Gender and global health: evidence, policy, and inconvenient truths

摘要

Gender is missing from, misunderstood in, and only sometimes mainstreamed into global health policies and programmes. In this Viewpoint, we survey the evidence for the role of gender in health status, analyse responses to gender by key global health actors, and propose strategies for mainstreaming gender-related evidence into policies and programmes. We use the WHO definition of gender: "socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women". When gender identity does not correspond with assigned sex, people might identify themselves as transgender. An individual's experience of gender and gender relations can change according to context and situation. The term sex, by contrast, refers to biological characteristics that define human beings as female or male. The exact contributions that sex and gender make to health status are often hard to disentangle and quantify, and "biological influences and social influences do not operate independently".Moreover, they often interact with other social determinants of health.