The Gendered Role of Resilience in First Responders in South Africa

Abstract

First responders are routinely exposed to potentially traumatic events and occupational stress, placing them at heightened risk for mental health difficulties. Despite the prominence of psychological resilience in first responder research, insufficient attention has been given to gender differences in how resilience functions within male-dominated occupations. The present study investigated gender differences in the relationships between perceived stress, resilience, and mental health outcomes among South African first responders (n = 429). Participants completed the Perceived Stress Scale-10, the Connor–Davidson Resilience Scale-10, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5. Correlational and mediation analyses were conducted. There were no significant gender differences in overall levels of resilience. Perceived stress was associated with depression, anxiety, and PTSD for both genders. Resilience showed significant direct protective effects for men across all mental health outcomes, whereas for women it was significantly associated only with depression and PTSD but not anxiety. Mediation analyses revealed that resilience mediated the relationship between perceived stress and mental health outcomes for men only. These findings suggest that resilience operates through gender-specific pathways. It underscores the importance of conceptualizing resilience as a contextually shaped process rather than solely an individual capacity in first responder populations.

1. Introduction

The present study examines gender differences in the relationship between perceived stress, resilience and mental health outcomes among first responders in South Africa. First responders, including police officers, paramedics, firefighters and emergency medical personnel, face persistent exposure to potentially traumatic events and chronic occupational stress [1,2]. This places them at heightened risk for mental health difficulties such as depression, anxiety, substance misuse and post-traumatic stress disorder (PTSD) [3,4].

Notably, first responder professions such as policing and emergency medical services remain significantly male-dominated, and the occupational culture within these environments is often described as highly masculinized [5]. These cultures typically emphasize attributes such as toughness, emotional restraint, and self-reliance, shaping both behavioral expectations and norms around help-seeking [6]. Women entering these professions may therefore contend with additional gender-related pressures, including the need to navigate assumptions about competence, organizational practices that were historically designed around male workers, and subtle or overt forms of gender bias [5,7]. This broader occupational context is important to consider when examining perceived stress, gender, resilience, and mental health in first responder populations, as it may shape both the experiences and the psychosocial challenges faced by women in these roles.

Psychological resilience refers to an individual’s capacity to adapt positively and function effectively in the face of adversity or significant life stressors [8]. It encompasses the ability to regulate emotions, utilize constructive cognitive strategies, and engage in adaptive behavioral responses that support continued wellbeing. Rather than simply reflecting the absence of distress, resilience highlights a dynamic process through which individuals mobilize internal and external resources to withstand hardship, maintain psychological health, and ultimately foster personal growth [8,9].

Although resilience is often considered a universal construct, a growing body of scholarship has highlighted the intersection between resilience, mental health and gender dimensions [10,11]. This work has demonstrated that women are at greater risk of developing adverse mental health outcomes after stressful or traumatic events compared to men [12,13,14]. Women are reported to be more likely to develop PTSD, depression and generalized anxiety disorder [10,15,16]. For instance, a multi-country study on gender differences in mental health outcomes among healthcare workers during the COVID-19 pandemic found that women reported greater exposure to stressors and heightened psychological distress compared to men [17]. Similarly, cross-sectional studies undertaken among emergency healthcare workers have highlighted that women experience adverse mental health outcomes at higher rates than men [18,19]. Within the South African context, studies among first responders and healthcare workers have also documented gender differences in mental health outcomes [20,21]. Women have been found to be at increased risk of experiencing anxiety and depression, whereas men are reported to be more susceptible to substance use difficulties [21,22]. Some studies have also suggested that women in first responder occupations are more likely to report lower levels of resilience compared to men [20].

Findings regarding gender differences in mental health outcomes have been interpreted as evidence of gender-based differences in coping, exposure to stressors, or biological susceptibility [11,16]. However, recent critiques challenge these assumptions and suggest that prevailing models of resilience may inadvertently privilege coping styles more frequently associated with men (e.g., emotional suppression, self-reliance, and problem-focused coping), while underrepresenting relational and communal coping strategies more often employed by women [11,23]. Scholars have also suggested that women often obtain lower scores on resilience measures because prevailing conceptualizations and assessments of resilience fail to account for the influence of gender roles and ideologies and related societal expectations. As a result, traditional frameworks may overlook the distinct ways in which women adapt to and navigate adversity [11,23].

