Observations About Gender Norms and Health - Part 2

By Lori A. Rolleri, MSW, MPH | October 24, 2017
Principal, Lori Rolleri Consulting

Gender norms have a deep impact at all levels of our society and culture. In Part 1 of this post, I talked about some of the ways inequitable gender norms can negatively affect health behaviors and outcomes. In this post, I’d like to take a look at how we can use evidence-informed strategies to change that. How do we address harmful gender norms in curricula designed to prevent adolescent pregnancy and STIs?

A Framework for Gender Programming

In 2000, Geeta Rao Gupta, then president of the International Center of Research on Women (ICRW), presented a continuum of approaches to addressing gender in health programs. Her model was designed to help program developers achieve greater impact. Along this continuum, four approaches to integrating gender into programs are described: (1) gender exploitative, (2) gender blind, (3) gender accommodating and (4) gender transformative.

Gender Exploitative

Gender exploitative programs take advantage of traditional gender roles to achieve project outcomes. For example, a social marketing campaign that uses an aggressive image of masculinity to promote condoms might have a positive effect on condom use. It appeals to the way some men want to see themselves, based on the gender characteristics they have been conditioned to admire. However, such a campaign can also reinforce traditional roles of men being the dominant partner in sexual relationships. This practice approach should be avoided.

Gender Blind or Neutral

Gender blind or gender neutral programs fail to acknowledge the role of gender in their theory of change. Many effective evidence-based pregnancy and STI prevention programs fall into this category. Gender blind programs do not necessarily do harm, but they may indirectly and unintentionally support the status quo of gender inequality.

Gender Accommodating or Sensitive

Gender accommodating or gender sensitive programs recognize and respond to existing gender norms and inequities. They seek to implement strategies that adjust to these norms. These programs do not actively seek to change gender norms and inequities, but they do try to limit any harmful impact.

For example, a reproductive health care facility that offers a male-friendly clinic during hours when young men are likely to attend can be very effective at providing needed services, but it does not necessarily work to change harmful gender norms that may be driving young men’s unhealthy sexual behavior.

Gender Transformative

Gender transformative interventions aim to accomplish three tasks: (1) raise awareness about unhealthy gender norms, (2) question the costs of adhering to these norms, and (3) replace or redefine unhealthy, inequitable gender norms with healthy and equitable ones.

Gender transformative programs often take an ecological systems approach—that is, they aim to change multiple forces in a person’s environment that may be perpetuating harmful gender norms (e.g., schools, workplaces, families, health centers, media, government).

Gender transformative programs also often take what is called a “gender synchronized approach.” Gender synchronization recognizes that gender is a relational concept; that is, it is difficult to change masculine gender norms without also changing feminine gender norms and vice versa.

Evidence-Informed Strategies for Change

Build Awareness of Gender Norms

1. Increase knowledge and awareness about existence of gender norms. What are the common gender norms in the community? Raise awareness about the existence of these gender norms for girls and boys. For example:

• Talk about data. Present and discuss sex data showing how men and women are impacted differently by certain health or social conditions (e.g., HIV, poverty, violence).
• Talk about media. Present and discuss a newspaper story, video clip, advertisement, and so on, depicting harmful gender norms. Ask youth how men and women are portrayed differently; what different messages they get about being in romantic relationships; and whether they think these portrayals are realistic and fair.
• Use theater. Develop a role play or skit where harmful, inequitable gender norms play a role in the decision a couple makes to use condoms or abstain from sex. Ask youth to identify the gender norms being played out in the skit. 
• Talk about real-life experiences. Ask youth to think about and discuss a time when they believe they were treated differently (either better or worse) because of stereotypical gender norms. 

Address the Costs of Gender Norms

2. Increase knowledge about the costs of adhering to rigid gender norms. Use critical questioning to bring forth the reasons why these gender norms exist and what their costs are to men and women. Critical questioning uses open-ended questions and challenges whether a belief is true, partially true or false. Youth are encouraged to use evidence to support their point of view.

Here’s an example of a critical question thread examining one popular gender norm:

• Some people believe that men can demonstrate their “manliness” by having many sexual partners. Where does this belief come from?
• How do you feel about this belief? Is it true, or partly true, or totally false?
• What are some of the ways this belief or norm affects the health and well-being of men? Women?
• How might life be different if people didn’t have this belief?
• On the balance, do you think there are more negatives or positives for men who hold this belief? For women?

Shift Towards Healthy Norms

3. Shift unhealthy gender norms towards healthy ones. Create opportunities for youth to reconfigure harmful, inequitable gender norms into healthy, equitable ones. 

