On May 29, 2023, Aidspan organized a webinar titled "Gender in Action, Professional Postures" to highlight the historical connection between gendered social assignments and gender inequality. The webinar featured Patricia Vasseur, a midwife, health anthropologist, and Sexual and Reproductive Health and Gender Focal Point at TeAM / Action Santé Team (AST). The webinar covered a range of topics, including understanding gender, gender's presence in everyday life, the influence of social and cultural norms, gender theory as a tool, the political significance of gender within states and the need for vigilance, gender and the world of work, the impact of COVID-19 on gender, gender and reproductive health, and gender and the environment.

The primary objective of the webinar was to raise awareness about the historical implications of gendered social assignments in perpetuating gender inequality. It not only highlighted the consequences arising from such situations but also presented practical solutions and strategies to address these issues across different aspects of society.

Our article describes the contribution from our key speaker, Patricia Vasseur who, from the outset, stressed that gender has a decisive influence on all social systems (professional, domestic, social, etc.).

What is gender?

‘Sex’ is biological but ‘gender’ is social. “Gender," says Patricia Vasseur, "is a fundamental element of social relations based on the perception of differences between the sexes. It defines the relationships between men and women, which:

• are based on a relationship of domination linked to gender;
• are prescribed by social norms; and
• define etiquette, codify moral order and regulate behaviour.

In her presentation, she highlighted the multiple inequalities faced by women, including social, economic and political inequalities, as well as inequalities in access to health, education and work. She showed how gender inequalities are reinforced by other factors such as age, ethnicity, disability, sexual orientation and rural or urban residence.

Gender: a staple of everyday life

Gender stereotyping

Table 1. Gender-assigned characteristics

In her presentation, Vasseur highlighted the gender stereotypes and social norms that limit women's choices and opportunities, and the extreme social behaviour (violence, exclusion and marginalization) to which they are constantly exposed.

More specifically, according to the speaker, there are attributes and/or strong social pressures that limit women's choices and opportunities and infringe their freedom and fundamental rights. For example:

• In public, a man is more approachable than a woman.
• A man has every right to be angry, he is bound to have a good reason, whereas an angry woman is a sign of her inability to control herself; she is often labelled as ‘hysterical’.

These stereotypes therefore conform to the specific ways of doing things that people associate with gender.

In general, people perceive these differences as the consequences of biology and take them for granted.

Social and cultural norms

Yet, according to the speaker, the systematic differences between men and women are not the result of biological determinism, but of social construction. Hence, let’s examine the social roles and cultural practices attributed to women, noting the many responsibilities entrusted to women, such as:

• To feed, educate and look after children and elderly relatives, and run the household and farm but without owning the land;
• To work professionally while still ensuring the smooth running of the household (the so-called 'double burden');
• To be expected to have children while still young;
• To be less literate, less well-informed than boys; and
• Taking the blame: husbands blame their wives for anything that goes wrong in the home.

In fact, gender can be divided into two categories:

• An observable empirical reality of division and hierarchy that organizes the social world in a binary way: men on one side and women on the other.
• A concept that analyses the scientific and political consequences of gender categorization and social norms, as well as the cultural and historical process of constructing differences and inequalities.

Gender theory: a tool

The presentation made it clear that gender in itself is not an ideology, but rather:

• a tool for analyzing social constructs and representations
• a tool for academic research into relations of domination and power.

Gender as a tool for critical analysis and action: a policy framework

In the above diagram, the concept of gender is presented as a tool for critical analysis and action, used to deconstruct gender binarity and challenge gender-based social norms and power relations. Vasseur stressed the importance of taking gender issues into account in all institutions and highlighted certain specific areas such as the world of work, health and the environment.

The political importance of gender within states and its drawbacks: the need for vigilance

Gender and the world of work: a paradox

On a professional level

, the inequalities and discrimination faced by women, such as limited career choices, the risk of harassment and obstacles to career advancement were highlighted.

In terms of health

, the speaker highlighted gender-based health inequalities, stressing the socially constructed normative behaviour and power relations that limit women's access to health services. She also emphasised the intersecting processes of stigmatization and discrimination faced by individuals on the basis of their age, ethnicity, social status, poverty, literacy, disability, sexual orientation and type of pathology (cardiovascular disease, TB, HIV, etc.). Inequalities in health are influenced by the patient's sex (male or female).

