by Kate Gilles
The global health and development community is increasingly focused on the influence of traditional gender roles on individuals' health and well-being and the implications for programs and services. Gender equality is now recognized as a human right and is specifically targeted by Millennium Development Goal Number 3, "To promote gender equality and empower women."1 But what exactly do gender and gender equality mean, and how can a gender-based perspective help achieve health and development goals?
Gender Is Not a Synonym for Sex
The words gender and sex are often used interchangeably, but there are important distinctions between the two concepts. Sex is based on anatomical, physiological characteristics of males and females, while gender is a social construct—that is, a society's assumptions about the way a man or woman should look and behave.2 Traditional gender roles encompass the activities, responsibilities, and decisionmaking power that a society has historically assigned to men and women within public and private spaces. The specifics may differ across societies, but no society assigns equal power or status to men and women.3
Gender identity is an individual's personal, internal sense of being a man or a woman or another gender.2 Although most societies define two categories of gender—man and woman—many cultures recognize other genders and individuals may identify as neither male nor female. A person's gender and gender identity are often assumed to be the same as their sex; that is, a person who was born with male anatomy is assumed to be a man and a person born anatomically female is assumed to be a woman. Although this may be true for most people, it is important to keep in mind that gender does not automatically correspond to sex, and that there are more than two categories of gender. The gender identity of transgender individuals does not match the sex assigned to them at birth. Transgender individuals generally choose to dress and present themselves as the gender with which they identify, rather than their birth-assigned sex. They may or may not choose to alter their body physically through hormones or surgery. Transgender people should be treated as the gender with which they identify, and referred to by their chosen name and pronoun.2
Just as gender and sex do not automatically correspond, gender identity and sexual orientation are not the same thing. A person's sexual orientation—their enduring physical, romantic, and/or emotional attraction to persons of the same and/or opposite sex—should not be assumed based on their gender or their sex. A transgender person may be attracted to individuals of the same sex, the opposite sex or both.2
Gender identity and gender roles are important determinants of the distribution of power, rights and access to resources among various groups in society.
Gender Equality: Beyond Women's Empowerment
In nearly all societies, traditional gender roles privilege men at the expense of women. Through the imposition and continuous reinforcement of rigid gender norms, society deprives women of rights, power, and resources. Traditional gender roles are a driving force behind women's lower economic status, low literacy and education, poorer health outcomes, and greater exposure to gender-based violence.3 For this reason, most programs that promote gender equality focus on empowering and working directly with women and girls. Indeed, Millennium Development Goal 3 is "To promote gender equality and empower women." Gender equity is the means. Gender equality is the result.
Gender equity connotes fairness and justice in the distribution of opportunities, responsibilities, and benefits available to men and women, and the strategies and processes used to achieve gender equality. Gender equality is equal treatment of women and men in laws and policies, and equal access to resources and services within families, communities, and society at large.
However, women are not the only ones harmed by traditional gender norms and inequality; men and transgender individuals also suffer negative consequences. A girl may be forced to leave school because her family does not believe that women need to be educated. A man may engage in unsafe sex because he believes real men don't use condoms. A transgender woman may not seek needed health care out of fear of discrimination and stigma.
Transforming traditional gender roles is critical to reducing the damage that those roles inflict on everyone. Increased gender equality—the equal treatment of all individuals, regardless of gender—benefits all members of society and achieving equality will require working with people of all genders. However, men and transgender individuals are frequently overlooked in the development and implementation of gender-focused programs.
The Transgender Community
The vulnerability of transgender persons, who transgress accepted notions of masculinity and femininity, is rooted in their gender identity and is, therefore, an important aspect of gender equality. Transgender individuals face high levels of discrimination and stigma, are at greater risk for gender-based violence, and are less able to access health services, including reproductive health care.4 Ensuring the equal status of the transgender community does more than protect the individual human rights of a minority group; it also promotes the broader principles of democracy and development, and contributes to the well-being of society as a whole.5
Transgender individuals directly challenge assumptions about gender and gender roles. As such, there is great potential for transgender individuals to be involved in and served by gender-transformative programming, in particular reproductive health programs. However, as a stigmatized population, the transgender community is frequently invisible, and very little is known about the unique needs of transgender people in various societies.6 More work needs to be done to understand the ways in which transgender persons can be engaged as clients and as supporters of programs that advance gender equality.
Men: Partners and Clients
Reproductive health programs may serve men directly and seek to address their unique health needs, or they may include them as allies for women's health. Both approaches present important opportunities to promote gender equitable norms and practices.