• Do a skit. Guide youth in the development of a role play or skit where men and women present healthy, gender equitable relationships.
• Use peer leaders. Invite peer leaders to talk about ways they have challenged harmful gender norms and how this has affected them.
• Teach skills. Teach youth new skills that will help them transform harmful gender norms and practices. This might include things such as conflict resolution; communication and negotiation skills about sex, condoms, getting tested; advocacy and support for girls’ empowerment.
• Critique media. After critiquing a newspaper story, advertisement, video or song lyrics, ask youth to think about how the story could be changed to reflect healthy gender norms.
• Write stories. Read a scenario that describes a negative outcome related to unhealthy gender norms. Ask youth to rewrite the scenario using healthy gender norms that lead to a more positive outcome.

Increase Skills

4. Increase skills needed to support more gender-equitable behavior. Even if knowledge, attitudes and peer norms are changed, some youth will need skills to behave in a gender equitable way. For example, if girls are conditioned to be passive communicators, they will need training on how to communicate assertively. If boys are conditioned to deal with conflict using violence, they will need training on how to resolve conflict using non-violent methods.

Model Gender Equality

4. Model gender equality in your words and actions. Young people learn from what they observe. Some questions to ask yourself: 

• Do you encourage boys and girls to participate equally in the classroom? Are girls and boys given equal time to speak? Equal chance to lead? 
• Are girls and boys who misbehave disciplined in the same ways?
• Do you support boys and girls in pursuing a variety of goals, activities, and roles? Or do you consciously or unconsciously steer girls and boys into traditional roles?
• Think about the images in your classroom, textbooks or teaching materials. Do they portray gender equitably?
• Think about the language you use. Do you use words such as “mankind,” “policeman,” “man power” or “man a table”? Adopt gender neutral language such as “humankind,” “police officer,” “human resources” and “staff a table.”

Cultivate Empathy

6. Cultivate empathy. Empathy is the ability to recognize, understand and respond to another person’s thoughts or feelings. Create situations where girls and boys are able to put themselves in new roles and empathize with each other’s experience. The fishbowl technique is one activity you might consider (see p. 34 in this report for an example). By understanding the pressures, costs and impact of living by a set of socially constructed gender rules, youth may feel greater motivation to treat each other in gender equitable ways.

Integrate Into Other Activities

7. Integrate gender into other learning activities and content. While it is good to have one or more dedicated lessons on the topic of gender, do not stop there. Learners’ awareness of gender and ability to challenge gender norms will be increased when gender is integrated into as many learning activities as possible.

Present Equitable Messages

8. Present clear, consistent and equitable messages about gender. Repeat these messages throughout the curriculum. It is best to test these messages with the youth you intend to serve to make sure they resonate before promoting them. Here are some I like:

• “Our strength is not for hurting. Show your strength—get tested.” (For men, Men Can Stop Rape)
• “I am strong. I am powerful. I protect myself from HIV.” (For girls, SiHLE) 
• “I decide what being a man or a woman means to me.”  (For girls and boys, Gender Matters)

Avoid Exploitive Approaches

9. Avoid unintentional gender exploitative approaches. Avoid activities or practices that may unintentionally reinforce harmful stereotypes about gender. For example:

• Do messages and images about obtaining reproductive health care services primarily focus on women? Do they suggest reproductive health is solely a woman’s concern? 
• Are men and women primarily represented in traditional gender roles? (e.g., women care for children and do housework, men provide; men seek sex, women set limits; women are submissive or “sexy”).

Consider Environments

10. Consider other forces in the learners’ environment. How can you complement the curriculum with activities that impact systems in a youth’s environment. For example: 

• Get parents involved. Include a homework assignment where youth interview their parents/guardians about sex and gender norms, or have youth and parents analyze a TV show or song lyrics for gender norms.
• Get the whole school involved. Engage youth in a school-wide campaign promoting gender equitable messages.
• Get the community involved. Invite community leaders to speak about positive, equitable gender norms.
• Write letters. Consider writing a letter to the newspaper or a political representative about a gender inequitable story/issue.
• Look at laws. Review and discuss a state or national law that encourages or discourages gender equality (e.g., maternity/paternity leave, Title IX).

Are You Trying to Make My Kid Transgender?

When we talk about gender norms and gender transformative programming, some parents or community members misunderstand the nature of the work. I’ve even had colleagues ask if I was trying to make every student transgender.

This means we have a lot of educating to do about gender roles and inequitable norms. Sometimes I think we just need to change something about our language and the way we talk about the work.

What are your suggestions?

Helping Teens Understand

What are your thoughts?

Lori Rolleri, MSW, MPH, is principal of Lori Rolleri Consulting, an independent public health consulting practice. Her work focuses on program assessment and planning, development and testing of behavior change interventions, training and technical assistance, technical writing and business development. Her primary areas of practice are sexual and reproductive health, adolescent development. gender equality, intimate partner violence prevention and parenting. She can be contacted at: lorirolleri@gmail.com.