Introduction by Croakey: The health sector, in Australia and globally, has been urged to step up advocacy and action for gender justice in the wake of wide-ranging attacks on gender and LGBTQIA+ rights around the world.
“We are in the fight of our lives in gender and health,” says the Lancet Commission on Gender and Global Health.
The Commission recently released a report resulting from its last five years of work, which makes “evidence-informed recommendations on how to incorporate gender justice into policies, programmes, and practices and thereby improve health and wellbeing for all people”.
“Gender influences everything – from the resources and opportunities available to you, to the care you receive. Yet gender is being weaponised, manipulated and politicised, with damaging implications for the health of communities around the world,” says the Commission.
Below, Dr Connie Musolino and Kristen Foley report from the recent Australian launch of the report, which was hosted by Stretton Health Equity at The University of Adelaide, and the Fay Gale Centre for Research on Gender.
Connie Musolino and Kristen Foley write:
Well-funded international far right networks have supported a rollback in gender and LGBTQIA+ rights across the world, speakers told the recent Australian launch of the Lancet Commission on Gender and Global Health report.
The commissioners called for colleagues, globally and in Australia, to bring a gender justice lens to their work, whether that be via gender-responsive health promotion, service provision, education, data capture, advocacy, or cross-sectoral partnerships.
In the United States, Executive Orders by the Trump Administration have directed the removal of terminology relating to gender from all Government-funded websites, directives, and policies, and from some scientific databases. In some cases, this has resulted in deletion of decades worth of data on the relationship between gender and health outcomes.
Yet, the ‘war on gender’ is not confined to the USA, and has uneven impacts on progress towards health for different groups in different political settings, the Commission reports.
In Poland, conservative groups are seeking to remove the term gender from public policy documents. In Uganda an Anti-Homosexuality Act was legislated in 2023. In Kenya, the report showcases the threat of aggressive gender marketing of health-depleting products to women because they are a ‘growth’ market.
The report further details how the removal of funding and the disruption of existing coalitions will likely reverse decades of progress towards equal opportunity and reproductive rights legislation.
Launch event
At the Australian launch, the Lancet Commissioners called on more than 100 people joining in person and online to work in solidarity to bring a gender justice lens to their work, whether that be via gender-responsive health promotion, service provision, education, data capture, advocacy, and cross-sectoral partnerships.
The Lancet Commission began in March 2020 at the beginning of the COVID-19 epidemic. The Commission was assembled as a multi-disciplinary group of experts working at the intersection of gender and health.
Over the past five years, this expert group has worked with academics, health workers, policy makers, community and civil society, to synthesise existing research and evidence to develop recommendations on progressing gender justice for global health equity.
Australian Commissioners Professor Fran Baum, from the University of Adelaide, Professor Sharon Friel, from ANU, and Professor Emerita Raewyn Connell, from the University of Sydney, were joined for the launch in Adelaide by the Commission’s Co-Chair, Professor Sarah Hawkes, from Monash University Malaysia.
A suite of health and gender activists and scholars spoke at the event about the current state of gender rights in Australia, connecting key challenges for local and global health organisations.
Professor Barbara Baird from Flinders University presented on the Fight for Reproductive Justice in SA as part of the SA Abortion Action Coalition, which resulted in some of the most progressive policies on abortion rights and access in the world.
However, she argued that we cannot be complacent as recent anti-abortion campaigns have gained strength (and funding) from international movements, and which test the legal thresholds of free speech.
Holley Skene, CEO of SHINE SA, provided reflections from working at the interface of inclusive and equitable sexual and reproductive primary healthcare in South Australia.
Skene discussed the importance of gender and sexuality inclusive care for people who do not find mainstream services accessible and safe, and how services that reinforce the gender binary exclude many community members.
Front: Prof Emerita Raewyn Connell, Honourable Catherine Branson AC SC, Prof Sarah Hawkes, Prof Fran Baum. (Photo provided)
Key takeaways
Professor Fran Baum chaired a panel and audience Q&A session, consisting of University of Adelaide academics Professor Megan Warin, Dr Jared Dmello, and Dr Connie Musolino, as well as Professor Sarah Hawkes and Professor Sharon Friel.
The panel reflected on key takeaways from the report, and brought a gender justice lens to topics such as:
- fatness, epigenetics and mother blaming, especially for poorer and marginalised women
- the history of women’s health centres in Australia
- the role of social movements, solidarity and coalition-building across sectors
- how commercial actors can employ gender to sell health-depleting products
- gender and queer politics in the US, including the elimination of data on trans and gender diverse people from historical records and population monitoring.
- The report represents a significant advance in consensus building regarding how gender and gender justice should be conceptualised and defined. It notes while gender is discussed in global health, action on gender justice remains slow and uneven.
The lack of a shared understanding of gender and related terms is identified as a major obstacle because it results in disagreement, misinterpretation, discrimination, and frayed collaborations.
In research and health data systems, the Commission found that gender and sex are often conflated, which ignores and masks the multiple dimensions of gender and how they interact with sex.
While the term ‘gender’ seeks to make visible the social roles and attributes that are projected onto people and bodies, the report identifies that in global health, gender often becomes a shorthand for women and girls.
This excludes the needs of trans and gender diverse people; ignores how gender relates to the health of boys and men; and presumes that reproductive labour is women’s ‘natural’ and ‘expected’ role in society – rather than a choice.
The report provides a thorough and thought-provoking history of the political and cultural foundations of how ‘gender’ definitions and knowledge developed and have been operationalised in global health systems.
At the launch, Professor Emerita Raewyn Connell described the long progress made through the 20th century on making gender visible as a social construct, so that the biological divisions between females and males could be understood in relation to gender, rather than a proxy for them.
This is important because it makes new conversations about health possible, such as the way that gender stereotypes shape ideas, desires, and actions, which can shape how men and women might access health services and their treatment. Further, LGBTQIA+ people might be alienated from health services altogether because they do not conform to gendered stereotypes.
Disruption and translation
The Lancet Commission’s overarching aim was to identify ways in which health practitioners, policy makers, researchers, and civil society can use more inclusive understandings of gender to improve health policies and programmes.
The Commission’s vision of a gender justice approach “recognises the diversity of needs and experiences, calls for the inclusion of all people, and aims to achieve both equity and equality for all”. The report illustrates this through gendered analysis of historical and contemporary case studies from around the world.
The Commission acknowledges that achieving the vision of gender justice will require “fundamentally disrupting systems and structures related to global health that inequitably and unfairly concentrate decision-making power, do not uphold universal human rights commitments to equality and non-discrimination … and overlook the gendered aspects of the social, cultural, political, economic, and legal determinants of health and wellbeing”.
Professor Sarah Hawkes told the audience in Adelaide that the Lancet Commission report provides a set of principles and policy ideas to be implemented in different settings and that “local translation has to be the next step”.
Professor Sharon Friel said the power of the report is that it “provides a list of principles and values and explanations that enable a negotiation in the Australian politic, policy and practice”.
A recording of the event is here; organisers plan to send a copy of the report to relevant Australian Ministers and Shadow Ministers to advocate for gender justice in all policies.
Author details
Dr Connie Musolino, Stretton Health Equity, The University of Adelaide (who presented on a webinar series organised by The Lancet organised to inform the report).
Kristen Foley, Research Centre for Public Health, Equity and Human Flourishing (PHEHF), Torrens University Australia
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