Gender norms are the ideas about how males, females and people of other genders should act in a particular culture according to custom. Gender roles are the learned behaviors considered to be appropriate to our sex and gender, as determined by prevailing cultural norms. Gender relations intersect with other influences on social relations – age, ethnicity, race, religion, sexual orientation, gender identity – to formulate the social position of individuals within a particular group or culture.  

African tribal women filling water

Gender norms, roles and relations are some of the most important social determinants of health outcomes as they create disparities in access to and quality of health services. Gender affects population health because cultural norms have evolved to be unequal and inequitable, based on patriarchal and male-dominant systems.  

Sticking to the norms culturally assigned to one’s biological sex can have detrimental effects on health outcomes. Male or masculine norms of bravado and machismo can cause men to act overconfident.  This could result in denying health issues and only visiting a provider when long overdue. Female or feminine gender norms in many cultures that married women are “owned” by their husbands have led to women losing power over their bodies, resulting in higher rates of gender-based violence, unplanned pregnancies and unsafe (and often illegal) abortions. Gender norms in many cultures also lead to stigma and bias against non-binary people, which can lead to higher rates of mental health issues, such as anxiety and depression.   

Too many civil registries and national vital statistics registration systems continue to ignore gender norms, roles and relations. And many still do not disaggregate or analyze the data collected by sex and gender.  

This exacerbates inequities in health outcomes among women, men, and non-binary people. Until we take a fully gender-responsive approach to data collection, analysis and use that seeks to transform harmful gender norms, we will fail to tackle the root causes that are driving poor health outcomes and early deaths for women, men, non-binary and transgender people.