Women who use charm, relational skill, or calculated interpersonal strategies to get what they want are too often diagnosed with mood or psychotic disorders instead of the personality-based problems that better explain their long-term patterns. That mismatch is not just an academic error — it shapes treatment, legal outcomes, family decisions, and a person’s access to care. This article traces how bias and measurement gaps create the problem, illustrates the clinical distinctions that matter, and offers concrete steps clinicians, researchers, patients, and advocates can take to reduce harmful misdiagnosis.