Narcissism in Women: How to deal with a female narcissist

Understand the need for a fresh perspective when working with female narcissists.
Written by Ella T

This article takes a look at narcissism, with a special focus on narcissism in women and how their traits can differ considerably from their male counterparts.

Whilst this article talks specifically about women and men, it is important to recognise that those who identify with neither female or male pronouns are often the subject of narcissism name calling. This is a topic that we hope to discuss in future blog posts – so keep an eye out.

Narcissist women can often fly under the radar of diagnosis, so it is critical for practitioners to understand what the key differences are.

What is Narcissistic personality disorder (NPD)?

Narcissistic personality disorder (NPD) sits on a broad spectrum of severity, those with it often being unaware, or in denial, that they have it. It is prevalent, highly comorbid with other disorders and very variable in its characteristics. Whilst the underlying pathology remains the same, its presentation falls into three broadly accepted subtypes:

  1. The grandiose “overt” narcissist,
  2. The vulnerable “covert” narcissist
  3. The “malignant” narcissist.


It is within these subtypes that we can identify gender differences.

Before we explore this, let’s paint a a picture of what NPD looks like.

Understanding the traits of a narcissist woman

It is important to recognise the key difference between someone with NPD and the narcissistic qualities that can be displayed by anyone (including you!).

Signs of a narcissistic womanpuppet-master

For instance, the signs of a narcissistic woman may be that she uses manipulative tactics to get what she wants. However, this ‘female narcissist’ as she might be labelled, only occasionally does this and does not have any of the other traits defining NPD, so she would not be clinically diagnosed.

The DSM-5 lists nine key narcissistic traits

To be diagnosed at least five of these traits must be present in the individual:

  • Exaggerated feelings of superiority and self-importance
  • Regular fantasies about personal power, intelligence, success, or attractiveness
  • A firm belief in personal specialness
  • A strong need for attention, praise and admiration from other people
  • Entitled behaviour, such as a desire for special treatment
  • A habit of using manipulation tactics
  • Low empathy or disinterest in the emotional needs of others
  • A tendency to envy others or assume others envy them
  • Arrogance and scorn for others.


Giancarlo DiMaggio, psychiatrist and researcher in the treatment of narcissism, identifies seven domains, “maladaptive self–other schemas; poor self-reflection and intellectualising; disturbed agency; maladaptive coping; poor theory of mind and empathy” which therapists should look for when working with patients with NPD.

This brings up the question…

Are Narcissists born or made?

Understand the making of a narcissist; join experts in the field with our all-in-one video series on navigating narcissism. Click here to find out more.

What causes narcissistic personality disorder?

As with all personality disorders, there are a range of factors that contribute to the development of NPD. Our current understanding identifies inherited traits and early childhood experiences as key contributors to its development.

Now let’s dive into the differences between narcissist traits, female or male.

How female narcissists differ from males

Gender bias is a controversial and widely debated issue in the DSM-5, which currently reports that up to 75% of individuals with NPD are males. Due to discrepancies in socialisation and gendered expectations related to femininity and masculinity, the characteristics of someone with NPD can differ drastically between female and male. This is something that must be critically considered in diagnosis.

Most gender stereotypes are defined within two categories. The first is reflective of ‘agentic characteristics’, defined as dominance, assertiveness, competitiveness and need for achievement. The second are ‘communal characteristics’, defined as tenderness, selflessness and nurturance. Agentic characteristics have been closely correlated with the narcissistic personality and the masculine stereotype, whereas communal characteristics are more likely to be typical of women and the feminine stereotype (Grijalva et al., 2015).

Males with NPD often score higher in entitlement, exploitativeness and a lack of empathy (Richman and Flaherty, 1990), being more likely to express overt “grandiose” narcissism. To the contrary, females with NPD use more indirect and discreet ways to fulfil their narcissistic goals, often displaying the covert “vulnerable” narcissism subtype (Morf & Rhodewalt, 2001).

When angered by a slight provocation, what is defined as ‘narcissistic rage’, the behaviours exhibited can also illuminate the distinct differences between genders. Whilst men tend to be aggressive and explosive (malignant), narcissist women will often withhold attention and withdraw affection, again characteristic of the “vulnerable” narcissist subtype. This subtype can be missed by the DSM-5 because of its current overemphasis on capturing grandiose themes (Green et al., 2023).

Now that we have covered the ways in which NPD presents itself and recognised the key differences between genders, it is evident that there must be greater consideration of the subtypes within this highly variable personality disorder.

Why stop here?

To find out more about how to treat NPD, join expert Wendy Behary as she delves into the groundbreaking treatment strategies for working with Narcissist patients. Gain all the tools you need to work with patients impacted by NPD, whether they have it, or are subject to narcissistic abuse. Click here for the video course.

Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415-422.
Gescher, D. M., Kahl, K. G., Hillemacher, T., Frieling, H., Kuhn, J., & Frodl, T. (2018). Epigenetics in personality disorders: today’s insights. Frontiers in psychiatry, 9, 579.
Green, A., MacLean, R., & Charles, K. (2023). Clinician perception of pathological narcissism in females: a vignette-based study. Frontiers in Psychology, 14, 1090746.
Grijalva E., Newman D. A., Tay L., Donnellan M. B., Harms P. D., Robins R. W., Yan T. (2015). Gender differences in narcissism: A meta-analytic review. Psychological Bulletin, 141(2), 261–310.
Morf, C. C., & Rhodewalt, F. (2001). Unraveling the paradoxes of narcissism: A dynamic self-regulatory processing model. Psychological inquiry, 12(4), 177-196.
Richman, J. A., & Flaherty, J. A. (1990). Gender differences in narcissistic styles. New perspectives on narcissism, 73-100.

Written by Ella T
October 31, 2023
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