Gender –4/18/01

Health – Sex and gender relationship affect health status and they interact with other factors – social class, race and ethnicity, age, sexual orientation – to shape not only health status, but also the physician-patient relationship and treatment by the health care system.

Harrison – Traditional constructions of gender are hazardous to our health.

With regard to physical health, traditional masculinity appears to put men at greater risk for a variety of physical conditions, such as heart disease and stroke, various forms of cancer, and chronic liver disease. Their greater likelihood to smoke, drink alcohol, and engage in violence renders them more susceptible not only to these diseases, but also to accidents, homicide, successful suicide, and alcohol and illicit drug abuse. In fact, it seems that the more a man confirms to traditional masculinity, the greater is the risk to his health.

Statistics:

Gender gap in life expectancy. 6.4 years longer for women. 78.8 vs. 72.2 this is modified by race: white males 73.4 vs. black males 65.2. White females 79.6 vs. black females 73.9

What are some of theories –

Biological Theories:

Chromosomal: The presence of two X-chromosomes in females is significant. The X chromosome carries more genetic information than the Y, including some defects. However, a female typically needs two defective X chromosomes for most genetically linked disorders to manifest themselves; other one healthy X chromosome can override the abnormal one.

Hormonal – estrogens appear to give women some protection against heart disease.

Marital Status – related to life expectancy for men. This relationship did not hold for women; women were more negatively affected by low income than by lack of a spouse.

Most studies report that men rely almost totally on their spouses for social support. Women have wider social support networks than men. When a woman’s husband dies, she retains the social support of relatives and friends.

Heart disease – number of behavioral and cultural factors that are contributors

Cigarette smoking higher for men.

Type A personality (Coronary Prone Behavior Pattern) Characteristics of Type A individuals are more than twice as likely as laid-back Type B personalities to suffer heart attacks, regardless of whether or not they smoke. Characteristics of type A closely parallel those typical of traditional masculinity: competitive, inpatient, ambitious, aggressive, and unemotional.

Type D – strong, silent type.

Class enters in – serious stressors in blue-collar workers – speed-ups, little or no control over work, and low rewards.

Cancer -

Men’s death rate due to cancer is more than 58% higher than women’s cancer death rate. Cigarette smoking contributes to this – lung cancer.

Industrial hazards – asbestos, exposure to toxic fumes, and chemicals. Men are more likely to experience toxic workplace exposures – another byproduct of occupational sex segregation.

Although men make up 54% of the labor force, they account for 92% of workers who die from job-related injuries.

Other causes – chronic liver disease and cirrhosis of the liver are frequently caused by excessive alcohol consumption and related malnutrition. Men are more than four times more likely than women to drink heavily are are. Contributes to higher accidental death rate.

Aggressiveness – higher suicide rate and their higher death rate due to homicide.

Alcohol and Drug Addictions – hyper-masculinity related to higher rates of substance abuse.

Traditional Femininity: The same appears to be true with regard to women who firmly adhere to traditional femininity.

Heart Disease – While employed women face the doubly stressful burden of job responsibilities couples with home and family care, they do not appear to more likely than full-time homemakers to develop coronary heart disease. In fact, some studies indicate that just the opposite may be the case. In general, women employed outside the home appear to be healthier than nonemployed women, even when employed women must fulfill multiple roles.

Other intervening variables – age – heart disease climbs rapidly for postmenopausal women.

Syndrome X – hypersensitivity in the nerves leading to the heart, esophagus, and chest.

Some researchers have argued that far less is known about heart disease in women because, until quite recently studies of heart disease focused exclusively on male subjects. Cardiology is male-dominated in terms of both physicians and patients. Recent studies show that most physicians do not respond as quickly to female patients’ symptoms of heart disease as they do to male patients’ symptoms. – For example, high cholesterol monitoring, heart attack or congestive heart failure. In ED women with complaints about chest pains wait twice as long as men to see a doctor and twice as long for an EKG and they are 50% less likely to be given medications that inhibit further damage to the heart and other parts of the body following a heart attack.

Occupational hazards –

Certain female-dominated jobs – micro-chip and electronic component assembly involve extensive exposure to toxic chemicals.

Historically women have been prohibited from employment in certain occupations (for example in battery production, type-setting in printing) in that there is concern that the work environment was potentially hazardous to the fetus.

Problems – Pregnancy Discrimination Act of 1981 forbids employment discrimination against women workers solely on the basis of pregnancy. This type of discrimination looked only at women’s reproductive health but not at men’s.

Most exclusionary policies were common in male-dominated industries but not in equally hazardous female-dominated occupations.

The major cause of work-related death for women is homicide. These deaths are largely a result of women being concentrated in retail trade and food services, Which showed increases in job-related homicides in recent years, most of which were associated with robberies or robbery attempts.

Women have higher morbidity rates than men. Women have higher rates of illness from acute conditions and nonfatal chronic conditions; they are slightly more likely to report their health as fair to poor.

The higher morbidity of women may be related to their longer life expectancy. The older one is, the more likely one is to suffer from a chronic illness. Although women tend to live longer than men do, there are indications that their quality of life may be poorer.

