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We examined whether cultural sexism (county- and state-level gender attitudes) moderates the efficacy of psychotherapies by re-analyzing data from a previous meta-analysis of randomized controlled trials of youth psychotherapy for the most commonly targeted problems (depression, anxiety, conduct, attention-deficit hyperactivity disorder; 2,698 effect sizes (ESs); 314 studies; N=19,739; ages 4-18). Higher cultural sexism was associated with lower ESs for studies with greater than or equal to 50% girls; this association became stronger as the proportion of girls in the samples increased. Cultural sexism was unrelated to ESs for studies with greater than 50% boys. An interaction between state- and county-level sexism revealed that psychotherapies were most beneficial when they were conducted in states and counties with the lowest cultural sexism. Thus, the context in which psychotherapies are delivered is associated with psychotherapy efficacy for girls.