Gender and health
Gender refers to the characteristics of women, men, girls and boys that are socially constructed. This includes norms, behaviours and roles associated with being a woman, man, girl or boy, as well as relationships with each other. As a social construct, gender varies from society to society and can change over time.
Gender is hierarchical and produces inequalities that intersect with other social and economic inequalities. Gender-based discrimination intersects with other factors of discrimination, such as ethnicity, socioeconomic status, disability, age, geographic location, gender identity and sexual orientation, among others. This is referred to as intersectionality.
Gender interacts with but is different from sex, which refers to the different biological and physiological characteristics of females, males and intersex persons, such as chromosomes, hormones and reproductive organs. Gender and sex are related to but different from gender identity. Gender identity refers to a person’s deeply felt, internal and individual experience of gender, which may or may not correspond to the person’s physiology or designated sex at birth.
Gender influences people’s experience of and access to healthcare. The way that health services are organized and provided can either limit or enable a person’s access to healthcare information, support and services, and the outcome of those encounters. Health services should be affordable, accessible and acceptable to all, and they should be provided with quality, equity and dignity.
Gender inequality and discrimination faced by women and girls puts their health and well-being at risk. Women and girls often face greater barriers than men and boys to accessing health information and services. These barriers include restrictions on mobility; lack of access to decision-making power; lower literacy rates; discriminatory attitudes of communities and healthcare providers; and lack of training and awareness amongst healthcare providers and health systems of the specific health needs and challenges of women and girls.
Consequently, women and girls face greater risks of unintended pregnancies, sexually transmitted infections including HIV, cervical cancer, malnutrition, lower vision, respiratory infections, malnutrition and elder abuse, amongst others. Women and girls also face unacceptably high levels of violence rooted in gender inequality and are at grave risk of harmful practices such as female genital mutilation, and child, early and forced marriage. WHO figures show that about 1 in 3 women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
Harmful gender norms – especially those related to rigid notions of masculinity – can also affect boys and men’s health and wellbeing negatively. For example, specific notions of masculinity may encourage boys and men to smoke, take sexual and other health risks, misuse alcohol and not seek help or health care. Such gender norms also contribute to boys and men perpetrating violence – as well as being subjected to violence themselves. They can also have grave implications for their mental health.
Rigid gender norms also negatively affect people with diverse gender identities, who often face violence, stigma and discrimination as a result, including in healthcare settings. Consequently, they are at higher risk of HIV and mental health problems, including suicide.
The work of WHO is aligned with and supports the advancement of the Sustainable Development Goals, particularly SDG 3: Ensure healthy lives and promote well-being for all at all ages, and SDG 5: Achieve gender equality and empower all women and girls. The Organization is committed to non-discrimination and to leaving no-one behind. It seeks to ensure that every person, regardless of gender or sex, can live a healthy life.
Gender inequality hinders progress to fulfill everyone’s right to health. Efforts in support of Universal Health Coverage (UHC) must focus on reaching those most often left behind, such as marginalized, stigmatized and geographically isolated people of all sexes and gender identities, with a special focus on those in situations of increased vulnerability, including poor people, persons with disabilities and racialized and indigenous peoples. Addressing discrimination against women and girls is critical to achieving UHC.
WHO develops norms, standards and guidelines on gender-responsive health service provision and delivery, and commissions research on issues focusing on gender equality, human rights and health equity. WHO also supports country-level action to strengthen health sector response to gender-based violence, as well as to address gender equality in health workforce development and gender-related barriers to health services.
