| Gender stereotypes affect health care

UBC researcher Joy Johnson calls for new investigations

Gender stereotyping impacts the health care that men and women receive, says a Vancouver-based researcher.

Dr. Joy Johnson, scientific director of Vancouver’s Institute of Gender and Health and a University of British Columbia nursing professor, spoke at the University of New Brunswick Fredericton campus last week on the implications of sex and gender for medical treatment.

“There are assumptions we as the public take for granted,” said Johnson. “For instance, [that] everyone in Canada has equal access to health care.”

Gender is a social construct that defines a person’s characteristics based on stereotypes of masculinity or femininity – brawny, muscular individuals are considered “manly,” while long-haired, well groomed, large-breasted individuals are “feminine.” Rather than strictly classifying people as either male or female, Johnson explained, gender spans a continuum from extreme masculinity to extreme femininity, as measured by a scientific scale called the Bem Sex Role Inventory.

Gender characterizes the way we interact with each other; it defines our dress, our posture, our opportunities, and even the availability of monetary means.

In terms of physiology, organs define one’s sex. However, like gender, sex is also a continuum. “Sex is a biological construct,” Johnson explained. “It’s not a single thing. There are a number of factors that make up who we are.”

It should then come as no surprise, she asserted, that gender influences the way doctors and patients interact. A study conducted by Robert A. Fowler and reported in the Canadian Medical Association Journal (CMAJ) in December 2007 investigated treatment of patients in emergency rooms in relation to their sex. Fowler found that men were more readily attended to and received more rigorous treatment than women.

Other concerns Johnson raised about sex and gender included the diagnosis of depression, where there tends to be a greater bias toward diagnosis in females. Reported rates of depression in women exceed those of men, despite the significant numbers of male suicides. Johnson suggested that this might be related to societal pressures that push men to avoid displays of emotion.

Societal norms may also account for the discrepancies between genders of patients seen at health clinics, said Johnson. More women tend to go for treatment while men feel largely out of place, making interactions with their general practitioner challenging.

“Your doctor’s office is a feminized space. Think about the magazines and think about the colour of the walls. When you look around, most of the people are women,” Johnson said.

Sex and gender play roles in many other medical areas, ranging from drug dosages to reactions to surgery and treatment, exposing the need for further research and integration of such knowledge into medical schools and treatment methods. The scope of repercussions in sex-alteration procedures, the effects of testosterone on female bodies and estrogen on male bodies, and the psychological benefits of such procedures in transgendered individuals demand more investigation.

When asked about the lack of investigation of the H1N1 virus with respect to gender, Johnson said there was dearth of meaningful difference in the reaction of either gender during preliminary tests. She also mentioned the recent discovery of heightened susceptibility to H1N1 in pregnant women.

Johnson urged researchers to make it a priority to address issues of gender in medicine in order to affect policy changes.

“It is the job, certainly, of researchers to think about these things,” Johnson said.