262522 Expanding gender and health: Gender expression as a social determinant of health

Tuesday, October 30, 2012

Allegra R. Gordon, MPH , Dept. of Social & Behavioral Sciences, Harvard School of Public Health, Boston, MA
Sari L. Reisner, MA , The Fenway Institute, Fenway Health and Harvard School of Public Health, Boston, MA
Background: Gender expression, defined in a recent Institute of Medicine report as “characteristics in appearance, personality, and behavior culturally defined as masculine or feminine,” represents a theoretically and methodologically under-investigated social determinant of health. Method: A review of public health research related to gender expression and health was conducted and synthesized. Guided by this formative research and a social ecological understanding of the dynamic and multilevel influences on health, this paper proposes a conceptual model situating gender expression alongside and intersecting with other well-established social determinants of health inequalities. Results: To date, research on gender expression and health has primarily focused on gender nonconformity in children and adolescents, and on lesbian, gay, bisexual, and transgender populations. The impact of gender expression on psychological and physiological health across the life course, and in interaction with diverse sexual orientations, is not well understood. Identified were theoretical and methodological gaps and opportunities, including: (a) measurement issues and research methods, (b) potential resilience-generating and strengths-based processes that may accompany diverse gender expressions, (c) integration of socio-structural factors (stigma, violence) as they relate to gender expression, and (d) changes in gender expression across the lifespan. Discussion: Gender expression is a social determinant of health that warrants additional consideration in future public health research, programming, and practice. Attention to gender expression is particularly pressing given growing evidence that gender nonconformity in childhood is a common target for stigmatization and abuse, which in turn can correlate with adverse mental and physical health outcomes across the lifespan.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Identify at least two potential pathways linking gender expression to health. 2. Describe one way that gender expression in general, and gender nonconformity in particular, could contribute to positive health outcomes.

Keywords: Gender, Measuring Social Inequality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in the field of public health research and practice for the past ten years, with a particular focus on the relationships between gender, sexuality and health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.