‘Should you turn this into a complete gender matter?’ Gender mainstreaming in medical education

Abstract

The incorporation of a gender perspective in medical education aims toward better health, gender equity, and a better health care for both men and women. In this article, participants' responses to a Dutch gender awareness-raising project in medical education are discussed. Eighteen semi-structured interviews were held with education directors and change agents. Resistance towards and obstacles for gender mainstreaming in medical education were implicit in four themes: (1) biomedical knowledge was perceived to be gender neutral, to which knowledge about women could be added to the body of knowledge either with or without framing them as gender issues; (2) the relevance of gender was unofficially denied by downplaying it, particularly in comparison with culture/ethnicity; (3) medical education's social accountability was hardly mentioned and gender inequalities in health were framed as feminist political issues and not medical issues; and (4) we were urged to communicate carefully to increase acceptance and avoid overt resistance which situated gender inequalities outside the medical domain. Recommendations to change educational material were widely discussed; but specific features of gender were easily lost. This was especially true for power differences between men and women. Nevertheless, dominant systems of thought were challenged.

‘Important… but of low status’: male education leaders’ views on gender in medicine

“…Reports from such implementation efforts describe the hard work required to inform and interest teachers. 3,[39][40][41][42] One obstacle is that gender issues seem to be considered to represent women's issues. Studies carried out in the USA 43 and Canada 44 showed that female medical faculty staff were more gender-sensitive and found gender discrimination to be more of a problem than men did.…”

“…Obviously, the way gender‐related issues are discussed can cause irritation. The project leaders of a Dutch programme designed to mainstream gender‐related issues were urged to communicate carefully to avoid resistance 42 . However, focusing on form more substantially than on content is a way of disregarding and downgrading an issue.…”

“…Similar findings were described in a Dutch study with education directors and agents of change. Power‐associated differences between men and women and gender inequalities in health were framed as feminist political issues and not as medical issues 42 . Moreover, an Australian study reported that medical staff were reluctant to engage in uncomfortable discussions that might challenge the notion that all people are treated equally and identically 40…”

“…Accordingly, bringing more male teachers into gender education in medicine might improve the status of the gender‐based perspective. Earlier research has shown that mainstreaming and implementing a gender‐based perspective in medicine is facilitated by alliances between persons (women) aiming for change and senior male faculty leadership 39,40,42 . There is, however, an inherent dilemma in this strategy: improving the status of gender education by involving more men in it may endorse the asymmetry of the respective status of men and women.…”

“…Here, teachers are key persons. Reports from such implementation efforts describe the hard work required to inform and interest teachers 3,39–42 . One obstacle is that gender issues seem to be considered to represent women’s issues.…”