Ageing, the Body and the Gender Regime

Health, Illness and Disease Across the Life Course

Susan Pickard, Jude Robinson, Susan Pickard, Jude Robinson

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429786532
• Edition: 1
• Topic: Ciencias sociales
• Subtopic: Feminismo y teoría feminista

The current (postfeminist) gender order comprises a highly complex coexistence of old and new norms and expectations, freedom and constraints, within a neoliberal social order underpinned by individualism and involving a shift in gender performance by men and women.

Health, illness and disease at different points in the life course can be used as a vehicle to illuminate structural and cultural inequalities that persist despite several decades of progressive reform in western countries. This collection brings together a number of key researchers, both established and new to the field, and based across North America, Australia, the UK and Europe, and comprises both empirical and theoretical work. Drawing on a wide range of disciplinary fields, including medical sociology, medical anthropology, nursing, gender studies, sociology of risk and age studies, all authors use heath, well-being, illness and disease as a lens through which to explore the complexities and inequalities associated with late modernity.

This book will be of interest to scholars and students of age studies, medical sociology and anthropology, gender studies, healthcare and nursing.

1 Embodying gender in the everyday

Exploring space, body-scrutiny and safety

Julia Coffey and Helen Cahill

Introduction: youth, gender, and health inequalities

Issues of gender and embodiment are currently central in discussions of women’s health and well-being. The wide-ranging public discussion facilitated by the #MeToo movement has shown the significance and scale of gender-based violence and harassment in contemporary Western societies. In this chapter, we draw on empirical data from a research workshop exploring young women’s negotiations of gender, sexuality, violence, space and safety. The examples we present provide a powerful illustration of the workings of continuing gendered inequalities in young women’s everyday lives, and the need to address these issues at the level of relationality and embodiment in order to produce the potential for change.

It is often assumed that youth and health go hand-in-hand: in other words, to be young is to be healthy, at least in comparison with older population groups. This is largely due to the definition of health being used (health as the absence of disease) with young people, the population group least likely to suffer from illness (Cahill, 2015). However, the World Health Organisation’s definition of health reflects contemporary understandings that health is about more than merely the absence of disease but rather that it encompasses physical and mental health, and general social ‘well-being’ (WHO, 2006). Young people have often been approached in health discourse in relation to preventable risk factors relating to so-called ‘lifestyle’ choices relating to sexual behaviour and substance use. A prevention lens is commonly harnessed with the aim of educating young people towards making healthy choices, thus avoiding negative health impacts and resultant problems. More recently, public health approaches have turned attention to the structural and environmental conditions influencing health outcomes, paying greater attention to the intersections between social inequalities and poor health outcomes rather than just the choices made at an individual level. This has drawn greater attention to the ways in which location, social class, gender, sexuality, culture and ethnicity work to influence health outcomes.

This growing ecological attention to the factors influencing health outcomes resonates with the attention in feminist literature to intersectionality (Crenshaw, 1991), with its focus on the ways in which colour, class and gender intersect to produce social disadvantage. The employment of a gender lens is particularly needed for two of the most significant health and well-being issues, which impact young people globally: gender-based violence and mental illness. These health issues are both inherently social in nature and thus cannot be effectively addressed via use of an individualistic focus on health choices. In this chapter, we report on a study investigating ‘gender in the everyday’ as experienced by young women at an Australian university campus, identifying the lack of a sense of safety from sexual violence and the intersecting pressures to appear attractive with negative impacts on well-being and participation.

Gender-based violence on the global agenda

A number of recent events have placed the gendered inequalities underpinning violence against girls and women on the global agenda. In 2015, the United Nations made a key development goal of ending all forms of discrimination and violence against girls and women by 2030 (United Nations, 2015). This goal recognises the structural nature of gender inequity, which underpins all forms of discrimination and violence. There is growing data highlighting the insidious and widespread nature of gender-based violence. The Violence Against Children surveys have been used in a range of countries in Asia and Africa to collect data about physical, emotional and sexual violence experienced by young people aged 13 to 24 years (Division of Violence Prevention et al., 2009; Swaziland UNICEF and CDC, 2007; Zimbabwe National Statistics Agency et al., 2013). A six-country study of gender-based violence found that experience of sexual violence for females before 18 years can range between one in five to one in three girls and that rates were higher in countries where there are also higher rates of acceptance of gender inequity and where other violence-endorsing attitudes persist (Fulu et al., 2013, p. 87).¹ The increased availability of data about gender-based violence has intersected with increased interest and attention to the health, social and financial vulnerabilities that particularly impact young women.