Perceived stress plays a central role in understanding mental health outcomes, as it reflects the extent to which individuals appraise situational demands as overwhelming or exceeding their coping resources [24]. Existing studies among first responder populations have highlighted heightened levels of perceived stress among this population group [25,26]. This has been ascribed to the cumulative and often unrelenting exposure to traumatic incidents, high work intensity, shift work, and the pressure to make rapid, life-or-death decisions in unpredictable environments [26,27,28]. Additionally, organizational challenges including limited resources, understaffing, and inadequate supervisory support further intensify perceived stress and can erode coping capacity over time [29]. Notably, these stressors may intersect with gender, potentially shaping how men and women appraise stress and mobilize resilience. Understanding perceived stress within this broader occupational and gendered context is therefore critical for clarifying its relationship to mental health outcomes in first responder populations.

The current study is grounded in the theoretical framework of stress and coping theory, which proposes that individuals’ psychological responses to adversity are shaped by their appraisal of stressors and their available coping resources [24,30]. Within this framework, perceived stress reflects the extent to which situational demands are evaluated as exceeding one’s capacity, while resilience represents a key adaptive resource that buffers the impact of stress on mental health [30]. This model is particularly relevant for first responders, whose exposure to chronic occupational stress interacts with personal and contextual resources in gendered ways.

Based on the study’s objectives, several hypotheses were formulated. First, it was hypothesized that men and women would not differ in their overall levels of resilience. Second, perceived stress was expected to be positively associated with symptoms of depression, anxiety, and PTSD across both genders. Third, resilience was hypothesized to function as a protective factor across both genders, demonstrating negative associations with mental health difficulties. Finally, it was hypothesized that resilience would mediate the relationship between perceived stress and mental health outcomes for both genders.

2. Materials and Methods

2.1. Participants and Procedure

Participants were first responders (n = 429) in the Western Cape province of South Africa, and included police officers (n = 309) and paramedics (n = 120). As part of a larger study on the mental health of first responders, an electronic survey was constructed using Google Forms and posted on Facebook groups consisting of first responders, together with an invitation to participate in the study. Research assistants also visited police stations and hospitals to recruit participants in person and to share the electronic link. The sample of first responders thus represents a convenience sample as South Africa’s privacy legislation prevented us from accessing centralized databases of first responders for random sampling purposes.

Slightly more than half of the sample were men (55%), and the majority worked in an urban setting (92.3%). The sample was almost equally divided between those who were single (48.5%) and those who were married (51.5%). The mean age of the sample was 39 years (SD = 9.93) and the average number of years serving as a first responder was 13.24 years (SD = 9.65).

2.2. Measures

Participants completed a brief demographic questionnaire as well as the following standardized instruments: the Perceived Stress Scale-10 (PSS-10) [31] the Connor-Davidson Resilience Scale-10 (CDRISC-10) [32], the Patient Health Questionnaire-9 (PHQ-9) [33], the Generalized Anxiety Disorder-7 (GAD-7) [34], and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) [35].

The PSS-10 is a 10-item self-report measure of the extent to which events are appraised as stressful. Participants respond to the 10 items using a five-point scale ranging from 0 (never) to 4 (very often) with higher scores reflecting higher levels of perceived stress. An example of an item of the PSS-10 is “How often have you felt that you were unable to control the important things in your life?” The authors of the PSS-10 reported a Cronbach’s alpha of 0.78 in the validation study of the PSS-10 [31]. A South African study with university students reported a McDonald’s omega of 0.86 and a Cronbach’s alpha of 0.85 for the PSS-10 [36].

The CDRISC-10 is a 10-item self-report measure of resilience or the ability to cope with challenges and adversity. Responses to the 10 items are made on a five-point scale that ranges from 0 (not true at all) to 4 (true nearly all the time), and higher scores reflect higher levels of resilience. An example of an item of the CDRISC-10 is “Under pressure, I stay focused and think clearly.” In the validation study of the CDRISC-10, Campbell-Sills and Stein reported a Cronbach’s alpha of 0.85 and found that a one-factor model was the best representation of the structure of the CDRISC-10 [32]. In South Africa, Pretorius and Padmanabhanunni reported a Cronbach’s alpha of 0.95 and confirmed the unidimensionality of the CDRISC-10 in a sample of schoolteachers [37].

