HIV Prevention,Gender and Sexual Health

Abstract

Drawing on a review of relevant literature as well as global experience, this paper focuses on aspects of the growing feminisation of the HIV epidemic, especially the combination of age and gender which makes young women particularly vulnerable to HIV. It also briefly touches upon the gender-constructed vulnerability of young men. The linkages between gender, sexual health and HIV-and what works to forge these linkages-have now been well established. Not acting on the basis of this knowledge in order to avert millions of infections and deaths due to HIV, is no longer an option.     

Gender and Feminization in Health Care Professions

Within health care, there has long been a gender division of professional labor: men have predominated in higher-status, higher-paying professions like medicine and dentistry, while women’s health care work has been clustered in so-called support occupations such as nursing. Historically, health care professions were gendered, and beliefs about gender came to be embedded in professional work. Recently, however, traditional gender divisions of labor are being challenged by the feminization of professions in the United States and Canada. Women’s participation is expanding in traditionally male-dominated professions. This article explores the nature and causes of this feminization and considers whether feminization is changing the significance of gender to health care employment.     

Understanding Gender as a Fundamental Cause of Health: Simultaneous Linear Relationships between Gender,Mental Health,and Physical Health Over Time

Abstract

Responding to calls to move beyond mental or physical health examinations of gender and health, and to systemically understand the relationships between mental health, physical health, and social identity locations, we explored the extent to which gender is a fundamental cause of health by estimating the relationships between gender, mental health, and physical health simultaneously. We analyzed nationally representative longitudinal data from Waves I and III of the American Changing Lives Survey, and estimated general and gender-specific structural equation models to better understand direct and indirect effects of the structural relationships between gender, mental health, and physical health over time. Our findings suggest mental health outcomes drive the likelihood of physical health outcomes in the case of women only, whereas for men, there is no direct nor significant relationship. However, we find persistent effects of anxiety on limited daily activities for men, but not for women. In conclusion, we discuss potential lessons learned from using such analytic methods and the implications of our findings as they relate to gender and health.     

Integrated Behavioral Health and Counseling Gender and Sexual Minority Populations

abstract

Counselors are increasingly expected to operate within an integrated behavioral health framework across systems of care. This critical literature review provides an overview of the integrated behavioral health paradigm, including the practice of interprofessional collaboration, with specific application to lesbian, gay, bisexual, transgender, queer (LGBTQ), and other gender and sexual minority issues. Implications for practice and research are discussed, along with a focus on concrete recommendations for application practicing interprofessionally with and on behalf of LGBTQ clients.     

Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents

SUMMARY

This paper will focus on ethical dilemmas that arise in the treatment of adolescents with gender dysphoria. We will begin with a discussion of ethical and legal issues pertinent to the treatment of any adolescent, and then proceed to the gender dysphoric adolescent, since there is a great deal of overlap between the two areas. The authors re-view legal decisions, the existing data on adolescent decision-making, and ethical principles that may help the clinician in resolving some very complex situations. Utilizing case vignettes of three gender dysphoric adolescents, the authors provide a pragmatic illustration of the ethical dilemmas involved in evaluation and treatment of these youth. It is the authors' belief that treatment interventions should be based on respect for the adolescent's autonomy and confidentiality where he or she is deemed competent to make decisions.     

Men,Gender, and Health: Toward an Interdisciplinary Approach

Abstract

The anatomy and physiology of the ears, nose, and sinuses are reviewed. Diseases and injuries typically associated with water sports are discussed, with emphasis on pathophysiology, treatment, and preventative measures.

“Screening for Chlamydial Infections in Women Attending Family Planning Clinics: Evaluation of Presumptive Indicators for Therapy,” JULIUS SCHACHTER, EILEEN STONER, and JEANNE MONCADA. Chlamydia trachomatis was recovered from the cervices of 9.8 percent (268/2,729) of women attending seven family planning clinics. The infection rate varied from 5.5 percent to 22.5 percent in different clinics. Chlamydial infection could be associated with younger age, nulliparity, being black and use of oral contraceptives. Most (70 percent) of the chlamydial infections were inapparent and presumptive indicators for antichlamydial therapy that are useful for symptomatic women will not make a major impact on this reservoir. It is concluded that chlamydial cultures are needed to deal with the high prevalence of these infections. (Western Journal of Medicine 1983 Mar;138:375–379.)     

