Breaking Barriers: Integrating Gender Perspectives in Medical Education

Session Report

Tanu Paliwal

A Four Week Online Certificate Training Course on Healthcare & Gender Equity: Emerging Dimensions, Policies, Impact & Way Forward was organized by the Gender Impact Studies Center (GISC), at the IMPRI Impact and Policy Research Institute, New Delhi and Center for Ethics (CFE), Yenepoya (Deemed to be University), Mangalore from August 28th, 2023 to August 31st, 2023. 

On Day 1, our second speaker Ms Sangeeta Rege, Coordinator, Centre for Enquiry Into Health and Allied Themes (CEHAT), Mumbai took the session on “Gender in Medical Education”.

The session commenced with an engaging activity involving silhouettes, prompting participants to discern gender and illustrating how societal roles are often defined by gender, which is dynamic and can vary across time and regions. 

Gender Vs Sex

Prof Rege elucidated two  fundamental concepts: sex as a physiological characteristic present at birth, and gender as a social construct encompassing roles, expectations, and obligations that evolve across diverse cultures, such as India and the West.

The presentation expanded to encompass gender identity, incorporating transgender identity, and the recognition that sex identity includes intersex identity, supported by research indicating a range of chromosomal combinations beyond the traditional XX and XY. She underscored the importance of acknowledging intersex variations in the health sector, particularly in obstetrics, where professionals may encounter challenges in communicating to parents about ambiguous genitalia in newborns. The recommendation was to counsel parents, observe the child’s behavior, and consider prepubertal surgeries.

The presentation delved into the cultural definition of gender roles portrayed in images, emphasizing the absence of research evidence supporting stereotypes such as women being fragile or emotional. It highlighted how these stereotypes, perpetuated in societal systems, can lead women to resort to unconventional health practices before seeking professional help, especially when women’s health is not a priority in non-working scenarios.

A distinction was drawn between men and women’s health prioritization, pointing out the existing stereotypes in health systems. Despite gender norms impacting dressing, skills, games, and tasks, the narrative discouraged creating a hierarchy, stressing the value of gender differences without assigning importance.

Gender Inequalities in Health Systems 

Prof Rege explained gender inequalities in health systems, noting that global research studies often extrapolate from male subjects to females, resulting in potential health disparities. The presentation extended to diverse gender identities, including challenges faced by trans individuals in accessing healthcare facilities due to stigma and misperceptions. An innovative example from a Mumbai hospital was cited, where a dedicated ward for trans individuals was established, highlighting the need for broader awareness.

Addressing root causes of gender inequalities in health, the session cited research articles, including one on unnecessary hysterectomies in women from farming communities. It emphasized the need for sensitive responses to diverse needs, particularly considering social determinants.

Prof Rege focused  on health budgets, lamenting the lack of significant increases and attributing this to inflation. The session touched upon a study revealing stereotyping of female patients and labor room violence by medical teachers, leading to the importance of gender-integrated education. 

Gender and Education 

The shift towards competency-based medical education in the 2019 MBBS curriculum was noted, with efforts to integrate gender perspectives across disciplines.An assessment of the feasibility of integrating gender concerns in undergraduate education revealed positive outcomes, with students showing increased attention during diverse teaching methods. 

Prof Rege outlined four overarching themes: gender analysis in health, gender, sexualities, and sexual and reproductive rights, gender-based violence, and gender, ethics, and rights.

The session concluded with a film presentation by CEHAT on stigmas surrounding adolescent pregnancy and abortions highlighted the need for awareness and psycho-social support for patients in issues related to reproductive health, emphasizing the crucial role of healthcare providers in destigmatizing these issues.

Acknowledgement Tanu Paliwal is a research intern at IMPRI.

Read also : Gender Implications of Health Policies