We assume our gender based on the physiological characteristics we possess at birth. So, a person is considered a man or woman by society because they have certain distinct features – even allowing for uncommon cases where individuals present with both male and female features.
Society has structured itself around this gender dichotomy, arguably since the first humans walked the earth. And while gender roles have been fluid over time, biological differences have been more fixed; at least, we have usually thought so.
While the biological difference between sexes is a preexisting condition, imposed gender roles contribute towards creating an avenue for men and women to have varying health and healthcare experiences. But just how much do these experiences vary? Quite a bit, it turns out.
How nature screws us over
The most notable biological difference between men and women is in their reproductive organs. These differences alone put male and female health needs in different categories. Where the physical act of sex is concerned, though both sexes share the risk of contracting diseases, they do not equally share the responsibility for protection. Women, being more prone to infections than men, are required to manage their reproductive systems in a more careful and delicate manner.
Meanwhile, for the party that is seemingly always eager to perform, men’s role in the reproductive process is fleeting. The woman is saddled with the rest of the responsibility, usually at a significant health cost. And women who are able to opt out of reproduction, for whatever reason, almost always bear the burden of contraception. The fact that there is only one (two, if you count abstinence) means of contraception available to men, does little to ease the burden on women. This primary method of contraception – male condom – is the most common contraceptive. Yet in developing countries, it is mostly controlled by men, leaving women in even less control of fertility and more at risk of contracting infections.
All of this is not to say that men do not face some serious health risks. For men, it begins even before they are born. In-utero deaths (stillbirth) of male babies are higher than for female babies, and even when they survive till birth, males are still more likely to die during infanthood. After that, they are still not out of the woods either; the mortality rate for males is higher than for females, and they are more prone to heart disease; cancer; lung disease; kidney disease, etc. These have been attributed to differences in hormones, metabolism, genes, and the reproductive anatomy of males and females.
So biology screws over both sexes, perhaps fairly so. But how do the two fare under socially imposed differences?
How society screws us over
You may believe that gender roles do not affect a person’s health nor the quality of – and access to – healthcare, but there is ample reason to believe otherwise. For instance, the type of work usually reserved for men typically exposes them to more on-the-job risk and danger than women. In Japan, death from overworking is a relatively mainstream phenomenon, referred to by the term karoshi. On the other hand, because women are usually assigned a lower status in many societies, this leaves them more susceptible to domestic violence. Domestic violence, often physical and sexual, can result in several health issues including abortions/miscarriages, mental health problems, and even death.
Unsurprisingly, socioeconomic factors influence health outcomes. For example, weaker bargaining power due to low social status exposes young Sub-Saharan African girls to an HIV infection rate 16 times greater than the male infection rate. Meanwhile, other social factors such as educational attainment, and economic status (both of which are often lower for women than men) also affect the quality of and access to healthcare. Where individuals do have access to healthcare, men seem to have more favourable interactions with service providers than women.
While it is true that It is true that women outlive men, longer life comes with substantial health challenges. The evidence seems to show that there is a significant impact on female health mainly due to their assigned gender features which dictate their position within society.
Is Gender Equity the Way Out?
Biological differences already make it certain that men and women will have different health experiences. But while biology can be blamed for the difference, social roles have created the inequity.
Nigeria is perhaps so steeped in gender inequality that even data to show just how badly we are doing does not exist. There might be little we can do to control individual health experiences that are largely predetermined by biology, but we can certainly start with upgrading our healthcare services. Particularly for the underserved – especially women – within society who are most vulnerable to health concerns, and least likely able to receive or afford appropriate health services.
So the health issue sits within a wider concern about gender equity, one that Nigeria looks unwilling to tackle properly.