Gender and Employment Restructuring in British National Health Service Manual Work

While managerial initiatives to cut costs through increased labour flexibility are widespread, we have limited knowledge of the micro-politics of gender and contemporary restructuring at the local level: of the processes and dynamics through which flexibility and other initiatives reconstitute or transform gendered patterns of work and advantage in specific workplaces. This case study, based upon extensive interviewing, observation, and examination of documentary materials, examines the gender implications of several different types of restructuring initiatives in three types of manual work at two hospitals in an NHS Trust. On the whole, it finds that restructuring created more continuity than change in gendered patterns of work and advantage in the two sites. The case study suggests, first, that employment restructuring incorporates elements of structural, institutional and interactive gendering; managers use women's subordination in the workplace and labour markets to achieve their objectives, and male workers actively resist loss of their advantages. Second, it suggests that competitive tendering exercises have a disproportionately negative impact upon women workers, while functional flexibility initiatives are somewhat more positive. Third, the case study suggests union resistance to restructuring is limited and particularly circumscribed in relation to restructuring of women's jobs.     

The Effects of Sexual Orientation,Gender Identity,and Gender Role on the Mental Health of Women in Taiwan's T-Po Lesbian Community

SUMMARY

We obtained via the Internet a convenience sample of Taiwanese heterosexual (n = 287) and sexual minority females (n = 260). A significantly greater percentage of sexual minorities (lesbian and bisexual females) than heterosexuals reported they had used tobacco or alcohol. Relative to heterosexuals, sexual minorities were significantly more likely to report a serious suicide attempt. Overall, gender identity (masculine, feminine, and androgynous) and gender role (butch, femme, and pure or undifferentiated) were poor discriminators of lesbian mental health. Differences between sexual minorities and heterosexuals were more robust than were the variations in gender identities and gender roles among lesbian and bisexual women. We discuss the implications of these findings for further clinical research.     

Gender and the Mental–Physical Health Connection Among U.S. Adults

Using data from the 1995, 1998, and 2001 panels of Aging, Status, and Sense of Control (ASOC) Survey, we examine gender differences in the relationship between self‐rated physical health and mental health over time (n = 2,543). Gender‐stratified path models highlight how the nature of the mental–physical health relationship changes when we use indicators of mental health that have traditionally been labeled as female sensitive (depression) or male sensitive (heavy drinking). Results show that women and men are similar in that mental health has a stronger effect on physical health than the reverse. However, this is only the case when we use gender‐sensitive measures of mental distress: Men who drink heavily and women who are depressed report poorer self‐rated physical health over time, while heavy drinking for women and depression for men have no significant effects on their self‐rated physical well‐being. These results provide evidence of a health process that is gendered in its expression but more universal in its outcome—the exact measure might vary, but men and women alike are physically harmed by mental health problems.     

The Politics of Reproductive Health in Peru: Gender and Social Policy in the Global South

This article analyzes the politics of reproductive health policy-makingin Peru in the context of healthcare reform initiatives undertakensince the early 1990s. In Latin America, women's body politicsare emerging within a complex architecture of institutionalizedsocial stratification and religious lobbies. The case of Peruis approached from a gendered, specifically South-World analysis,revealing the deep embedding of a vast constellation of reproductivehealthcare issues within the nascent social welfare policy-makingprocess. Through limited national public health insurance schemes,a new social policy model, based on a targeted poverty-reductionparadigm, is now partially addressing the reproductive healthneeds of the majority of Peruvian women. Policy implementation,however, is highly contested, fragile, and has been subjectto setbacks and deadly abuses. The article shows that, in addressingdeveloping countries such as Peru, the role of internationalactors and the impact of unconsolidated democratic institutionsare two key variables in the comparative analysis of socialpolicy regime formation.     

Gender Difference and Gender Disadvantage

This paper explores the theoretical foundations of American sex discrimination law. Traditional legal frameworks have analyzed gender issues in terms of gender difference. Yet, inder this approach, sex-based differences have been both overlooked and overvalued. In some instances, such as occupational restrictions and military service, courts have transformed biological distinctions into cultural imperatives. In other cases, such as those involving pregnancy, sex-based differences have remain unacknowledged and unaddressed. The alternative framework proposed here focuses less on gender difference than on gender disadvantage- on inequalities in the sexes' social status, political power, and economic security. Taking issues surrounding occupational restrictions, protective labor, and maternity policies as representative samples, the paper suggests how a contextual inquiry can usefully shift gender discrimination law from its focus on difference to the consequences that follow from it. For most of this nation's history, the law's approach to gender difference has alternated between exaggeration and neglect. Neglect has been the preferred strategy; the recent cluster of Bicentennial conferences on women and the Constitution is an ironic reminder of the fact.¹ When the nation's founding fauthers spoke of "We the People" they were not using the term generically. Although subject to the Constitution's mandates, women were unacknowledged in its text, uninvited in its formulation, unsolicited in its ratification, and, before the last quarter-century, largely uninvolved in its interpretation. Yet, as these recent conferences also testify, such patterns of silence have been broken. Women have found a voice. How we should use it is a question worthy of greater exploration. The following analysis considers a specific set of questions about voice. How we describe the relation between the sexes involves a politics of paradigms that legal decision makers rarely acknowledge or address. For the most part, traditional legal frameworks have analyzed gender issues in terms of gender difference. Under this approach, sex-based distinctions have been both overvalued and overlooked. In some contexts, such as occupational restrictions, courts have transformed biological differences into cultural imperatives. In other cases, such as those involving pregnancy, those differences have remained unrecognized. Significant progress will require an alternative framework, one focused not on gender difference but on gender disadvantage.     

