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This work presents some reflections on the issue of gender in mental health and occupational therapy practices of two historical situations showing two different but related practices: on one hand aspects linked to the performance of women in the public domain and on the other hand, stand out the implication of gender relations in such action. This paper intent to analyze the impact of those representations of gender in the field of mental health and its relationship with the current practices of occupational therapy. It presents the constituent elements of the concept of gender to identify care logic aimed at responding to the issue of mental health, reproducing the structure of power and domination of gender relations. Intents to include gender mainstreaming in occupational therapy practices wherever instrument interventions, strategies, or devices in health, bearing in mind that the tension between the practice of occupational therapy and the gender system constraints, is always in relation with the particular process of subjectivation of each of the subjects with which intervenes.