Pushing the boundaries of data to ensure gender equality across the life span
Authors: Jessica K Levy, Margaret E Greene
Journal: The Lancet Global Health (2020)

The growing global commitment to gender equality is handicapped by the systematic limitations of the measures and data available. In The Lancet Global Health, Elissa Kennedy and colleagues illustrate challenges in identifying and measuring the impact of gender inequality on health and wellbeing, as well as in how to interpret the data we have and the generalisations that can be made.1Kennedy E Binder G Humphries-Waa K et al.Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific region.Lancet Glob Health. 2020; 8: e1473-e1488Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar The authors point out that gender-relevant indicators for many aspects of health and wellbeing are lacking, and particularly so for children, younger adolescents, and males. This poses several problems. First, the available data reflect the social norms held by the people who conduct the research and thus reinforce what they and others already believe about gender and age as social categories. Second, there are limitations to what can be learned about gender disparities when data for certain indicators are not collected across all groups, making it impossible to compare outcomes and trends. Let us delve deeper. A main finding of Kennedy and colleagues' work is that clear gender inequalities emerge during early adolescence.1Kennedy E Binder G Humphries-Waa K et al.Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific region.Lancet Glob Health. 2020; 8: e1473-e1488Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar Is it possible that many of the gender inequalities that exist before adolescence are invisible to us simply because the data that would reveal them are not being collected? For example, although the desire to protect 10–14 year olds from the intrusion of data collection is laudable,2Devries KM Naker D Monteath-van Dok A Milligan C Shirley A Collecting data on violence against children and young people: need for a universal standard.Int Health. 2016; 8: 159-161Crossref PubMed Scopus (8) Google Scholar certain behaviours, such as sexual activity or exploitation, are either highly stigmatised or are believed not to be occurring at those ages and are, therefore, often neglected in data collection efforts among children.3UNICEFResearch on the sexual exploitation of boys: findings, ethical considerations and methodological challenges. United Nations Children's Fund, New York, NY2020Google Scholar Likewise, how can gender gaps between girls and boys in adolescence be understood when we use measures that do not capture the experiences of both? Many reproductive health measures, for example, are obtained from girls only, despite the fact that data on boys' contraceptive use, fertility intentions, and reproductive experiences have important implications for boys' lives as well.4Kavanaugh ML Kost K Frohwirth L Maddow-Zimet I Gor V Parents' experience of unintended childbearing: a qualitative study of factors that mitigate or exacerbate effects.Soc Sci Med. 2017; 174: 133-141Crossref PubMed Scopus (19) Google Scholar, 5Read S Grundy E Wolf DA Fertility history, health, and health changes in later life: a panel study of British women and men born 1923–49.Popul Stud (Camb). 2011; 65: 201-215Crossref PubMed Scopus (41) Google Scholar Beyond preventing a truly gendered analysis of these measures through comparing the experiences of boys and girls, the lack of data on boys reinforces girls' and women's responsibility for contraceptive use, pregnancy, and childbearing.6Greene ME Berger BO Hakobyan L Stiefvater E Levtov RG Getting to equal: men, gender equality, and sexual and reproductive health and rights. Promundo-US, Washington, DC2019Google Scholar The indicators at our disposal reflect gendered assumptions that we cannot escape as long as we fail to compare groups across these measures. In addition to having incomplete data, efforts towards gender equality are also constrained by the ways in which we continue to interpret the data we do have. Kennedy and colleagues correctly highlight that most existing data for research on gender inequality are sex disaggregated and conflate the concepts of sex and gender; however, rather than labelling their own data as being sex disaggregated, the authors explicitly state that they have assumed sex to represent gender for their analysis.1Kennedy E Binder G Humphries-Waa K et al.Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific region.Lancet Glob Health. 2020; 8: e1473-e1488Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar Is it not the responsibility of researchers to present the meaning of these measures and outcomes? By not labelling their data as sex disaggregated, the authors risk further perpetuating the false notion that sex and gender are interchangeable. Perhaps more importantly, they are missing an opportunity to underscore the ways in which sex-disaggregated data often reflect a system that is built on underlying gender norms. To fully understand why disparities exist and be able to address their upstream sources, we must explore how the cultural values, expectations, and beliefs associated with being a woman or feminine and being a man or masculine translate into disparate exposure to, experience of, and treatment for health-related outcomes. Finally, implicit in their very definitions, the terms gender and gender norms are contextual and vary over time.7Darmstadt GL Heise L Rao Gupta G et al.Why now for a Series on gender equality, norms, and health?.Lancet. 2019; 393: 2374-2377Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar Indeed, Kennedy and colleagues found substantial differences in gender-related outcomes within the Asia-Pacific region and emphasised the need for more context-specific data collection.1Kennedy E Binder G Humphries-Waa K et al.Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific region.Lancet Glob Health. 2020; 8: e1473-e1488Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar Nevertheless, the Article's overarching message suggests that the findings are generalisable to childhood and adolescence more broadly. To imply that these findings have regional—or even global—application could undermine efforts to explore cultural variations in gender norms and be detrimental to programmes and policies that address gender equality. If gender-related data continue to be collected, used, and interpreted in the same ways, we will only shine light into corners we already knew existed and leave other areas in shadows. Why not challenge ourselves to reshape what we are learning about the world beyond what we have understood of it in the past? The data we use are expressions of society's underlying assumptions: that boys are not experiencing violence, that their fertility is not as meaningful as girls' fertility, that 10–14 year olds are not having sex, and so on. By not pushing the boundaries of data and reimagining appropriate indicators to measure gender-related disparities in health and wellbeing, we risk reinforcing restrictive gender norms and missing opportunities that could advance a global commitment to gender equality across the life span. We declare no competing interests. The views and opinions expressed in this paper are those of the authors and do not reflect the official position of any of the organisations for which the authors work. Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific regionThese findings call for a focus on gender policy and programming in later childhood and early adolescence before gender inequalities become embedded. Full-Text PDF Open Access