1. Envisioning Gender TransformativeHealth Promotion for WomenLorraine Greaves, BC Centre of Excellence for Womens HealthAnn Pederson, BC Centre of Excellence for Womens HealthNancy Poole, BC Centre of Excellence for Womens HealthRose Durey, Womens Health Victoria7th Australian Womens Health ConferenceMay 7-10, 2013 Sydney, NSW

2. This presentation Will identify a new approach to healthpromotion for women Will describe a new framework and planningtool and our process of development Will challenge all of us to distinguish gendertransformative initiatives from gender-specificand gender-sensitive initiatives in relation to arange of topics 3. Uncritical Health PromotionCampaigns 4. Stereotypes Continue to be Exploited 5. Rethinking health promotionfor women What would be an approach that improveswomens health and womens status at thesame time? What would it look like? How could we create a useful framework andtool for practitioners, womens groups, policyand program developers? 6. Raising the Bar 7. Gender Transformative Health PromotionGender-transformative approachesactively strive to examine, question, andchange rigid gender norms and imbalanceof power as a means of reaching health aswell as gender equity objectives.Source: Elisabeth Rottach, Sidney Ruth Schuler, and Karen Hardee for the IGWG, GenderPerspectives Improve Reproductive Health Outcomes: New Evidence (Washington, DC: PRB for theIGWG, 2009). 8. A continuum of approachesGenderInequityGenderEquity 9. Make Death Wait Heart and Stroke Foundation of Canada 10. Go Red For Women presents: Just a Little Heart Attack American Heart Association 11. Heart of the Matter by Barbra Streisand for Cedar Sinai Streisand Womens Heart Centre 12. Gender-sensitivity is not enoughGender sensitivity is recognizing thedifferences, inequalities and specific needs ofwomen and men and acting on this awareness. Source: The Federation of Medical Women of Canada, 2002 13. Mainstreaming is not enoughMainstreaming gender equality is acommitment to ensure that womens and mensconcerns and experiences are integral to thework of an organization, incorporating allaspects of its activities, from employmentissues, through to organizational governance,delivery and outcomes.Source: Derbyshire H (2002). Gender Manual: A Practical Guide for DevelopmentPolicy Makers and Practitioners. London: Department for International Development. 14. Gender-transformative approaches . . . encourage critical awareness among men andwomen of gender roles and norms; promote the position of women; challenge thedistribution of resources and allocation of dutiesbetween men and women; and/or address the power relationships betweenwomen and others in the community, such asservice providers or traditional leaders.Source: Elisabeth Rottach, Sidney Ruth Schuler, and Karen Hardee for the IGWG, GenderPerspectives Improve Reproductive Health Outcomes: New Evidence (Washington, DC: PRB forthe IGWG, 2009). 15. So what did we do? 16. Theoretical foundations: Gender theory1. Intersectionality Intersectionality is not the intersectionitself, but what the intersection reveals about power.(Dhamoon, 2009:9; Crenshaw; Hancock)2. Historical / patriarchal - (Tuhiwai-Smith, 1999,Decolonizing Methodologies - Research and IndigenousPeoples, Chapter 1, Imperialism, History, Writing andTheory pg. 29)3. Colonialist assumptions - (suggestions: Young, 2001;Rutherford, 2010; McConaghy, 1998)4. Gender norms and roles - (suggestion: Butler, 2004,Undoing Gender) 17. Core Principles of the Framework Women-centred Gender analysed Equity-oriented Culturally-safe/relevant/sensitive Evidence-based Action-oriented Strengths-based Harm reduction Trauma-informed 18. Melbourne Feedback Gender as a social determinant ofhealth How do other determinants intersectwith gender? Gender transformation is a majorstrength It needs outcomes and a planningcomponent 19. Gender as a SDOH 20. Lessons Learned Integrating gender into health promotion issupported and required Gender transformative health promotionapproaches are appreciated Linking the Framework to existing healthpromotion paradigms is important Feasibility and usability were