]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/adolescent-mental-health). Known mental health risks for children and adolescents include violence, particularly sexual violence and bullying, stigma and discrimination, harsh parenting, and severe socioeconomic problems. Social and media pressure (Santoniccolo et al. Int J Environ Res Public Health. 20:5770, 2023) and the exploration of one’s own identity are other significant risk factors at this stage of life. Sex, as a biological reproductive endowment, and gender, as a social construction of expectations, attitudes, behaviors, etc., that are considered appropriate on the basis of sex, are also conflicting elements in psychological development during childhood and adolescence. While there are still big questions about gender and mental health, we know that gender, as a sociocultural construct that determines inequality between men and women, influences different ways of becoming ill and is a risk factor for developing mental disorders. Gender norms can harm children and adolescents by increasing the disparity between the reality they live in and their future expectations and aspirations. When discussing gender-sensitive mental health interventions, we mean interventions aimed at reducing the aforementioned inequalities. There is little literature on this subject for children and adolescents. The first question we should address is whether these inequalities are present in our clinical interventions. It would be essential to determine how to modify or prevent gender-based inequalities in the social environment close to the patient, and more ambitiously, how to generate changes in society. This chapter seeks to understand how gender influences mental disorders in children and adolescents, and highlights how gender affects clinical practice and the therapeutic approach.