Australian data shows that 95 per cent of violence is perpetrated by men (Australian Bureau of Statistics, 2013). Younger women are particularly vulnerable to sexual violence with 48 per cent of women as compared to 18 per cent men over 18 years reporting sexual harassment during their lifetime (Australian Bureau of Statistics, 2013). In 2017, the findings of the first large-scale study of the prevalence of sexual assault and sexual harassment at Australian universities was released by the Human Rights Commission (Australian Human Rights Commission, 2017). The report paints a disturbing picture of the prevalence of these behaviours at Australian universities finding 51 per cent of respondents reported experiencing sexual harassment in any location during 2016, and 26 per cent of respondents reported that sexual harassment occurred in a location associated with the University, including travel to and from campus. For this group of respondents who had experienced sexual harassment, 29 per cent experienced inappropriate staring or leering, 23 per cent experienced sexually suggestive comments or jokes and 13 per cent experienced intrusive questions about life or appearance. The survey also found that 7 per cent had experienced a sexual assault at any location during 2015 and/or 2016 and that 1.6 per cent of respondents reported that the assault occurred at a location associated with the University. The results of the survey reflect the unacceptably high levels of sexual violence in the broader Australian community. The report outlines a number of recommendations for universities to address the high levels of harassment and assault occurring on campuses, including examining the gendered power relations that exist in particular spaces and contexts such as campus bars and colleges.

Qualitative first-hand accounts shared via social media have triggered a flashpoint for global discussions of the scale of sexual harassment and gender-based violence in the everyday lives of women. Escalated media attention came in October 2017 when The New Yorker reported that dozens of women had accused Harvey Weinstein, a prominent Hollywood film producer and executive, of sexual harassment, sexual assault or rape. Shortly after, more than 80 women in the film industry subsequently accused Weinstein of such crimes. Subsequent discussions triggered many similar allegations against powerful men around the world and led a great number of women to share their own experiences of sexual assault and harassment on social media under the hashtag #MeToo. The affordance of social media as a tool to enable women to voice their concerns and to take victimisation out of the closet worked to re-illuminate the significance of hierarchical gender relations underpinning all forms of gender-based violence. It exposed to public view the pattern of silencing around sexual assault and the ways in which widely held cultural norms not only naturalise but also continue to idealise (heterosexual) gender binaries of female passivity and male domination.

Poor mental health is patterned by gender relations

Use of a gender lens has enabled recognition that poor mental health is a gendered phenomenon with girls and young women reporting higher levels of poor mental health (particularly anxiety and depressive symptoms) than boys or young men (Bremberg, 2015; Fergusson et al., 2007; Patton et al., 2014). In the Australian context, girls of 16–17 years are more than twice as likely as boys to experience major depressive disorders with 19.6 per cent of girls compared to 8.2 per cent of boys of 16–17 years experiencing mental health problems (Lawrence et al., 2015). Another large Australian study investigating the age group 15–19 years showed that just under 60 per cent of females were very concerned about coping with stress as compared with around 25 per cent of males, and 28 per cent of females indicated a major concern about depression as compared to 16 per cent of males (Bullot et al., 2017). This study also revealed other gender-related stressors with over 40 per cent of females reporting that they were highly concerned about body image as compared with only 17 per cent of males. Given this data, gendered inequalities can be seen as the underlying causes of two of the most significant health and well-being issues for young women. Theories of the body are important to help understand these issues since the corporeal condition of identifying as ‘woman’ is key to the experience of these inequalities.

Embodied approaches to understand youth, gender and health

Contemporary feminist scholarship seeks to attend to the way in which the body is shaped in relation to ever-changing social, historical and structural contexts which surround it and in which people live (Blackman, 2008; Grosz, 1994). ‘Embodied’ approaches to youth and health emphasise that the body is more than an object upon which culture and society are written and highlight the importance of addressing bodies and embodied experiences as meaningful sources and agents of change (Coffey, 2016; Coffey et al., 2016; Coffey and Watson, 2015). A range of work has shown how specific attention to issues of embodiment can illuminate crucial details and depth relating to the intersecting forces connecting bodies and sociocultural contexts that are commonly missed in the youth public health agenda (Coleman, 2009; Keane, 2005; Renold, 2018; Ringrose and Harvey, 2015).

