Objective: The causal reasons for gender differences in suicide attempt and suicide death have been addressed by previous studies: Some emphasized suicidal intent, while others focused on method lethality. The present study is to examine the effects of suicidality levels defined as severity of intent and method lethality on gender differences. Methods: The data were collected through Korea Foundation for Suicide Prevention (KFSP). Trained interviewers categorized a total of 1,269 patients’ responses to questions regarding death wishes and the chosen methods: 1) severe (29.1%), 2) moderate (31.3%), and 3) mild (39.6%), and looked into their characteristics and risk factors related to gender. Results: The severe group showed no gender differences in the choice of lethal methods, that is 59.4% men and 46.9% women used fatal methods such as hanging or chemical poisoning (p = 0.075). In contrast, moderate and mild groups showed gender differences (p = 0.001, respectively). Most women in the moderate group chose drug poisoning (69.1%) rather than hanging (1.0%) or pesticide poisoning (3.9%). The mild group showed similar results. Conclusion: The present study examined the contrasting effects of suicidality levels on gender differences in suicide attempts: The severe group fail to reach significant differences, whereas the other two groups did. The future study on suicide attempt should be focused on the severe group whose characteristics were much closer to the actual suicide. The present findings have useful implications for gender-free prevention program.