Handbook on Gender and Health

This post was contributed by Dr Jasmine Gideon, senior lecturer in Development Studies at Birkbeck’s Department of Geography, Environment and Development Studies. Here, Dr Gideon offers an insight into her new book: The Handbook on Gender and Health

My monograph ‘Gender, Globalization and Health in a Latin American Context’ develops the idea of a gendered political economy of health and uses this framework to consider health reform in Chile. Compiling the Handbook on Gender and Health offered me an opportunity to develop my ideas further through directly engaging with a wide range of

Dr Gideon's book cover features an piece by Gambian artist Suelle Nachif titled 'Faj' ('heal')

Dr Gideon’s book cover features a piece by Gambian artist Suelle Nachif titled ‘Faj’ (‘heal’)

academics and policy makers working in this area.

The Handbook offered an opportunity to highlight empirical examples from across the globe and draw attention to case study analysis of specific issues that I was not able to include in my own book. Working on the Handbook was also a chance to think about what my ‘dream team’ of authors would look like and bring together a wide range of writers working on a variety of health-related issues, ranging from the historical development of health systems and how women and men are located within this to more ‘contemporary’ debates around migration, climate change and low paid labour which all have critical implications for health, particularly when viewed through a gender lens.

The Handbook brings together a wide range of disciplinary perspectives to consider four overarching themes, all constituting distinct but over-lapping elements of a broader gendered political economy of health. These are:

Gender equity vs gender equality

The first theme is the tension between ideas of gender equity and gender equality and how these translate in practice when applied to the health sector. Chapters explore the difference between ‘reductionist’ approaches where categories of women and men are not sufficiently explored, for example by failing to address how other axes of inequality (e.g. race/age/ class) can affect people’s ability to engage with health systems. In contrast a gender equality approach seeks to promote gender justice.

According to UN Women (2010), this entails ending the inequalities between women and men that are produced and reproduced in the family, the community, the market and the state. However, at the same time it requires that mainstream institutions are more accountable and transparent and points to the second theme discussed in the book.

Dr Jasmine Gideon

Dr Jasmine Gideon

The gendered nature of health systems

Several of the chapters reflect on the need to uncover the gendered nature of the health system itself and shed light on the diverse ways in which women’s interests are frequently marginalised or health policies work to reinforce women’s gendered roles and responsibilities.

Including marginalised voices

The third theme that is examined is the importance of incorporating the voices of excluded groups in policy processes as several chapters highlight the health costs of failing to engage with marginalised sectors of society.

Challenging ‘one size fits all’

Finally the fourth theme that emerges from a number of the chapters is the importance of appropriate policy responses and a move away from the ‘one size fits all’ approach, often espoused by international donors and global health discourses.

Within the Handbook authors from the Global North and South highlight how many of these challenges have wider relevance to all of our lives and that ‘gender’ remains central to any analysis of health, regardless of the level of development within the health system or wider economy.

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“Girlness” is a state of mind: Exploring contemporary Japanese women’s theatre and visual arts

This post was contributed by Dr Nobuko Anan, lecturer in Japanese Studies at Birkbeck’s Department of Cultures and Language. Here, Dr Anan offers an insight into her new book on Japanese girls’ culture

Dr Nobuko Anan's new book 'Contemporary Japanese Women’s Theatre and Visual Arts Performing Girls’ Aesthetics' (Palgrave Macmillan, 2016)

Dr Nobuko Anan’s new book ‘Contemporary Japanese Women’s Theatre and Visual Arts
Performing Girls’ Aesthetics’ (Palgrave Macmillan, 2016)

Japanese girls’ culture evokes various images, such as Hello Kitty, cute fighting girls in anime and female students in the sex industry. However, in my monograph, Contemporary Japanese Women’s Theatre and Visual Arts: Performing Girls’ Aesthetics (Palgrave 2016), I have introduced another type of Japanese girls’ culture, which I call “girls’ aesthetics.” These aesthetics are not well known outside of Japan, but are present in many types of contemporary Japanese women’s theatre and visual arts.

An escape from the pressures of Japanese society

Girls’ aesthetics arose in the early twentieth century Japan with the establishment of Western-style girls’ mission schools and the publication of girls’ magazines. These physical places and objects created a space where girls could escape from societal pressures within Japan’s growing empire.

In this space, girls rejected their future as the embodiment of state-sanctioned motherhood, that is, reproducers of culturally and ethnically “pure” Japanese citizens, and instead fantacised same-sex intimacy in (what they imagined as) a tolerant West and romanticised death as a means to reject motherhood. The influence of these themes can be seen in the contemporary period, for example, in the Rococo/Victorian-inspired Gothic-Lolita fashion and boys’ love manga, which are mainly consumed by female readers.