The PHQ-9 is a nine-item measure that is used for the screening, diagnosing and measuring of the severity of depression. The items of the PHQ-9 are scored on a four-point scale ranging from 0 (not at all) to 3 (nearly every day), and higher scores are indicative of higher levels of depression. An example of an item of the PHQ-9 is “over the past two weeks how often have you been troubled by little interest or pleasure in doing things?” The authors of the scale reported Cronbach’s alpha coefficients of 0.89 and 0.86 in two different samples. The psychometric properties of the PHQ-9 in the current sample as well as confirmation of the unidimensionality of the PHQ has been published separately [38].

The GAD-7 is a seven-item measure that is used for the screening and assessing of the severity of generalized anxiety disorder. Participants respond to the seven items of the GAD-7 using a four-point scale ranging from 0 (not at all) to 3 (nearly every day), and higher scores reflect greater levels of anxiety. An example of an item of the GAD-7 is “over the last two weeks how often have you been troubled by feeling nervous, anxious, or on edge?” Spitzer and colleagues reported a Cronbach’s alpha of 0.92 for the GAD-7 in the validation study. The psychometric properties of the GAD-7 for the current sample has been published separately [39].

The PCL-5 is a 20-item self-report measure of the 20 PTSD symptoms of the DSM-5. It uses a five-point scale that ranges from 0 (not at all) to 4 (extremely), and higher scores indicate higher levels of PTSD. An example of an item of the PCL-5 is “how much were you bothered by avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?” Blevins and colleagues reported Cronbach’s alpha coefficients of 0.94 and 0.95 for two different samples of college students [35]. A South African study examined the factor structure of the PCL-5 and reported estimates of internal consistency (alpha and omega) of 0.95 [40].

2.3. Ethics

The Humanities and Social Sciences Research Ethics Committee of the University of the Western Cape granted ethical approval (Ethics Reference: HS23/2/4, 23 May 2023) and the study was conducted in line with the Declaration of Helsinki. Participants provided informed consent on the landing page of the electronic link and no incentives were offered for participation.

2.4. Data Analyses

Participants had to respond to all items and thus there were no missing data. All analyses were conducted using IBM SPSS for Windows version 30. Statistical indices obtained included descriptive statistics (means and standard deviations), intercorrelations between study variables (Pearson r) for men and women separately, estimates of internal consistency (α and ω), and distribution indices (skewness and excess kurtosis). Data is regarded as normally distributed if skewness and excess kurtosis values range between −2 and +2 [41]. In addition to skewness and kurtosis, we also conducted the Shapiro–Wilk test to examine the normality of scores and a statistically significant Shapiro–Wilk test would indicate that data are not normally distributed. However, even if the Shapiro–Wilk test was significant, we interpreted this cautiously as it has been empirically demonstrated that the test is very sensitive to sample size, and in larger samples (>300) it is able to detect very small, practically unimportant departures from normality [42]. The range of the skewness and kurtosis values would indicate that any nonnormality that is present in the data is of a minor nature. In addition, based on simulation studies that demonstrated the robustness of Pearson’s r [43] and t-tests [44] under conditions of nonnormality in large samples, parametric statistical tests were used.

A two-sample t-test was used to examine the differences between men and women in terms of levels of resilience. Fisher’s z-test was used to statistically compare the correlation coefficients obtained for women and those obtained for men.

Mediation analysis, for men and women separately, was conducted with the PROCESS macro in SPSS. In the mediation model perceived stress was used as the independent variable, depression, anxiety, and PTSD were the dependent variables and resilience the mediator. The statistical significance of the mediating effect was evaluated using bootstrapped 95% confidence intervals. PROCESS relies on ordinary least squares regression estimation in which the normality assumption relates to the residuals. However, Hayes [45] recommends the use of bootstrapped confidence intervals, rather than p-values to evaluate the statistical significance of effects as the distribution of confidence intervals is not normal in shape. Thus, bootstrapped confidence intervals were obtained for all effects, direct and indirect.

To determine whether the obtained results might be influenced by demographic differences between men and women, we used a two-sample t-test to compare men and women in terms of age and chi-squared to compare men and women in terms of the relationship status (single or married/in a relationship).

3. Results

The intercorrelations between study variables for men and women separately, descriptive statistics, distribution indices, and reliabilities are reported in

Table 1. Descriptive statistics, distribution indices, reliabilities and intercorrelations.

