Gone are the days when health programs were designed simply to punish or reward people to encourage behavior change. We now know that permanent behavior change is more complex and subtle, and this has led to the proliferation of programs that address factors such as motivation, confidence, social support, and social determinants of health.
Among these programmes, we observed a trend towards gender-targeted interventions. Examples include programs for men that focus on the rugby fan base as a way to get them to take care of their health, and those for women that focus on small, holistic health changes to reduce the impact of harmful ideals on the body.
While biological sex depends on our anatomy and physiology, sex is a social identity. Our gender identities accompany society’s expectations of how to act or not.
There is no doubt that sex shapes the way we “do” health – the way we eat, sleep, exercise, socialize and manage stress. While gender-specific needs are important, a gender-based approach may ignore people who don’t know either, and runs the risk of creating new biases.
A case for health programs focused on women
It can be argued that women-centered health programs were developed as a treatment for an overwhelmingly patriarchal society.
The most obvious bias in health research is that much of the data on women’s health has been collected by and from men.
Gender disadvantages or inequalities for women also result from poor representation in leadership positions and unfair standards that place higher expectations on them.
For example, women spend more time than men doing unpaid household chores and take on care responsibilities. These imbalances flow to shape how women spend their time and take care of their health.
In response, women’s research centers have been established in New Zealand and internationally to help bridge the gap in knowledge related to women’s health.
Similarly, organizations such as the YWCA and Women’s Health Victoria put gender inequality at the center of their work and help create a better understanding of how health programs can effectively support women’s long-term outcomes of behavior change.
In New Zealand, Shift supports young women to be physically active by focusing on collaboration, fun, community building and leadership. Next Level Health empowers women through the use of a comprehensive, weight-neutral approach to behavior change. This shifts the focus away from body weight and defines health more broadly, emphasizing well-being, connection to people and place and other behaviours.
As a result, sleep, self-care and stress management become just as important as physical activity and nutrition. Such programs create a more holistic and health-friendly view and go against the body image that women often face due to the social pressures to reach a “perfect” body.
A ‘hard’ approach to men’s health
Despite the male-dominated health system, men are still more likely to develop various health ailments, including coronary heart disease and being overweight.
When it comes to healthy behavior programs, it’s hard to recruit men. This may be due to the fact that men are less likely to seek help.
There have been urgent calls for healthy, male-centred lifestyle programs that often use male-dominated “male” sports (rugby and football) to entice men to join.
Some, like Tough Talk, play with stereotypical masculine traits to encourage men to discuss their health. In parallel with women’s health research, male health research centers are rapidly becoming popular.
Given these gender differences, a gender approach can be justified. Gender equality and health equity are global priorities and these programs can address them. Playing on people’s gender identities may work for employment and efficacy as well.
Slide through the cracks
While gender interventions aim to fill certain gaps, they may actually create new ones, especially when we consider that many health programs are funded through competitive grants at the national level which often favor projects with the greatest impact (largest segment of the population).
People who identify with the broader group of LGBTQI+ are at risk with regard to mental health. This disparity exists because of the larger inequalities that this society faces.
Some solutions may come from gender-diverse marketing that emphasizes gender responsiveness, rather than putting a specific gender at the center of campaigns.
Perhaps non-gender health programs can create an open discussion about how people define their gender, rather than repeating an inherited gender story. Admittedly, this could be ideal for a lifestyle program.
We don’t argue against gender-specific programming. Gender bias in health research is an ongoing issue that, among other things, requires targeted actions to eliminate harmful inequalities.
But we suggest gender consideration as an approach compatible with lifestyle programmes, where gender is embraced but not led by the programme. Choose your own path approach that allows for diverse identities and independence, regardless of gender. Otherwise, the gaps we aim to fill may become gaps elsewhere.
The difference between sex and gender, and why they are both important in health research
Introduction of the conversation
This article has been republished from The Conversation under a Creative Commons license. Read the original article.
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