Gender inclusion in global health can start with our words

What is the impact of language that, implicitly or explicitly, excludes women? Drs Anthea Katelaris & Meru Sheel discuss

There is increasing recognition that women are uniquely affected during public health emergencies. For example, women may be exposed to infections in their roles as caregivers, as seen with Ebola outbreaks. The needs of women may be overlooked in responses, illustrated by the unmet need for comprehensive sexual and family planning services during the 2015-2016 Zika virus outbreak. Furthermore, maternal mortality may increase if access to maternal health services is interrupted.

Appropriate responses require workforces to reflect the populations they serve. This means it is crucial to have women, from diverse backgrounds, represented at all levels of preparedness and response efforts, to ensure the needs of women get specific consideration. While women remain under-represented in leadership roles in global health, there are increasing efforts to explore and address these inequities, for example through the Women in Global Health movement.

But how often do you still hear male-centred language used as the default? Manpower. Mankind. Forefather. Fraternity. We hear these words almost every day. We think the impact of language that, implicitly or explicitly, excludes women is underappreciated and requires our attention.

We think that male-centred language perpetuates the exclusion of women in health and medicine. Linguistics tells us that language has the power to shape beliefs and unconscious biases in subtle ways, which affect behaviours and actions, and become reality. Male-centred terms may also contribute to subliminal messaging that reinforces women’s underrepresentation in historically male-dominated fields and leadership roles. It is easy to dismiss this as political correctness. But this is not merely an annoyance or formality. Words matter, and the wrong ones can distance women, undermine confidence, and contribute to imposter-syndrome.

Given our everyday word choices have meaning and power, changing the language we use can be a starting point in creating change. This requires active effort, because it is pervasive and often unnoticed. Instead of ‘manpower’, we should use ‘workforce’, ‘personnel’, or ‘staff’. Try ‘community’ instead of ‘fraternity’, ‘forebears’ or ‘ancestors’ instead of ‘forefathers’, and ‘humanity’ instead of ‘mankind’. The global health community, and the health sector in general, can also make conscious efforts to speak up and educate others when gender-exclusionary terms are used.

Addressing women’s participation and representation in global health is complex and requires diverse approaches. However, as a community we must at least commit to using language that is inclusive, to create an environment in which women can feel empowered to participate. This is no more important than in global health, where the stakes are so high and gender considerations need prioritising. Words have power to shape how we think and act, so we need to choose them thoughtfully.

About the authors:

Anthea Anthea Katelaris (@AntheaKatelaris) is a public health doctor completing her specialist training with the Australasian Faculty of Public Health Medicine. She studied Public Health at the London School of Tropical Medicine & Hygiene and is currently undertaking field epidemiology training through the Australian National University.



Meru Sheel (@MeruSheel) is an epidemiologist and Senior Research Fellow at the National Centre for Epidemiology and Population Health at the Australian National University. She passionate about global health, and diversity, equity and leadership in the health sector.


Competing interests: We have read and understood the BMJ policy on declaration of interests and declare we have no conflicts of interests.

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