Sometimes men and women must be treated differently

There are times when men and women must be treated differently. These days sexism seems to be in the news more often than usual. A woman got €45,000 from the Equality Tribunal when she didn't get a job that was given to a less qualified man. A TD was reprimanded for pulling a female TD on to his knee during an all-night Dáil sitting. A sexual assault case involving a sailor who asked his female colleague for "a quickie", slapped her buttocks and grabbed her by the breasts with both hands, was dismissed in a district court in Cork. A Senator accused another Senator of speaking through "her fanny". But are they all examples of sexism?

Sexism is direct or indirect discrimination against people based on whether they are men or women. The Equality Tribunal case was clearly sexism in practice. If Tom Barry wouldn't have manhandled a male colleague because he knew he wouldn't get away with it, his behaviour in the Dáil was sexist. If a man had grabbed another man's genitals and asked him for a quickie would the case have been dismissed? I think not. The case would probably never get to court because most men grabbed by their genitals would deal with it on the spot. Would Se Norris have used such offensive language towards a male Senator? Possibly, therefore this example is not sexism, which must involve discrimination and favourable or unfavourable treatment because of one's gender. Having bad manners, being boorish and engaging in horseplay, no matter how unpleasant, do not constitute sexism.

The World Health Organisation distinguishes between a person's "sex" and "gender". Male and female are sex categories, while masculine and feminine are gender categories. Sex refers to the biological and physiological characteristics that define men and women, such as men having testicles and women menstruating.

Social constructs
Gender refers to the socially constructed roles, behaviours and attributes that society considers appropriate for men and women, such as women in Ireland being 50 times more likely to look after home and family, and men more likely to be radio presenters. Roles are not allocated in this unfair way because women are biologically better at housework or men have voices physiologically more suited to radio. They happen because of sexism.

While sexism is never okay, there are times when men and women must be treated differently. The HSE's recent document Equal but Different: A Framework for Integrating Gender Equality in Health Service Executive Policy, Planning and Service Delivery, explains why gender is important to all health outcomes.

A typical heart-attack victim is often seen as a 60-year-old male, yet a woman is 10 times more likely to develop heart problems than breast cancer. She will also experience treatment delays at all stages of care because, somehow, heart disease is not seen as a woman's problem. Gender characteristics determine obesity rates in men and women, with men more likely to be overweight. Being big is seen as masculine, skinny men are weedy. Thin women are viewed favourably because small is feminine. A recent survey from the National Consumer Agency found that 72 per cent of food shoppers are women, so men do not control their food availability. Men are five times more likely to kill themselves than women because of gender characteristics such as male roles and attitudes to seeking help. In fact, everything about health, and all diseases, are influenced by gender.

Gender mainstreaming is the method used to assess the implications for women, men and transgender people of any planned action on health, including legislation, policies and programmes. The new framework means the HSE will always have to incorporate the gender perspective and analyse the gender consequences of every decision before it is made.

Within the health system, gender mainstreaming still has a long way to go. The team who produced The Establishment of Hospital Groups as a Transition to Independent Hospital Trusts (2013) had a strategic group consisting of six men and two women, and a project group consisting of six women and two men, one of whom replaced another woman. All four external experts were men. Typically, a strategic group does all the talking and makes all the decisions, and a project group does all the work. Does this explain the composition of the groups? The new framework should mean these imbalances and unfair distribution of power and labour cannot happen in the future. Watch this space.

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