Lesson 3: Gender & Health

The categorisation pertains to specific phenotypic characteristics that are said to be underpinned by biology. For example, a set of certain physiological factors, such as chromosomes (XX) and hormonal thresholds that create specific genitalia and phenotypes, such as increased fat deposits in certain parts of the body, are used to categorise bodies with these factors as being of “female sex”, which then leads to a “woman” gender assignation. 

These physical, bodily factors, with these linguistic identifiers, carry a wide-ranging set of social expectations and stereotypes. 

According to the World Health Organisation gender also includes norms, behaviours, and roles associated with being a woman, man, girl, or boy, and how they interact with each other and society (source). 

The last component to consider is how gender dictates specific experiences, which in turn affect health. For instance, 60.3% of racialised women are cleaners or housekeepers in the United States19. This intersection of race, gender, and class, which are all artificial classifications of western imagination, drives a disproportionate exposure to endocrine disruptors through the use of cleaning chemicals. 

In addition to this there is further disruption to the endocrine system through shift work, which is often associated with these professions (source, source). 

Finally, we also have to consider how those who experience discrimination through class, gender, and race are more likely to live in neighbourhoods with higher levels of air pollution (source, source). 

All of these factors driven by a gendered experience lead to racialised women having higher rates of breast cancer, diabetes, and obesity (source, source, source). 

We are proposing that, as part of an ecological approach to health, we consider how gender plays a role in the exposure to endocrine disruptors and other stressors. In understanding this we can consider wider preventive healing strategies that are more robust and ecological (e.g., better work rights to ensure that racialised women are not exposed to harmful chemicals or forced into constant shift work).

As it has been established both gender and sex are cognitive products of white imagination and have been created to uphold it. Writer and sociologist professor Katerina Deliovsky explains that in a white society there is intrinsic value in aligning with and performing whiteness and heterosexuality (source). We would go further, whiteness can only exist through heteronormativity, as it supports a patriarchal wealth generation and retention model. 

As part of transitioning Europe from a land-based society into feudalism, they needed structures to justify land ownership. Who owned land, who inherited land, and who worked the land was determined and sustained by societal norms (source, source, source). One of the key strategies was to control the sexuality (heteronormativity), sex (reproduction), and gender (norms + behaviours) of white European woman (source). 

Historically, for wealthy white women, their role in whiteness was to produce the next white male heirs (source). For the white working class women, their role was to produce cheap land labour (source). To keep birthing labourers and heirs, the society needed a defined class structure as well as a binary gendered and heteronormative structure. 

As time and greed progressed, European landowners set their violent ambitions to the rest of the world. A new justification was needed, one that would support the kidnapping, enslavement, torture, and genocide of Indigenous Peoples from Africa, Turtle Island, and Abya Yala. 

Colonisation imposed the white ideation of class, gender, and race on our Peoples. Indigenous Peoples from Africa living under systemic slavery in the Americas were needed not only for enslaved labour but also to produce more enslaved labour (source). They were grotesquely diminished to “breeders”, their sexuality, sex, and gender controlled for the continuity of enslaved labour (source). 

In this new domain, white women were then needed for the “reproduction of European domination”. The worldwide spread of heteronormativity, including gender norms, is “specifically tied to colonial rule and contemporary geopolitical arrangement” (source).

So, what is the purpose of this? The generation of profit, or now, in modern terms, capitalism. Capitalism needs people to continue reproducing for the purposes of either heirs or cheap labour; it cannot sustain itself without this. 

Furthermore, whiteness needs funding which comes from the continual generation of wealth. We cannot divorce heteronormativity from gender, sex, or the generation and sustenance of wealth. Breaking gender norms is often perceived as a threat, which can be punished through social sanctions, and this can lead to poor health outcomes. 

The very real implications of transgressing norms include violence, homelessness, and exclusion from work and from health care (source). 

Trans people – their knowledge, ideas, and lived experience of transgression – are redefining gender, the relationship between our bodies and gender, and the roles we play through our bodies. Meanwhile, there are numerous cultures for whom the idea of gender that goes beyond a binary is nothing new. The Zapotecas have a muxe community, which is often erroneously conceptualised through a western lens, saying they are a “third gender”. However, they are neither. They are, as many say: “muxe”. Despite the fact many muxe do not identify as trans, seeing it as a primarily western that goes beyond a binary is nothing new. The Zapotecas have a muxe community, which is often erroneously conceptualised through a western lens, saying they are a “third gender”. However, they are neither. They are, as many say: “muxe”. Despite the fact many muxe do not identify as trans, seeing it as a primarily western phenomenon unaligned with their cultural experience of gender, sometimes they feel they must organise under the political label of “trans” to make their experiences more legible, especially when it comes to their fight for human rights and against discrimination. In a culture that thrives on categorisations of people to create hierarchies that support supremacy, these transgressive conceptualisations – old, new, and ever-changing – of the human body are being acutely and violently challenged.

Gender is an important factor to consider when it comes to planning kind and robust healthcare. Whilst there is a significant and growing knowledge bank regarding how the ways we are gendered  affect health habits, such as smoking, drinking, or seeking preventive health, the wider lived experience of gender – the expectations, experiences and roles attached to the idea of being a “man” or “woman” is generally ignored. This is a substantive knowledge gap for care. It is not good enough to be told that women are more at risk for breast cancer, when “both sexes” have breast tissue, or that ovarian cancer is more prevalent in women simply because they are part of what is labelled as “the female anatomy”. Should the external environment of these sexed and gendered organs be taken into account? We must also consider Trans People: how can we better understand their organ function in the context of the gendered experiences of being both trans and expected to fulfil a role of “man” or “woman”?

Endocrine disruptors (ED) are chemicals that are ingested from our external environment through our skin, respiratory tracks, and mouth. 

Once inside the body, they mimic the body’s hormones, which can cause dysregulation of the endocrine system (source). 

The endocrine system regulates and mitigates the function of our hormones, which in turn regulate the function of many of our physiological processes, such as digestion, sleep/wake cycle, skin repair, metabolism, blood pressures, stress response, emotional regulation, and reproduction (source). In short, the endocrine system is a significant part of our human physiology (source). 

Therefore, when chemicals disrupt or dysregulate this system, it is has the potential to be part of the disease pathology of a wide range of diseases and illnesses. 

EDs have been linked to various cancers, including those in our reproductive system, depression, anxiety, Parkinson’s, dementia, autoimmune disorders, obesity, diabetes, miscarriages, neurodevelopmental disruption in the womb, and the list continues (source, source, source, source, source).

Endocrine disruptors are mainly man-made due to industrialisation. As this list highlights, they have been insidiously introduced to every single part of our life. 

Without strict regulation that supports life rather than capital, they are almost impossible to avoid. Furthermore, as materiality can be cheaper to produce with EDs, those who are economically impoverished due to societal discriminants and marginalisation are the most exposed. 

For instance, cheap social housing that contains cheap and synthetic materiality in carpets, furniture, paint, and walls contains EDs. 

Another factor to consider when it comes to the inequity of exposure is that the multi-–ethnic working class also has more exposure due to working in many of the places that produce materiality with EDs, or their work requires them to be in close and constant contact with EDs. Hygiene workers, long-haul drivers, factory workers, nurses, miners, etc. are all over-exposed to EDs (source, source, source, source).