Gender inequality and restrictive gender norms: Framing the challenges to health
Abstract
Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.
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These 'rules' about how women and men are expected to be and act are internalized by individuals at a young age, reinforcing a systemic inequality that undermines the rights of women and girls and devalues what is considered female or feminine.
“These 'rules' -about how women and men are expected to be and act- are internalized by individuals at a young age, reinforcing a systemic inequality that undermines the rights of women and girls and devalues what is considered female or feminine (Heise et al., 2019).”
From The influence of school textbooks on the configuration of gender identity: A study on the unequal representation of women and men in the school discourse during the Spanish democracy (2022) · cites this paper as Heise et al., 2019
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Disrupting gender norms in health systems: making the case for change
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“In brief, awareness of such evidence provides further support for the need to integrate the gender-feminist perspective in health, not only in research but also in its translation into real practical implications.(84) Biological factors Conversely, other studies show that differences in anxiety disorders between sexes…”
BackgroundBerk, M., Köhler‐Forsberg, O., Turner, M., Penninx, B. W. J. H., Wrobel, A., Firth, J., Loughman, A., Reavley, N. J., McGrath, J. J., Momen, N. C., et al. (2023) · World Psychiatry · doi:10.1002/wps.21110 · Cited by 336 · see citing works
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Gender-related variables for health research
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Enhancing brain health in the global south through a sex and gender lens
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- Authors
- Heise, L., Greene, M. E., Opper, N., Stavropoulou, M., Harper, C., Nascimento, M., Zewdie, D., Darmstadt, G. L., Greene, M. E., Hawkes, S., Heise, L., Henry, S., Heymann, J., Klugman, J., Levine, R., Raj, A., & Rao Gupta, G.
- Affiliations
- Johns Hopkins University (US)
- Overseas Development Institute (GB)
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (BR)
- City University of New York (US)
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 393
- Issue
- 10189
- Pages
- 2440-2454
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2947511672
- Cited by
- 1,163
- References
- 181
- Citations by year
- 2026: 165 · 2025: 210 · 2024: 214 · 2023: 190 · 2022: 141 · 2021: 128 · 2020: 89 · 2019: 26
- FWCI
- 24.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Gender, Health, and Social Inequality
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- gender inequality, health disparities, sexism, patriarchy, intersectionality, health care discrimination, health care access, social injustice, health behavior, environmental toxins, substance use, stress, global health, Sustainable Development Goals, well-being
- MeSH terms
- Delivery of Health Care, Female, Humans, Male, Socioeconomic Factors, Sexism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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