Gender differences in perceived triggers and progression factors of vitiligo: evidence from Brazil

= 12.43). Open-ended responses to a single attribution prompt were coded inductively by two trained psychologists, with inter-rater agreement assessed by Cohen's kappa and disagreements resolved through consensus. We computed code freq uencies overall and stratified by gender and used Similarity Analysis (IRaMuTeQ) to map co-occurrences between attributional themes and gender. Psychological attributions dominated the corpus. The most frequent codes were stress, emotional factors, rumination, genetics, depression, family loss and trauma. Within their gender, women cited stress, depression, sadness and anxiety more often than men did. Men were roughly four times more likely than women to cite genetic inheritance. Progression attributions clustered around generalized psychological state and were similar across gender. Brazilian adults with vitiligo construct gendered explanatory models that mirror broader cultural scripts about masculinity, femininity and the legitimacy of emotional disclosure. Care for vitiligo is likely to be improved by gender-responsive psychological assessment, validation of patient explanatory models and integrated dermatological-mental health pathways.