Men have distinct sexual and reproductive health needs that are frequently not addressed by programs and services that have been designed primarily with women in mind. Addressing problematic gender norms should be a key component of health services for men: Stereotypes regarding masculinity—for example, invulnerability, strength, and promiscuity—may promote risky behavior and hinder men's ability to access health information and care, and studies have shown that men with less equitable gender norms (that is, men who are more likely to support traditional gender roles) have poorer health outcomes.7
Men can also be reached through programs serving their female partners; men have proven to be supportive allies in women's reproductive health programs and women themselves often request that their male partners be included. Involving men in reproductive health can improve couples' communication, increase support for child spacing and family planning, reduce intimate partner violence, and positively affect attitudes toward gender equality.8
There are a variety of ways in which men can be positively engaged, as clients and allies, to promote health and gender equality. Constructive men's engagement describes strategies that "promote gender equity; increase men's support for women's sexual and reproductive health and children's well-being; and advance the reproductive health of both men and women."3 Constructive men's engagement provides a framework for programs to involve men in appropriate and positive ways.
Programmatic Approaches for Achieving Gender Equality
Approaches for integrating a gender perspective within reproductive health programs have evolved as awareness and understanding of gender and gender norms has grown. More programs are moving beyond simply recognizing the influence of gender roles and are adopting a gender transformative approach that seeks to transform those roles and actively promote gender equity. To further advance the goals of gender transformative approaches, the Interagency Gender Working Group (IGWG) has recently introduced gender synchronization strategies, which recognize the relational nature of gender and seek to coordinate and integrate activities for women and men in a mutually reinforcing and beneficial way.3
More information on programmatic approaches for integrating gender and advancing gender equality, including detailed information on gender synchronized strategies and resources for training, can be found on the IGWG website: www.igwg.org
Kate Gilles is a policy analyst at the Population Reference Bureau.
- United Nations Population Fund, "State of World Population 2008. Reaching Common Ground: Culture, Gender and Human Rights" (2008), accessed at www.unfpa.org/swp/2008/presskit/docs/en-swop08-report.pdf, on July 21, 2011; and United Nations, Millennium Development Goals (2010), accessed at http://www.un.org/millenniumgoals/, on July 6, 2011.
- Gay and Lesbian Alliance Against Defamation (GLAAD), "Media Reference Guide, 8th edition" (May 2010), accessed at www.glaad.org/files/MediaReferenceGuide2010.pdf, on July 12, 2011; Institute of Medicine, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding (Washington, DC: The National Academies Press, 2011); and Fenway Health, "Glossary of Gender and Transgender Terms" (January 2010 revision), accessed at www.fenwayhealth.org/site/DocServer/Handout_7-C_Glossary_of_Gender_and_Transgender_Terms__fi.pdf?docID=7081, on July 6, 2011
- Margaret E. Greene and Andrew Levack for the Interagency Gender Working Group (IGWG), Synchronizing Gender Strategies: A Cooperative Model for Improving Reproductive Health and Transforming Gender Relations (Washington, DC: Population Reference Bureau, 2010).
- FORGE, "What You Should Know About Violence Against LGBT Individuals" (October 2010), accessed at http://forge-forward.org/2010/10/what-you-should-know-violence/, on July 6, 2011; and Myra Betron and Evelyn Gonzalez-Figueroa, "Gender Identity and Violence in MSM and Transgenders: Policy Implications for HIV Services" (July 2009), accessed at http://pdf.usaid.gov/pdf_docs/PNADU585.pdf, on July 6, 2011.
- Liz Galst, "Saving Lives, Promoting Democracy, Alleviating Poverty, and Fighting AIDS: The Case for Funding Lesbian, Gay, Bisexual and Transgender Populations" (March 2010), accessed at www.arcusfoundation.org/images/uploads/downloads/Saving_Lives_Report_Arcus_Galst_2010.pdf, on July 13, 2011.
- Institute of Medicine, The Health of Lesbian, Gay, Bisexual, and Transgender People.
- Christine Ricardo and Fabio Verani, "Engaging Men and Boys in Gender Equality and Health: A Global Toolkit for Action" (2010), accessed at www.promundo.org.br/en/sem-categoria/engaging-men-and-boys-in-gender-equality-and-health-download/, on June 28, 2011; and Barker, G. et al., Evolving Men: Initial Results from the International Men and Gender Equality Survey (IMAGES) (Washington, DC: International Center for Research on Women (ICRW) and Rio de Janeiro: Instituto Promundo, 2011).
- Ricardo and Verani, "Engaging Men and Boys in Gender Equality and Health"; and Margaret E. Greene, "SysteMALEtizing: Resources for Engaging Men in Sexual and Reproductive Health" (July 2006), accessed at www.igwg.org/igwg_media/IGWG_SysteMALEtizing.pdf, on July 1, 2011.
- Rebeca Grynspan, "Message on the International Day Against Homophobia" (May 17, 2010), accessed at http://content.undp.org/go/newsroom/2011/may/rebeca-grynspan-message-on-the-international-day-against-homophobia.en, on July 21, 2011.