Variable/Scale	1	2	3	4	5
1. Perceived stress	–	0.10	0.24 **	0.29 **	0.27 **
2. Resilience	0.19 *	–	−0.12	−0.10	−0.12
3. Depression	0.31 **	−0.20 *	–	0.67 **	0.50 **
4. Anxiety	0.24 **	−0.22 **	0.77 **	–	0.62 **
5. PTSD	0.29 **	−0.22 **	0.66 **	0.70 **	–
Mean	20.45	26.48	9.51	7.73	31.19
SD	6.59	8.02	6.42	5.86	16.97
Skewness	−0.67	−0.40	0.37	0.38	0.10
Kurtosis	0.92	−0.19	−0.49	−0.81	−0.49
Shapiro–Wilk statistic	0.97	0.98	0.97	0.94	0.99
p-value of Shapiro–Wilk	<0.001	<0.001	<0.001	<0.001	<0.001
α	0.80	0.92	0.89	0.92	0.95
ω	0.79	0.92	0.89	0.92	0.94

* p < 0.01, ** p < 0.001.

. The intercorrelations for women are reported above the diagonal, and for men below the diagonal.

The skewness values in Table 1 ranged between −0.67 and 0.38, while the kurtosis values range between −0.81 and 0.92 and were thus within the acceptable range to substantiate that all the variables were approximately normally distributed. The Shapiro–Wilk test, on the other hand, were statistically significant for all the variables, indicating nonnormality. However, the test values ranged between 0.94 and 0.99 and these values were very close to 1, perhaps highlighting the oversensitivity of the Shapiro–Wilk test in detecting mild nonnormality violations in large samples. Reliability indices (α and ω) ranged between 0.79 and 0.95 and reflected satisfactory reliability of all scale scores.

Table 1 further indicates that perceived stress was significantly positively associated with the indices of mental health for both men and women thus indicating that higher levels of perceived stress were associated with higher levels of depression, anxiety, and PTSD. Fisher’s z-test indicated that there were no significant differences between the intercorrelations of men and women in respect of depression (z = 0.78. p = 0.44), anxiety (z = 0.55. p = 0.58) and PTSD (z = 0.22. p = 0.83).

Resilience, on the other hand, was negatively associated with the indices of mental health, but only in the case of men were these associations significant, while in women they were not. Thus, higher levels of resilience were associated with lower levels of depression (r = −0.20, p = 0.002), anxiety (r = −0.22, p < 0.001), and PTSD (r = −0.20, p < 0.001), but only for men. A two-sample t-test also indicated that there was no significant difference (t = 1.24, p = 0.22) in levels of resilience between men ($\overline{X}$ = 26.05, SD = 8.24) and women ($\overline{X}$ = 27.01, SD = 7.73).

The result of the mediation analysis (direct and indirect effects) are reported in

Table 2. Results of the mediation analysis.

Effects	Men				Women
	B	SE	95% CI	β	B	SE	95% CI	β
Direct effects
Stress → Depression	0.36	0.06	[0.24, 0.48]	0.36 **	0.24	0.07	[0.11, 0.37]	0.26 **
Stress → Anxiety	0.26	0.06	[0.15, 0.37]	0.29 **	0.27	0.06	[0.15, 0.39]	0.30 **
Stress → PTSD	0.87	0.16	[0.56, 1.17]	0.34 **	0.73	0.18	[0.37, 1.077]	0.28 **
Resilience → Depression	−0.22	0.05	[−0.31, −0.12]	−0.27 **	−0.11	0.06	[−0.22, −0.00]	−0.14 *
Resilience → Anxiety	−0.19	0.05	[−0.28, −0.11]	−0.27 **	−0.10	0.05	[−0.20, 0.01]	−0.13
Resilience → PTSD	−0.58	0.13	[−0.83, −0.33]	−0.28 **	−0.33	0.15	[−0.63, −0.04]	−0.15 *
Indirect effects
Stress → Resilience → Depression	−0.05	0.03	[−0.10, −0.01]	−0.05 ☨	−0.01	0.01	[−0.05, 0.01]	−0.02
Stress → Resilience → Anxiety	−0.04	0.02	[−0.09, −0.01]	−0.05 ☨	−0.01	0.01	[−0.04, 0.01]	−0.01
Stress → Resilience → PTSD	−0.13	0.07	[−0.29, −0.02]	−0.05 ☨	−0.04	0.04	[−0.13, 0.03]	−0.02

Note: B = unstandardized regression coefficient; SE = standard error; 95% CI = 95% confidence interval; β = standardized regression coefficient; PTSD = post-traumatic stress disorder. * p < 0.05, ** p < 0.001, ^☨ significance established with 95% confidence intervals.