Those who embrace the traditional feminine role are more prone to depression and other psychological problems. This is evidenced by mental health statistics as well as their higher morbidity and greater likelihood of institutionalization.

Broverman’s study – the healthy male, the healthy female, and the healthy adult

Depression, histrionic personality, and agoraphobia. Higher rates in women. Race and ethnicity is a factor. Women of color and poor women who head households have the highest rates of depression of any group.

Other researchers have found that married women are more susceptible to depression than both never-married women and married men.

A number of theories to explain these differences. Hormones.

Learned helplessness hypothesis – Females are socialized to respond passively to stress.

Social Status hypothesis – the traditional roles afforded to women offer limited sources of personal satisfaction compared with the diversity of jobs available to men. Women who have high-income, high-status jobs also have high levels of psychological well being and few symptoms of psychological distress, irrespective of marital status.

Histrionic personality – demanding, dependent, manipulative, melodramatic, scatterbrained, and seductive but frigid. Given the close resemblance of the histrionic personality to our culture’s traditional conception of normal femininity, some analysts have argued that females are socialized into careers as hysterics.

Agoraphobics – 80% are women. Agoraphobics tend to be passive and dependent and have difficulty expressing their personal needs – traits traditionally fostered in females

Eating Disorders – women 90 to 95% of anorectics are women.

However, recently researchers are questioning whether is has gone unrecognized in women of color or gay men, etc.

Beauty Norms – normative standards have had negative impacts on women’s self-esteem and have led to unnecessary cosmetic surgery – breast implants for example

Sexism in Health Care -This system of physical and mental health care has not infrequently done more harm than good, particularly to women.

Barbara Katz Rothman argues that the functional model of health has traditionally made women more than men susceptible to "illness labeling" by the medical establishment. In fact the nonfunctional woman was a status symbol during the 19^th century.

Physicians took over the natural biological events in women’s lives: menstruation, pregnancy and childbirth, lactation, and menopause. The medicalization of pregnancy and childbirth is just one example of often unnecessary medical intervention into normal biological events in a woman’s life. Menopause is another. Now a new one – perimenopausal syndrome.

This is further complicated for poor women and women of color – These women are often the objects of research. J. Marion Sims kept a number of black female slaves for the sole purpose of surgical experimentation. When he could no longer operate on slaves, he operated on poor indigent Irish women.

Sterilization has been directed to the poor and to women of color. As recently as 1972, 100,000 to 200,00 sterilizations took place under the auspices of federal programs.

People of color, gay men and lesbians, and the poor, both historically and currently.

Tuskegee Study of Untreated Syphilis in the Negro Male 1932-1972, more than 400 Black men diagnosed with syphilis were denied treatment for the disease so that researchers from the U.S. Public Health Service could observe the disease’s effects on Black men over the course of their lifetimes

In response to the inadequacies and abuses of traditional health care, feminists have begun to offer alternative services. These have as their core principles: a nonhierarchical structure; an egalitarian and mutually educational relationship between patient and provider; a recognition of external (i.e. structural rather than personal) causes for individuals’; physical and psychological troubles; and a commitment to advocacy and action to bring about social change.

This article discusses how dominant views of beauty and physical appearance are socially and culturally constructed. It looks at common views of beauty and how dominant beauty standards affect women differently based on race, ethnicity, age, class, and disability. It also examines how the energy women put into meeting beauty standards can lead to increased mental and physical health problems for women.

Mental Health – For most women, not adhering to narrow, standardized appearance expectations causes insecurity and distraction, but for many, concerns about appearance can have serious emotional impact. Up until adolescence, boys and girls experience about the same rates of depression, but at around age twelve, girls’ rates of depression begin to increase more rapidly. Another study of the impact of body image on onset and persistence of depression in adolescent girls found that whereas a relatively positive body image does not seem to offer substantial protection against the occurrence of depression, it does seems to decrease the likelihood that depression will be persistent.

Physical Health – Perceived or actual variation form society’s ideal takes a physical tool, too. High school and college-age females who were judged to be in the bottom half of their group in terms of attractiveness had significantly higher blood pressure than the young women did in the top half. The relationships did not hold for men.

Women constitute 90% of people with anorexia. The incidence of anorexia has grown dramatically since the mid-1970s, paralleling the social imperative of thinness.

Clothing – "tight jeans syndrome." In earlier times, the same problems have arisen with the use of girdles, belts, and shoulder bags. Meralgia paresthetica, marked by sciatica, pain in the hip and thigh region.

Approximately 33 to 50% of all adult women have used hair-coloring agents. Evidence over the past 25 years has shown that chemicals used in manufacturing hair dyes cause cancers in animals, but the connection to humans is not clearly established. Some National Cancer Institute researchers have noted that there is a significantly greater risk of cancers of the lymph system and of a form of cancer affecting bone marrow, in women who use hair coloring.

Silicone implants – case reports indicate a potential relationship between the implants and connective tissue diseases.

There is a medicalization of normal body types – ie, Sprague-Zones gives the example of the American Society of Plastic and Reconstructive Surgeons (1982) stated that "there is a substantial and enlarging body of medical information and opinion, however, to the effect that these deformities (they are talking about small breasts!) are really a disease....."