{"id":47189,"date":"2020-04-17T19:29:13","date_gmt":"2020-04-17T18:29:13","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=47189"},"modified":"2020-10-27T10:28:52","modified_gmt":"2020-10-27T09:28:52","slug":"gender-equality-should-not-be-about-competing-vulnerabilities","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/17\/gender-equality-should-not-be-about-competing-vulnerabilities\/","title":{"rendered":"Gender equality should not be about competing vulnerabilities"},"content":{"rendered":"<p><em>Pascale Allotey and <span style=\"font-size: 1rem\">Michelle Remme<span style=\"font-weight: 400\"> discuss solutions and strategies to tackle gender equality<\/span><\/span><\/em><\/p>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400\">This year, 2020, marks the 25<\/span><span style=\"font-weight: 400\">th<\/span><span style=\"font-weight: 400\"> anniversary of the Beijing Declaration and Platform for Action where 17,000 participants, 30,000 activists and 189 governments met in China to affirm that equality between women and men is a matter of human rights and a condition for social justice.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The declaration acknowledged that while the status of women had advanced in some important respects, progress was uneven, inequalities persisted, obstacles remained, and these had serious consequences for the health and wellbeing of all. The call to action brought the peripheral \u2018women\u2019s agenda\u2019 into the mainstream development agenda, and has been the foundation for a range of initiatives to promote women\u2019s empowerment as a means to achieve equality. However, gender equality and how to achieve it has, in broad terms, resulted in three, often competing, agendas.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">First, the agenda to improve women\u2019s health outcomes remains unfinished. This agenda holds as its central tenet, the transformation of gender power relations as fundamental to gender equality. Health outcomes for women who face sexual and other forms of violence cannot improve in societies that do not hold partners and other perpetrators to account. Women are unable to fulfil their potential or exercise their rights over their own bodies where policies deny access to sexual and reproductive health services. Women are unable to contribute to the development of scholarship, evidence, policies and practices that impact on their lives when societal norms perpetuate structures that exclude women from opportunities to engage. The empowerment of women is critical to this agenda in order to redistribute and balance power.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The second agenda relates to men\u2019s health outcomes. Harmful and restrictive gender norms around masculinity contribute to the underlying causes of poor health outcomes for men and boys, such as of high rates of suicide and high-risk behaviours.<sup>1<\/sup> The evidence for the poorer health outcomes is borne out through the global burden of disease studies. While the analysis draws on gender roles, the dynamic does not rely on the prevailing impact of patriarchy and gender power relations. However, targeted interventions focused on men\u2019s health could reduce the overall burden of disease, with spillover benefits for the psychological and physical health of their female partners, family members, and society as a whole.<sup>2<\/sup><\/span><\/p>\n<p><span style=\"font-weight: 400\">A third agenda outlines the need to refocus the gender discourse to recognize the fallacies of heteronormativity and of gender as binary. The arguments for gender equality under this agenda highlight the intersectionality of gender power relations and the stigma and mistreatment often faced by LGBTQI communities. Addressing gender equality under this agenda would need to include the development of an evidence base to better understand\u00a0 the range of health needs, as well as strategies to uphold rights and eliminate discrimination.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">These agendas have created arguments for competing vulnerabilities, competition for resources and have diluted efforts to advance gender equality. The dissonance relates to a fundamental difference in the expected outcome of equitable health policies and programmes. For the women\u2019s rights and LGBTQI rights advocates, gender equality (and equity) is one of the outcomes of health programmes, and is on equal footing with health impact. Within a public health approach, which underpins many of the men\u2019s health arguments, better health is the primary goal, and gender equality is instrumental in contributing to the improvement of health outcomes. In reality, however, there are significant opportunities for convergence. Gender equality should not be about competing ideologies.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">From a rights perspective, equality is not a zero-sum game \u2013 rights for one do not reduce the rights of another. Interventions to advance gender equality from the perspectives outlined above, all have the potential to improve ease of access to healthcare and resources.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We need different agendas promoting the specific health needs of women, men and people with non-conforming gender identities. But we also have a common agenda, which is to promote policies, approaches and investments that aim to transform structural gender inequalities and power dynamics.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We need to retain \u2018proximate\u2019 gender strategies that focus on women\u2019s empowerment, redefining masculinity or promoting diversity to overcome barriers and drive health access. However, we also need to go beyond these strategies, and refocus our efforts to address the upstream gendered power inequalities together. Otherwise, a gender equality agenda from a men\u2019s health perspective could focus on changing restrictive norms around masculinity, self-care and health-care seeking alone, and miss out on the opportunity to address the deeper power and privilege that underlies the perpetration of violence against women.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Achieving gender equality cannot be described with statistical data alone. Where inequality is rooted in the maldistribution of power and resources, the social justice perspective that underpins global health provides strong justification for interventions that have an explicit values agenda to right the wrongs in society.<sup>3<\/sup><\/span><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Pascale Allotey<\/strong> is the Director of the United Nations University&#8217;s International Institute for Global Health.\u00a0<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Michelle Remme<\/strong> is a Research Fellow at the United Nations University\u2019s International Institute for Global Health.<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Competing Interests:<\/strong> None.<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Acknowledgements:<\/strong> T<\/span><span style=\"font-weight: 400\">his opinion article draws on discussions from the group of \u2018gender disruptors\u2019 who met at a dialogue hosted by UNU-IIGH in April 2019.<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n<ol>\n<li><span style=\"font-weight: 400\">Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men\u2019s health gap: men must be included in the global health equity agenda. Bull World Health Organ. 2014 Aug 1;92(8):618\u201320.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400\">Hawkes S, Buse K. Gender and global health: evidence, policy, and inconvenient truths. The Lancet. 2013 May;381(9879):1783\u20137.<\/span><\/li>\n<li><span style=\"font-weight: 400\">Khosla R, Amin A, Allotey P, Barroso C, George A, Hardon A, et al. \u201cRighting the wrongs\u201d: addressing human rights and gender equality through research since Cairo. Sex Reprod Health Matters. 2019 Jan 1;27(1):329\u201332.<\/span><\/li>\n<\/ol>\n<p><em>This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/igo\/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.<\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pascale Allotey and Michelle Remme discuss solutions and strategies to tackle gender equality [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/17\/gender-equality-should-not-be-about-competing-vulnerabilities\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":46809,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[263],"tags":[],"class_list":["post-47189","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-global-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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