.

Table 2 indicates that in the mediation model:

• Perceived stress had significant (p < 0.001) direct effects on depression, anxiety, and PTSD for both men and women.
• For men, resilience had significant direct effects on depression, anxiety, and PTSD, while for women, resilience only had significant direct effects on depression and PTSD, but not on anxiety. The direct effects were stronger for men both in terms of the size of the standardized regression coefficients, as well as the levels of statistical significance (p < 0.001 versus p < 0.05).
• Resilience mediated the relationship between perceived stress and the indices of mental health, but only for men. In the case of women, resilience did not play a significant mediating role.
• The direct effects of perceived stress on depression, anxiety, and PTSD were of a moderate magnitude for both men (β = 0.29 to 0.36) and women (β = 0.26 to 0.30), indicating that perceived stress was a substantive correlate of poorer mental health in both groups. The direct effects of resilience on mental health outcomes were moderate for men (β = −0.27 to −0.28) but small for women (β = −0.13 to −0.15), with the effect on anxiety in women not reaching statistical significance. The indirect effects through resilience were small for men (β = −0.05 across outcomes) and very small for women (β = −0.01 to −0.02), suggesting that although resilience played a mediating role for men, the size of this mediating effect was modest.

With regard to demographic differences between the men and women, a two-sample t-test found that the women ($\overline{X}$ = 37.28, SD = 9.09) were significantly younger than the men ($\overline{X}$ = 40.41, SD = 10.38. t = 3.32, p < 0.001). A chi-squared analysis found that the men were more likely to be married than the women (χ² = 20.69, p < 0.001).

4. Discussion

The present study examined gender differences in the associations between perceived stress, resilience, and mental health outcomes among South African first responders. This population is consistently exposed to traumatic incidents and sustained occupational stress, making it crucial to understand both the risk pathways related to stress and the protective mechanisms that may buffer against adverse mental health outcomes [46]. The findings contribute to ongoing debates regarding the gendered nature of resilience and its role in shaping mental health outcomes in high-risk professions.

First, as hypothesized, the results indicated that there were no significant gender differences in overall levels of resilience. Men and women reported comparable resilience scores. This finding contrasts with studies in other first responder populations that have reported higher resilience among men; for example, research with military veterans found that men scored significantly higher on resilience than women [47]. However, the present finding aligns with studies that have reported no gender-based differences, such as research on trauma responders indicating that gender did not influence resilience or mental health outcomes [48]. The finding also supports critiques that gender disparities sometimes observed in resilience research may stem from conceptual or measurement limitations rather than true differences in psychological functioning [11]. For instance, some resilience measures have been criticized for reflecting traditionally masculinized notions of strength, independence, or stoicism, which may obscure how resilience is expressed by women or people who do not conform to traditional gender norms [23].

Second, perceived stress demonstrated significant direct associations with depression, anxiety, and PTSD for both men and women, with the standardized coefficients indicating effects that were generally in the moderate range. This suggests that the stressors experienced by first responders exerts a broadly similar psychological impact across genders, consistent with international research identifying perceived stress as a reliable predictor of mental health difficulties among high-risk occupational groups [49,50].

Third, contrary to our hypothesis and despite similar levels of resilience across genders, resilience demonstrated stronger and more consistent direct protective effects for men. Among men, the negative association between resilience and mental health outcomes was of moderate magnitude, whereas among women these effects were small and less consistent. In other words, although resilience functioned as a protective factor for both men and women, the strength and consistency of this protective effect differed by gender. For men, higher resilience was associated with lower levels of all three mental health outcomes namely depression, anxiety, and PTSD. For women, however, resilience was only significantly protective for depression and PTSD, and did not show a significant relationship with anxiety. This implies that resilience, at least as measured in this study, may be less effective in mitigating anxiety symptoms among women, and that other factors not captured by traditional resilience frameworks may be more relevant for understanding women’s anxiety in first responder roles.

It should also be noted that men in the present study were significantly older than women and were more likely to be married. These demographic differences may partly account for the observed gender differences in the protective role of resilience [47]. Age is often associated with greater life experience, more developed coping repertoires, and increased confidence in managing occupational stressors, all of which may strengthen resilience over time [48]. Similarly, marital status may reflect access to stable interpersonal support, which can buffer the psychological impact of exposure to stressful or traumatic events [49]. In this context, the stronger association between resilience and mental health outcomes among men may not be attributable to gender alone, but may also reflect the cumulative benefits of being older and having greater access to relational support.