A focus on embodiment entails a specific intention to place the body – and embodied experience – at the forefront of analysis. This approach also aims to highlight the active relations between bodies and the world. This focus on the body’s potential and lived experience can assist in moving beyond previous approaches in which the body is invisible or rendered inferior to the mind in a binary logic (Coffey, 2016). ‘Thinking through the body’ can open up a way of exploring the ways the body is implicated in the complexities and tensions in young people’s lives. It can also provide a lens through which the intersecting sociocultural forces associated with gender, place, ethnicity and sexuality, for example, can be explored and addressed.

In parallel with attention to embodiment and gender comes an effort to harness research methods, which enable attention to the ethico-socio-material processes which produce identities (Renold, 2018). Coleman and Ringrose (2013) urge attention to the ‘performativity’ of method and the importance of seeking methods which permit visibility of the assemblages of production. Use of embodied and performative drama-based methods can help draw attention to the workings of the social and material world as they foreground bodies as carriers of knowledge and permit attention to the intersection of the micro and the macro (Cahill, 2008; Cahill and Coffey, 2016; Cahill et al., 2015).

The alignment of a focus on embodiment and method is particularly important in the examples we discuss in this chapter. We report on a study investigating ‘gender in the everyday’ as experienced by young women at an Australian university campus, identifying the lack of a sense of safety from sexual violence, and the intersecting pressures to appear attractive with negative impacts on well-being and participation. In order to better understand the experience of gender in the everyday lives of young women on campus, and with an interest in approaching this understanding through a focus on the body, we recruited female participants to a half-day workshop with this as the stated purpose.

‘Gender in the everyday’: exploring embodied negotiations of risk and safety on a university campus

The workshop methods we used aimed to position young people to show and then to tell about the everyday nature of the micro experiences of gender-based inequalities that impact on well-being. We used embodied drama-based methods because they offer an opportunity for participatory enquiry into the fluid and material nature of human experience (Cahill et al., 2016). The research activities worked to mobilise bodies to ‘imagine’ and articulate differently ‘everyday’ gender scenarios. We worked beyond the more traditional qualitative focus group and interview methods, which tend to harness the individual ‘mind’ through talk, to focus specifically on the potential of moving bodies to create a response and highlight the significance of intersecting sociocultural forces. The emergent data show how using this kind of embodied approach and method can illuminate crucial details and depth relating to the intersecting forces connecting bodies and sociocultural contexts that are commonly missed in the youth public health agenda.

Our respondents included ten female university students aged between the ages of 18 and 23 years.² Following initial participatory games, they were asked to work in groups of four to create a still image with their bodies depicting the position of ‘the female undergraduate student on campus’. We ran the audio recorders to capture the small group discussions as they worked to design their freeze frame ‘scenes’ (Coffey and Cahill, forthcoming).

The following excerpt is taken from the transcribed audio recording from one group as they independently discussed the task. It gives a useful insight into the significance of embodied sensations in the experience of gender, and the work required by the young women to manage their bodies in negotiating perceptions of risk both in campus and other public spaces:

MON: I personally really like uni. But I still, you know, there still is always that concern . . . as females, we’re constantly on edge. I feel constantly on edge when I’m alone.

STEPH: And walking to my ca...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• Embodying the gender regime: Health, illness and disease across the life course
• 1. Embodying gender in the everyday: Exploring space, body-scrutiny and safety
• 2. Unscrambling risk, contesting expertise: The case of the human papillomavirus (HPV) vaccine
• 3. Bodies and boundaries in three generations
• 4. Contested chronic conditions fused with medical uncertainty: Gendered perspectives
• 5. Reclaiming menopause
• 6. Beyond lipstick and woodwork: Why gender matters when living with dementia
• 7. ‘Men are not women’: Biomedicine and the (hetero)sexing of ageing bodies
• 8. Toward an intersectional approach to health in later life: Incorporating age relations
• 9. Reproducing gender and smoking
• 10. Femininity and frailty through the life course
• Index