Sex & gender
Women are biologically different and continue to play different roles in society from men, particularly with respect to housework and caring activities—even when women work for pay.
Sex refers to the biological characteristics that distinguish female from male bodies, such as body size and shape. Women’s anatomy, genetics, hormones and physiology are different from men’s. This means some health issues only affect them (e.g. pregnancy and breast, cervical, ovarian cancers) and some health conditions affect them differently than men (e.g. lung cancer, schizophrenia).
- Females and males have different chromosomal patterns. Females have two X chromosomes. Males have one X and one Y chromosome;
- Sex differences account for the differences in women and men’s reproductive organs, hormones and the amount of fat to muscle we have on our bodies;
- Biology influences how our bodies work, how we see ourselves, how we appear to others, what keeps us healthy and what kinds of care we need.
Traditionally the health system treated people according to what was normal for male bodies. Health care researchers and providers understood health by how males experienced symptoms, disease, medications, and treatment. It was assumed that what worked for men would also work for women. Today this belief is changing.
Research continually shows that women’s experience of health is different than men’s. These differences are helping us develop new knowledge about women’s bodies and how different diseases, conditions, and health care impact women differently. For example, studies show women’s and men’s bodies react differently to alcohol, drugs and medications.
Gender also plays a key role in our overall health. Gender refers to the social roles, relationships, attitudes, behaviours and expectations that shape what it means to be female or male in our society. For example, gender influences what we think is appropriate behaviour, such as baby girls wearing pink and baby boys wearing blue. While these influences may be true, gender is most commonly talked about as the product of socialization, not the process. We usually refer to the process as gender role socialization. Gender:
- Influences how we feel, how we dress or talk, our goals in life, and what society considers acceptable as male or female;
- Roles influence our behaviour within the family, workforce or school system;
- Impacts social status and income: in almost every society men are paid more for similar roles and have more power than women.
Gender affects women’s health in many ways by impacting:
- Our exposure, risk or vulnerability to health conditions;
- The nature, severity or frequency of health problems;
- The ways in which we and others perceive our symptoms;
- Our behaviour and attitudes towards accessing care;
- Our access to health services;
- Our ability to follow prescribed treatments;
- Our long-term social and health consequences.
Not everyone identifies as female or male, woman or man. Some people identify with a gender that is different from the sex they were assigned at birth. Many people:
- Do not identify as any gender, neither male or female (agender, gender-independent);
- Go back and forth in identifying as male or female or identify as all genders (gender fluid, pangender); multi-gendered, outside the gender binary;
Some Indigenous Peoples identify as two-spirit to recognize their cultural and spiritual heritage and gender diversity.
Gender identity is not the same as sexual orientation. Sexual orientation is who you are sexually attracted to and/or with whom you prefer to have a sexual relationship.
The Vancouver Coastal Health Authority (VCH) Transgender Health Information Program
uses the term 'transgender' (trans) to describe “the wide range of people whose gender identity and/or gender expression differ from their assigned sex and/or the societal and cultural expectations of their assigned sex.”
- You may have been born with male sex organs but your internal sense of yourself is as a woman;
- You were born female but you don’t identify as either female or male.
It is important to note that sexual orientation is different from gender identity. The VCH Transgender Health Information Program states that everyone has both a gender identity and a sexual orientation. Trans people can be straight, pansexual, queer, asexual, bisexual, lesbian or gay, or something else.
Being transgender impacts your health on a number of levels. You may face:
- Discrimination and violence
- Health care providers who are insensitive to your personal identity
- Financial barriers that prevent you from accessing health care
There are other factors that impact women’s health and well-being in addition to sex and gender. While women have the same biology and are also diverse. Women have different cultural backgrounds, ethnicities, ages, educational backgrounds, incomes, sexual orientations, and abilities and live in different environments (e.g., rural, suburban, urban). This diversity means some women may be more at risk for certain health conditions or face challenges accessing health care than others.
Diversity refers to such differences in our ethnicity, culture, education, income, age, sexual orientation, and ability. Such diversity affects our values, beliefs and behaviour, all of which impact our health. For instance,
- Women living in rural areas have less access to health care than women living in urban centres;
- Women living with disabilities often have lower incomes and higher rates of unemployment that increase their risks for poor health;
- Lesbian, bisexual and transgender women experience more discrimination which impacts their health and access to health services.
The differences between women, from our unequal economic status to discrimination we may face due to our skin colour or sexual orientation, affect us in unique ways and put some women at greater risk for poorer health outcomes than others.
Equity happens when social systems and policies ensure everyone has access to the resources, power and opportunities they need to support their health and well-being in all aspects of life. A lack of health equity refers to unfair, unjust or preventable differences in health status within and among groups of people (populations)
Examples of inequities include women are:
- More likely than men to be paid less in the workplace. Women in Canada make approximately $8,000 less a year than men doing the same kind of work;
- Nearly half of the Canadian labour force but hold only 5.3 per cent of Canadian Chief Executive Officer (CEO) positions;
- Almost twice as likely as men to do more than 15 hours of unpaid housework per week.
When women experience inequities, it increases their health risks, impacts their attitudes about their health and reduces their ability to get the care they need to maintain or regain their health.