According to Patricia Vasseur, gender has been identified as a determinant of health inequalities, with normative social roles and behaviour affecting health. For example, behaviour associated with masculinity may expose men to higher risks, such as road accidents, smoking and excessive alcohol consumption, all of which contribute to reducing men's life expectancy.

Power relations between the sexes can also limit women's access to health services and to household money spent on health. Working men may find it difficult to visit health centers during working hours, and there is a social reluctance to seek treatment, as masculinity is often associated with strength and non-vulnerability.

Gender and COVID-19:

women were most affected by the pandemic

Vasseur pointed out that women were more affected than men by the COVID-19 pandemic.

Gender and reproductive health: fields covered

In the field of reproductive health,

gender inequalities are particularly marked, especially when it comes to birth control and motherhood. Women can face multiple forms of violence, such as child marriage, early pregnancy and female genital mutilation (FGM).

Gender is most marked in the area of birth control and maternity, namely the manifestation of multiple/cumulative violence (gender-based violence (GBV): excision/early pregnancy, child marriage, vesicovaginal fistulas...) which manifests itself in several forms:

• Oral: insults, contempt, mockery
• Physical characteristics: shouting
• Failure to respect a female client’s confidentiality.

Vasseur pointed out that health professionals, and women in particular, can play a role in responding to these problems, but obstacles such as care that does not respect human rights, and the emotional and owerlessness to heal, can prevent appropriate care.

She also focused on the multiple ways in which gender influences health, highlighting the gender-based inequalities and discrimination that individuals face in health systems, as well as the links between gender, reproductive health and the environment.

Gender and environment - Thematic areas

Vasseur also addressed the link between gender and the environment, stressing the importance of empowering women in the fight against climate change and environmental protection.

Women are often disproportionately affected by the effects of natural disasters and climate change, due to their dependence on natural resources, unequal access to these resources, and limited mobility and decision-making power. She believes that women are part of the solution. They need to be involved in environmental policies and project processes, as they are more sensitive to the needs of communities than men are.

What changes need to be made?

Vasseur addressed the issue of

change in professional practice from a gender equality perspective

. She stressed the importance of identifying discrimination and abusive behaviour in the workplace, as well as the mechanisms and social norms that underpin it. She highlighted the insidious and unconscious processes by which gender norms are constructed and ingrained within school education onwards.

In her presentation, she also focused on the case of midwives in

the field of sexual and reproductive health

, highlighting the GBV they may suffer themselves and perpetrate on their patients.

She then proposed

a gender-based approach to equity

in development projects, aimed at reducing inequalities between men and women by taking account of their specific needs. She gave examples of gender mainstreaming and suggested strategies for promoting change, such as training, monitoring changes and changing professional attitudes.

She also recommended the construction of indicators of change to assess the actions undertaken, stressing the optimism about the possibility of changing perceptions and behaviour, and the importance of a profound transformation based on the acquisition of knowledge, professionalism and ethical reflection.

Vasseur finished her presentation by proposing a global approach to the promotion of equality between women and men, identifying the necessary actions.  Here are the main points raised:

• Develop a different way of looking at women which tends towards recognition of their multiple abilities;
• Integrate women into working life and into decision-making in governance bodies on an equal footing with men;
• Strengthen basic training in the gender approach in medical education establishments and other non-health, commercial, administrative, economic (accounting, engineering, etc.) and communication training schools;
• Participatory training for members of governance bodies (situation analysis, reflective work on practices);
• Develop and consolidate gender indicators to monitor and evaluate the proposed actions;
• Advocacy and community communication messages to raise awareness of the gender aspect among the population and all those responsible for services other than health;
• Encourage women's village associations to work together;
• Ensure a favorable environment to enable women and girls to work or study in safety; and
• Working with men.

She also suggests drawing on the theory of behavioural change: Build indicators of change using "The 4Rs", i.e.:

• R1 - Representation: how are women and men represented/involved?
• R2 - Resources: how are resources distributed by gender?
• R3 - Reality (norms): what representations of gender influence this distribution?
• R4 - Realization: what actions and measures are needed to achieve the gender equality objectives?

Vasseur concluded her presentation by stressing that culture is not static, and that it is possible to transform attitudes, representations and behaviour by allocating resources, training, monitoring and evaluating actions. The change in perception is ongoing and the transformation of sensitivities requires time and perseverance, she said. Ethical reflection, the acquisition of fundamental knowledge and socializing professionalization are essential if we are to achieve a transformation of morals and civil relations.