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Surf therapy is increasingly being used as an intervention to address various health problems, including psychological symptoms. Although recent research supports the positive impact of surf therapy on psychological outcomes, it is unclear whether these outcomes differ between men and women. This study compared changes in depression/anxiety (Patient Health Questionnaire-4), positive affect (Positive and Negative Affect Schedule), and pain (Numerical Pain Rating Scale) between U.S. service men and women ( N  = 74) during six weekly surf therapy sessions. Overall, participants reported decreased depression/anxiety ( p  < 0.001) and increased positive affect ( p  < 0.001), but no change in pain rating following each session ( p  = 0.141). Significant gender differences were found in the magnitude of changes in depression/anxiety ( B  = −1.01,  p  = 0.008) and positive affect ( B  = 4.53,  p  < 0.001) during surf sessions, despite no differences in pre-session scores on either outcome. Women showed greater improvements in depression/anxiety and positive affect compared with men—an important finding, given that surfing and military environments are often socially dominated by men. Future research is needed to replicate these findings in other samples, extend this research to other underrepresented populations, and identify barriers and facilitators of the sustainable implementation of surf therapy across populations.

Gender Differences in Psychological Outcomes Following Surf Therapy Sessions among U.S. Service Members