By contrast, the women in the sample were younger and less likely to be married, which may suggest fewer opportunities to draw on the same forms of accumulated occupational experience or stable social support. This is important because resilience does not operate in isolation; it is shaped by broader social, relational, and occupational resources [50].

Existing research has shown that trait anxiety is a strong predictor of lower resilience among individuals with depression or anxiety disorders, suggesting that stable dispositional tendencies toward heightened worry and threat sensitivity can potentially undermine the capacity to adapt to stress [51]. Although the present study did not assess trait anxiety directly, it is plausible that such dispositional anxiety may contribute to the weaker association observed between resilience and anxiety in women. Women in male-dominated first responder environments may experience additional stressors such as concerns about personal safety, social exclusion and discrimination that aggravate trait anxiety responses [5]. These dynamics may, in turn, attenuate the protective effects of resilience as traditionally conceptualized.

Fourth, the mediation analysis provided further evidence of gender-specific pathways, showing that resilience mediated the relationship between perceived stress and depression, anxiety, and PTSD only for men. In other words, contrary to our initial hypothesis, resilience functioned as a mechanism through which stress translated into mental health outcomes for men only. For women, resilience did not significantly mediate any of these relationships. Importantly, this finding should not be interpreted as evidence of insufficient levels of resilience among women. Rather, it reflects broader limitations within the resilience literature, which has historically paid insufficient attention to gender as a contextual and relational factor in the development and enactment of resilience [5,52]. Much of the existing work conceptualizes resilience as an individual-level attribute, often aligned with self-reliance, emotional regulation, and personal mastery. These capacities resonate more strongly with masculine socialization and occupational norms. For women working in male-dominated first responder environments, resilience may be shaped less by individual traits and more by relational and contextual resources that are not captured within traditional resilience frameworks.

These findings highlight the importance of considering gender when examining resilience and caution against conceptualizing resilience solely as an individual capacity. Rather, resilience should be understood as a dynamic process that is shaped by broader contextual, relational, and organizational resources. For first responders, and particularly for women working in male-dominated environments, resilience is not developed or enacted in isolation but is deeply influenced by access to supportive networks, a sense of belonging, and inclusive workplace practices [52]. Viewing resilience through this broader lens acknowledges that individual adaptive capacities interact with structural conditions and social resources, and that these factors may differentially enable or constrain resilience across genders [5].

This perspective underscores the need for gender-responsive frameworks and interventions that move beyond individual-level skills to address organizational culture, mentorship, and systemic support as central components of resilience-building in high-risk professions. Bridges and colleagues [5] argue that women’s participation and sustained engagement in traditionally male-dominated domains depend heavily on a sense of belonging. This sense of belonging is fostered through relational mechanisms such as mentoring, access to role models, and supportive professional networks, which help mitigate isolation and counter social exclusionary practices common in masculinized organizational cultures.

The study has several limitations that should be acknowledged. First, the use of a cross-sectional survey design precludes causal inferences regarding the relationships between gender, perceived stress, resilience, and mental health outcomes. Longitudinal or prospective designs would be better suited to clarify the temporal ordering and potential causal pathways among these variables. Second, the sample comprised only two categories of first responders and participants were recruited from a single province, which limits the generalizability of the findings to other first responder groups and to different geographical or organizational contexts within South Africa. Third, all data were collected using self-report measures, which may be subject to reporting biases such as social desirability, recall bias, or underreporting of psychological distress, particularly in occupational cultures where mental health difficulties may be stigmatized [53]. Future research incorporating multi-method approaches, including clinical interviews or objective indicators, would strengthen the findings. Finally, the sample was overwhelmingly drawn from participants working in urban settings. Hence, the study could not meaningfully assess the influence of work context, nor could it draw conclusions about the role of urban versus rural residence in mental health outcomes.

5. Conclusions

This study examined gender differences in the relationships among perceived stress, resilience, and mental health outcomes in South African first responders. While men and women reported similar levels of resilience and experienced comparable negative impacts of stress on mental health, resilience operated differently across genders. For men, resilience functioned as a robust protective factor. For women, however, resilience showed more limited protective value and did not mediate the association between stress and psychological outcomes. These findings suggest that gender differences in the stress–mental health pathway may not be attributable to disparities in resilience levels but rather to differences in how resilience functions as a psychological resource.