highlighted Consultations led to change in content Methods were enhanced by a variety of media Examples are important for understanding 21. Framework Core of the frameworkis the continuum ofaction on gender DOH include social,environmental andbiological and producea gendered social world Gendered socialstructures includehealth research, policyand practice Health promotioninterventions eitherreinforce and maintaingender and healthinequities or challengethem Outcomes include bothimproved health andimprovements ingender equity and canreinforce more change 22. Following more than leading?Illustrations from alcohol 23. Girls and alcohol - Gender exploitativeAmericanMedicalAssociation 24. Girls and alcohol - Gender Accommodatingwww.grltlk.org 25. Girls, women and alcohol Gender transformativeFeministtradition ofevoking criticalthinking andsocial resistancearound alcoholhttp://jeankilbourne.com 26. Girls, women and alcohol Gender transformative 27. Girls and alcoholBeckys not drinking tonighthttp://www.youtube.com/watch?v=hIe9KGAJeko 28. When promoting low risk drinking guidelinesCanadas Low Risk DrinkingGuidelines suggest a limit of2 drinks at a time for women(10/week) and 3 drinks at atime for men (15/week)Sex differences indrinking limits reflectedin this campaignthisis good. 29. . But mendescribed asstronger thanwomen. 30. From the alcohol industry -Gender exploitative Emphasis onweight andcaloriesreflected inrecent alcoholadvertising. 31. Weight loss andimprovedappearance (e.g.,less wrinkles) seenin health promotionmaterials 32. How alcohol affectsyour appearance (andhow to improve it) 33. Pregnancy and alcohol-Gender exploitative 34. Pregnancy and alcohol - Gender exploitative 35. Pregnancy and alcohol - Gender accommodating? 36. Pregnancy andAlcohol - GenderTransformativeShares the weight ofchange betweenyoung men andwomenLinks the outcome tobroader communityhealth. 37. Pregnancy and alcohol - Gender transformative 38. Helps couples identifyand address tobaccorelated interactionpatternsGenderTransformativeBottorff, J., Carey, J., Urquhart, C., Poole, N., & Greaves, L. (2008). Couples and Smoking: What you need to know when you are pregnant.Vancouver, BC: British Columbia Centre of Excellence for Women's Health, Centre for Healthy Living and Chronic Disease Prevention, UBCOkanagan. 39. Gender Transformation and theObjectification of Women Objectification is when a womans entirebeing is identified with her body, and herbody or body parts are presented as sexualobjects 40. Examples from advertising 41. Examples from advertising 42. Impact of Objectification on Women Impairs cognitive and physical activities Shame, anxiety, self-disgust Eating disorders, low self-esteem,depression Poorer sexual healthFrom studies analysed in the American PsychologicalAssociation Task Force on the Sexualisation of Girls (2010) 43. Impact of Objectification on Women More likely to be smokers More likely to have poor motorperformance Less likely to participate in physical activity 44. Impact of Objectification on WomenNational Organization For Women (2007) 45. Take a Gender TransformativeApproach to Health Promotion Challenge social norms and attitudes thatperpetrate gender inequality Engage in structural advocacy Aim for gender and health equity 46. Gender transformative advocacy Changes to Australian National AdvertisersAssociation Code of Ethics:2.2 Advertising or marketing communicationsshould not employ sexual appeal in amanner which is exploitative anddegrading of any individual or group ofpeople. 47. Take a Gender TransformativeApproach to Health PromotionThe Australian, 17 July 2012 48. Putting the Framework into Practice 49. Questions for Discussion How do we switch our thinking from gendersensitive to gender transformative? What are the challenges in translating thisconcept for health promoters, women, policy-makers? What is the role of men in gender-transformativehealth promotion? 50. www.promotinghealthinwomen.cawww.bccewh.bc.caOur upcoming book: Making it Better: Gender transformative health promotion for womenRelease date, January, 2014This project was funded by the Canadian Institutes of Health Research.