Gender norms and the wellbeing of girls and boys
Authors: Kylie King, Simon Rice, Marisa Schlichthorst, Patty Chondros, Jane Pirkis
Journal: The Lancet Global Health (2021)

Gender and health has become an area of major research and policy focus.1Hawkes S Allotey P Elhadj AS Clark J Horton R The Lancet Commission on Gender and Global Health.Lancet. 2020; 396: 521-522Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar Elissa Kennedy and colleagues' meticulous study2Kennedy 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 (14) Google Scholar on the health-based gender inequalities experienced by young people in the Asia-Pacific region offers timely insights. Underscoring the burden shouldered by adolescent girls and young women, their study also shines a light on boys and young men. We support their urgent call for a focus on adolescent males to address gender-related disparities. Harmful masculine norms have profound lifelong health outcomes and risks for boys and men.3Courtenay WH Constructions of masculinity and their influence on men's well-being: a theory of gender and health.Soc Sci Med. 2000; 501385Crossref PubMed Scopus (2404) Google Scholar Addressing these aspects of masculinity requires adolescent boys to break the normative man code—ie, the set of male-specific expectations, pressures, and behaviours largely policed by peers and elders, which demands conformity to silence and suppression of vulnerable emotions, enactments of power, invincibility, and risk-taking. One approach to address this harmful code is to work directly with communities to shift norms and behaviours;4Heise L Greene ME Opper N et al.Gender inequality and restrictive gender norms: framing the challenges to health.Lancet. 2019; 393: 2440-2454Summary Full Text Full Text PDF PubMed Scopus (197) Google Scholar however, there are few published studies of programmes that do so for adolescent boys. A 2019 review by Gwyther and colleagues5Gwyther K Swann R Casey K Purcell R Rice SM Developing young men's wellbeing through community and school-based programs: a systematic review.PLoS One. 2019; 14: 1-20Crossref Scopus (8) Google Scholar of male-focused community and school programmes identified 40 English-language studies, but only 14 of these were gender sensitive or gender transformative. In the past 5 years there has been a groundswell of male-focused programmes for boys and young men in Australia. Most of the studies in Gwyther's review were Australian, and we are aware of four more recent or ongoing evaluations: our ongoing cluster RCT (ACTRN12620001134910) of the male-focused education programme Breaking the Man Code, and evaluations by others of the ACT's programme Silence is Deadly (ACTRN12617000658314), and the national programmes Man Cave and Ahead of the Game. Australian social enterprise Tomorrow Man runs the Breaking the Man Code programme to support adolescent boys to interrogate the risks associated with particular masculine norms, encouraging a redefinition of restrictive and harmful masculine practices. Positive aspects of masculinity are harnessed to empower lasting changes to behaviours and attitudes. Our ongoing RCT examines the effectiveness of the programme. This trial and the Ahead of the Game evaluation are part of a larger project, The Buoy Project, that advances male suicide prevention in Australia through interventions delivered to boys and men where they work, live, and play. We call for sensitised place-based and culturally appropriate approaches to be developed, implemented, and evaluated in other countries, including in the Asia-Pacific region and beyond. Without such programmes for adolescent boys, the opportunity to intervene before gender inequality crystallises is lost. Addressing this issue can alter otherwise entrenched lifelong and generational effects of health-related gender inequality. We declare no competing interests. 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 AccessGender norms and the wellbeing of girls and boysElissa Kennedy and colleagues (December, 2020)1 described the emergence of gender disparities in health and wellbeing across the first two decades of life, arguing that they are caused by harmful gender norms. The gender inequalities framework1 implicitly presupposes that, in a just society, males and females would show equal outcomes on every metric considered. This expectation is at odds with a vast body of research on sex differences in psychobehavioural traits and life outcomes in humans and other species. Full-Text PDF Open AccessGender norms and the wellbeing of girls and boys – Author's replyWe are pleased our Article1 has generated interest and discussion, including around the need to include boys in gender policy, programming, and research. Full-Text PDF Open Access