Orientation: Positive organisational behaviour impacts strongly on various individual and work-related outcomes. Gender perspectives in this paradigm have not yet been comprehensively researched. Research purpose: This article explores female perspectives on mental health and sense of coherence. The aim is to promote an understanding of gender-related subjective perceptions on mental health and sense of coherence from an emic perspective. Motivation for the study: Limited research exists regarding the perceptions of positive leadership behaviour of female leaders within South African who experience unique challenges within the business environment and remain healthy at the same time. Research design, approach and method: Data from a mixed-method research study are presented, thereby providing insights into quantitative and in-depth qualitative empirical data from 15 female leaders. The study followed a single, embedded case study approach. Main findings: The main findings show that sense of coherence, mental health and gender awareness are connected. Female leaders with a high sense of coherence refer to gender in a positive or neutral way in a male-dominated work environment. The results emphasise individual and social health-promoting strategies in an organisation and the way personal life orientation contributes to individual (mental) health. Practical/managerial implications: Organisations need to focus more on promoting mental health in terms of gender and gender-related positive psychology frames. Contribution/value-add: This study contributes to the literature on gender within the positive organisational behaviour paradigm, presents recommendations for future research and highlights the practical implications for organisations.