Gender and the state

The article argues from a Nordic, feminist and poststructuralist position that feminist state theories need to be developed methodologically. This claim is based on both theoretical arguments as well as empirical arguments arising from a case study on care politics in Denmark. In contrast to answering questions about the essence of the state, the aim of the article is to provide some analytical tools for studying the state. First, it focuses on two paradigms of feminist analyses of the state: differences between states (Nordic feminists), and differences within states (poststructural feminists). The article argues that each of the approaches has its merits and problems in terms of feminist engagements with the state. The second part explores an empirical case study on care politics in Denmark. The study illustrates the inadequacies of feminist approaches to the state to date. State discourses and policies on home-helpers are shown to have both empowering and disempowering effects on the women concerned. The third part of the article suggests a framework of three concepts believed to be helpful when analysing gender and the state: hegemony, contradictory effects and boundaries. The concepts are generated from the case study.     

Gender Role Ideology and the Gender Based Differences in Earnings

Much of the research on gender differences in occupational earnings still focuses on human capital and the structure of the labor market. However, these variables rarely explain even half of the gender gap in earnings. Most research has examined the impact of gender role ideology as it impacts occupational choice, which indirectly can impact earnings. Using data from the National Opinion Research Center General Social Surveys, this research focuses on the relationship between attitudes about gender roles and two variables: (a) earnings, and (b) occupational positions held by women and men. Findings show that traditional gender-role ideology contributes to lower observed earnings for both males and females, independent of the influences of human capital characteristics, occupational context, and ascribed characteristics. Results support socialization as a partial explanation for the gender-based earnings differences and suggest that, to the extent that economic rewards are used to assess the value of gender role expectations, traditional gender role attitudes might continue to change and lead to relatively equal earnings among women and men.     

The Social Costs of Gender Nonconformity for Transgender Adults: Implications for Discrimination and Health

Research suggests that transgender people face high levels of discrimination in society, which may contribute to their disproportionate risk for poor health. However, little is known about whether gender nonconformity, as a visible marker of one's stigmatized status as a transgender individual, heightens trans people's experiences with discrimination and, in turn, their health. Using data from the largest survey of transgender adults in the United States, the National Transgender Discrimination Survey (N = 4,115), we examine the associations among gender nonconformity, transphobic discrimination, and health‐harming behaviors (i.e., attempted suicide, drug/alcohol abuse, and smoking). The results suggest that gender nonconforming trans people face more discrimination and, in turn, are more likely to engage in health‐harming behaviors than trans people who are gender conforming. Our findings highlight the important role of gender nonconformity in the social experiences and well‐being of transgender people.     

Socioeconomic and Gender Health Disparities in Diabetes: The Lower Middle Income Case of Ghana

While literature theorizing the relationship between socioeconomic status (SES), gender, and health outcomes is robust in high‐income countries, there is less scholarship examining how SES affects men and women in lower middle income countries (LMICs). Focusing on the LMIC case of Ghana, I use Wave 1 of the World Health Organization Study on Global Aging and Adult Health (SAGE) to examine the relationship between SES and diabetes among Ghanaian women and men. Specifically, I examine how key SES measures such as educational attainment, employment status, and income singly and collectively predict the odds of diabetes for Ghanaian men and women. I also examine the explanatory value of the reversal hypothesis, which posits that those of high SES experience higher rates of non‐communicable diseases. Overall, I find that while Ghanaian men experience increased odds of diabetes with increased education, Ghanaian women have higher odds of diabetes compared to men regardless of educational attainment. Understanding health patterns in LMICs like Ghana is important for sociological inquiry on health disparities seeking to incorporate more global perspectives.