Gender refers to the socially constructed characteristics of women and men – such as the norms, roles and relationships that exist between them. Gender expectations vary between cultures and can change over time. It is also important to recognize identities that do not fit into the binary male or female sex categories. Gender norms, relations and roles also impact the health outcomes of people with transgender or intersex identities.
“Sex” vs. “Gender”
While most people are born either male or female (biological sex), they are taught appropriate behaviours for males and females (gender norms) – including how they should interact with others of the same or opposite sex within households, communities and workplaces (gender relations) and which functions or responsibilities they should assume in society (gender roles).
Income, education, age, ethnicity, sexual orientation and place of residence are all important determinants of health. When they intersect with gender inequality, they can compound the experience of discrimination, health risks, and lack of access to resources needed for health attainment.
Impact on health
There is not a problem per se in socially constructed differences between women and men, except when these differences limit opportunities or resources needed to attain health, and thereby result in discrimination and inequalities that may have negative consequences on health.
When individuals do not conform to established gender norms, relations or roles, they often face stigma, discriminatory practices or social exclusion – all of which negatively impact health. Gender norms influence access and control over resources needed to attain optimal health, including:
- economic (income, credit);
- social (social networks);
- political (leadership, participation);
- information and education (health literacy, academic);
- time (access to health services); and
- internal (self confidence/esteem).
Gender norms, roles and relations result in differences between men and women in:
- exposure to risk factors or vulnerability;
- household-level investment in nutrition, care and education;
- access to and use of health services;
- experiences in health-care settings; and
- social impacts of ill-health.
Gender equality in health
Gender equality in health means that women and men, across the life-course and in all their diversity, have the same conditions and opportunities to realize their full rights and potential to be healthy, contribute to health development and benefit from the results. Achieving gender equality in health often requires specific measures to mitigate barriers.
- A WHO Strategy for integrating gender analysis and actions into the work of WHO was adopted by the Sixtieth World Health Assembly in May 2007 (WHA60.25). The entire WHO Secretariat, including headquarters, regional offices and country offices, is responsible for implementing the WHO Gender Strategy, which includes:
- ensuring capacities for gender analysis and planning;
- mainstreaming gender in corporate functions, for example gender responsive results-based management planning, budgeting, monitoring and evaluation;
- disaggregating data and conducting gender analysis; and
- establishing accountability for mainstreaming gender.
- In 2015, the Gender, equity and human rights (GER) roadmap for action, 2014-2019: Integrating equity, gender, human rights and social determinants into the work of WHO went into effect. The GER Roadmap for Action is a 5 year plan to ensure an integrated approach for gender responsive, equity enhancing, and rights based WHO programmes.
- WHO has also developed tools to ensure systematic consideration of gender in the design, implementation and evaluation of health policies and programmes, which include the:
- WHO Gender Analysis Matrix (GAM) and Gender Analysis Questions (GAQ)
- WHO Gender Responsive Assessment Scale (GRAS) and Gender Analysis Tool (GAT)
- WHO Gender and health planning and programming checklist