OBJECTIVE: To analyze gender differences in the perception of mental health-related stigma and the acceptance of telemedicine in rural Peruvian communities served at the primary care level. DESIGN: Cross-sectional, correlational study. SETTING: Two rural communities in Peru: Villa Salvación (Manu, Madre de Dios) and Hierba Buena (Cajabamba, Cajamarca). PARTICIPANTS: A total of 339 individuals over 18 years old, selected through stratified probabilistic sampling (178 men and 161 women). MAIN MEASUREMENTS: Outcome variables included perceptions of mental health (understanding, valuation), stigma (fear of social judgment), willingness to use telemedicine, and privacy concerns. Explanatory variables were sex, educational level, length of residence, and type of health insurance. Proportions and adjusted odds ratios (OR) with 95% confidence intervals were calculated using logistic regression. RESULTS: Greater understanding and valuation of mental health were positively associated with educational level in both genders (P<
.05). However, women showed greater concern about social stigma when seeking help (47% feared «what others might say» vs. 38% in men
adjusted OR=1.5
95%CI: 1.0-2.4), while men were more skeptical about telemedicine's effectiveness (42% expressed doubts vs. 30% in women
adjusted OR=1.6
95%CI: 1.0-2.5). No significant gender differences were observed in overall willingness to use telemedicine or in privacy concerns. CONCLUSIONS: There are gender-related differences in perceptions of stigma and the evaluation of telemedicine in rural settings. While women face greater social pressure due to stigma, men are more likely to question the effectiveness of virtual care. These findings highlight the need for primary care interventions that consider gender dynamics to enhance the acceptance and effectiveness of telemedicine for mental health in rural communities.