Wednesday, May 1, 2013

Gender Differences in Health Issues

This semester, I took a class on gender and health, mostly to examine the role that gender plays in health policies and administration. So we had to write an essay in which we had to sort of discuss this. The essay is to (try to, ha!) answer these questions: What role does gender play in health policies, how policymakers address gender differences in health, are the health differences between women and men due to their biological make-up and/or are natural or are they more social--or both?
The book I'm citing (authors: Bird and Reiker) is Gender and Health: The Effects of Constrained Choices and Social Policies by Chloe Bird and Patricia Reiker, published 2008. It's one of the most important books I've ever read in my life, so I definitely recommend it to everyone.

You know how people like to attribute all our differences to our biology? Yeah, well, they're not quite right. Women are more likely to seek help than men are not because men are just naturally supposed to be independent, for example; social upbringing has everything to do with it. Men get certain diseases more than women do, also more so due to social standards than to their biologies, although we really can't know for sure all the time. But both nature and nurture are equally important, something we need to keep in mind when talking about gender and health.

If something's unclear, lemme knoooow.

Gender Differences in Health

People often attribute gender differences to biology alone; it is not uncommon, for example, for a person to claim that women and men[1] and are inherently different due to their biological, physiological differences, and this, they insist, explains why they respond to the same situations differently, including health-related issues. While we are confronted with this perspective on the one hand, we have a part of western feminism on the other, which does not respond well to the belief that women and men are inherently different due to their biological framework. (Western) feminism criticizes the focus on gender differences because it understands that these differences are the reason women are universally subjugated and discriminated against; it therefore suggests shifting the focus from women’s and men’s “inherent” differences to their inherent equality.[2] With this understanding of feminism, one finds Bird and Reiker’s acknowledgment of women’s and men’s differences in health matter. They admit that there are differences and that these differences are important—but they believe that why these differences are there is essential to our understating health policies as well as their effectiveness or ineffectiveness. Ultimately, gender health differences are neither biological nor social alone: they are both influenced by each other such that neither is more important than the other.
As Bird and Reiker agree, women and men do have unique biological differences, but these differences vary with certain social conditions (Gender and Health, 16). The social factors of these differences are often ignored because preference is given to the “biological” differences, and it is rather convenient to attribute all differences to biology alone; biology (science) is, after all, “objective” and therefore can’t be contested. Yet, while it is true that science/biology is “objective,” assuming there is such a thing indeed, how we teach it, explain it, and understand is subjective—and one of the many reasons is it is subjective is due to our cultural, social discourse understanding of gender. 

To support their argument, Bird and Reiker provide four diseases and health conditions that are prevalent: cardiovascular disease and the combination of immune function and disorders for physical health, and depressive disorders and substance abuse for mental health. Due to the lack of space for this essay, however, I will focus on women’s and men’s mental health. Research shows that women’s rates of depressive disorders are between 50-100% greater than men’s; this ratio includes both those who are treated as well as community samples (ibid, 31). That until recently, it was believed that this meant men were utterly immune to depression is an excellent example of the overlooking of social aspects of health-related issues. As the authors note,

the under-diagnosis of depression in men has been attributed to clinicians’ failure to recognize symptoms, men’s unwillingness to seek help for such feelings, and their tendency to cope with their feelings through drinking, drug use, and other private activities or actions (ibid, 32).

Men therefore have more options (or at least they seem to believe they do), even if they are bound to lead to more problems and even if they are more temporary, than women do.[3] Most societies, being patriarchal in nature, don’t value the independence and mobility of women and teach women that not only is it okay to seek help but that they are, for the most part, incapable of thinking and acting on their own, that they must rely on the help of men in virtually all aspects of life; the same societies understand masculinity for a man to be almost complete self-reliance—no turning to anyone for help, doing everyone on his own, etc.—but also that it is acceptable for women to talk “too much,” to share their problems with others, to talk about themselves while it is not as acceptable for men to do so. It is therefore not surprising that more women are likely to seek help than men in order to treat their depression. The biological and social differences here are clear: gender, while socially constructed, is determined by a person’s sex (which is biological), and how that person is raised to believe what is determined by her/his (traditional, male-dominated) society.

Once a society concludes that, for example, women are more immune to depressive disorders than men are, its policies are bound to be just as misled. Policymakers often do not consider the multiple factors involved in health issues—such as, for example, involuntary unemployment leading to stress, which affects a person’s mental and physical health. This is a part of what Bird and Reiker identify as constrained choices, which, they write, affect “men’s and women’s stress levels as they experience competing demands on their time and other resources, which can in turn affect their psychological and physical responses to stress” (ibid, 6). It is thus important for policy makers to consider constrained choices in addressing health issues, since doing so may help them identify the bigger, factors, those that are more worthy of public attention, that cause the problem in the first place. Once they understand, for example, what physiological and mental effects unemployment can have on individuals as well as on the larger society, they would be better able to find a more appropriate solution to mental and physical health issues that are caused primarily due to social and physical stress. 

[1] Here, I’m speaking from the perspective of the "average" person, who either does not know about other genders and sexes or does not acknowledge them, hence my reference to the traditional gender roles.
[2] As a Women and Gender Studies student, as well as an Islamic feminist and a student of Islamic and Western feminisms (the two are strikingly different), I often come across students and colleagues who do attempt to deny the differences between women and men, whether they are social or biological—although I agree with Bird and Reiker that both are equally significant.
[3] That men are more likely to turn to drinking and substance abuse than women are also makes sense to me from my own experiences and upbringing: although Islam discourages alcohol for both women and men, it is socially acceptable for men to drink in some Muslim communities, but it is absolutely unacceptable for women to do so. In some Muslim societies, such as South Asian, women are also degraded for smoking, although it is acceptable for them to smoke just as it is for men in some Arab countries, such as Jordan.

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