Gender includes the “social roles, social status, culturally established patterns, stereotypes, behaviors and attributes thought to be appropriate and expected for the genders, men and women” (Jewkes, Flood, & Lang, 2015). Gender-based power disparities and limited access to justice are primary drivers of health inequity around the world. Women’s equality shapes health, particularly reproductive health and infant and child health outcomes. (Varkey, Mbbs, Kureshi, & Lesnick, 2010). Bolstering education, economic and decision-making power can enable a cascade impact on health and well-being through access to care, and ability to implement health promotion.
Gender-based violence (GBV) is a powerful example of how gender influences health and equity. Intimate partner violence and non-partner sexual violence are the most common forms of gender based violence experienced by women and girls regardless of country. The global acceptance of violence in the home and in public reflects restrictive gender and social norms, and is thus a critical metric of women’s equity. Globally, an estimated 1 in 3 women experience violence by a husband/intimate partner in their lifetime, while men are more likely to be assaulted by a stranger or acquaintance than a wife or intimate partner (WHO, 2005). The multiple consequences of violence are both immediate and long lasting with negative health (e.g. injuries, sexually transmitted infections, depression, chronic pain), economic (e.g. loss of employment, insecure housing) and social (e.g. isolation, stigma) consequences for the woman, her children, family and community (Campbell, 2002). Gender-based violence is not limited to women; and includes violence perpetrated based on sex, gender identity, or perceived adherence to socially defined gender norms; thus victims include populations who are high risk, marginalized, or criminalized, such as men who have sex with men (MSM), transgender population and sex workers (USAID and Department of State, 2012). Lifting the stigma that stems from lack of adherence to socially-defined gender norms may also support gender equity, health, and justice. Social identities and related systems of power, oppression and discrimination can intersect; gender identity and other biological, social and cultural characteristics, such as sex, age, race, ethnicity, migration, caste or economic status interact on multiple levels (individual, family, community, institutions, and society) to constrain gender and health equity.