“Girlness” is a state of mind

Although girls’ aesthetics originated in schoolgirl culture in the modern times, one of its important characteristics is that it is embraced not only by female adolescents but also by adult women and in some cases by men. One of the points I have made in the monograph is that “girl” as an aesthetic category does not exclude people based on their sex or biological age. “Girlness” is a state of mind. Indeed, the monograph is about the ways adult women artists make use of girls’ aesthetics as a political tool to challenge stereotypical womanhood.

In these aesthetics, girls’ desire to escape motherhood through an eternal girlhood, which can only be achieved by death as a girl. Related to this, I discuss NOISE’s play about the group suicide of high school girls and Yubiwa Hotel’s production, where girlie adult women use violence on each other as if to help each other to terminate their lives as mothers. This rejection of motherhood can also be seen in Miwa Yanagi’s visual art work, in which time only circulates between girls and old women.

Imagined Westernised spaces

Another aspect of girls’ aesthetics is that they seek to escape the heterosexist and nationalist Japanese reality through imagined Westernised spaces. I explore this within the work of Moto Hagio’s and Riyoko Ikeda’s girls’ manga pieces, which are love stories between androgynous characters in the Western countries.

The two-dimensional nature of manga provides a space for imagining this liberation from material reality. I also examine how this two-dimensionality is captured or lost in theatrical adaptations by the Takarazuka Revue and Studio Life and a film adaptation by Shūsuke Kaneko and Rio Kishida.

While I discuss in great detail the ways girls adore the imagined West, I also explore the dance troupe KATHY, whose members demonstrate Japan’s ambivalent relationship with the West. They portray a nostalgic image of Westernised girls by wearing blond wigs and 1950s-style pastel-coloured party dresses, but they stage failures to dance ballet and other Western-style dances.

While this could be a critique of Westernisation of Japanese bodies, it is less clearly so, because the group is anonymous (the members cover their faces while they dance) and therefore we cannot be certain that they are Japanese.

About the book

Girls’ aesthetics provide a rich alternative conception of women, where many of the traditional dichotomies (e.g., girls as failures as opposed to “fully-fledged” women, Japanese women as the opposite to Western women, etc.) are reconfigured in ways that differ from Western representations of women.

This book is of interest for students in theatre, visual arts, media studies, Japanese studies and gender/sexuality studies.

More information about the book is available here.

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Gender and Class in English Asylums, 1890-1914

This post was contributed by Dr Louise Hide, Honorary Research Fellow in Birkbeck’s Department of History, Classics and Archaeology.

In July 1905, a young draper’s assistant from south-east London was admitted to Bexley Asylum. Gertrude L. was 25 and this was her third admission into a lunatic asylum.

Initially, she was described as ‘strange and irrational in manner’. But by January 1906, she was corresponding with her friends on the outside. One letter that was copied and left in her case file provides an intriguing insight into asylum life from the patient’s point of view:

in this so called asylum … you are … treated like the worst form of cattle … We work all the hours God sends without proper nourishment or a proper bed … our hours of work are from 8 in the morn to 20 or 30 minutes past 7 in the evening … and you never see the colour of a copper coin.

From the 1960s to the late ‘80s, Marxist and feminist scholars set out to disabuse Whiggish historians of the notion that the understanding and treatment of mental illness had followed an uninterrupted upward trajectory called ‘progress’ from the late 18th century. As a result of this work, we know a great deal about why and how people were admitted to asylums, but far less about what actually happened to them once the ward door had been shut and the key turned.

What was life like inside these vast ‘monster’ institutions? And how were relationships between doctors, nurses and attendants, and patients constructed by shifting ideas around masculinity and femininity?

Book coverMy book, Gender and Class in English Asylums, 1890-1914, sets out to answer these questions through a detailed analysis primarily of asylum case notes, committee minutes and annual reports. I have focused on two institutions, Claybury and Bexley. Each was built for 2,000 patients by the newly formed London County Council and opened in 1893 and 1898 respectively.

The turn of the century was an important moment in asylum history. Late Victorian psychiatry was experiencing a ‘clinical turn’ away from the old prison-like asylums towards the new mental hospitals, from the ‘lunatic’ to the mental patient, the attendant to the nurse. That, at least, was the idea even though the reality took some time to catch up.

Location is important, too. London had far higher lunacy rates than any other part of the country. Why?

Migration into the city was one reason. Lack of space and desperate poverty was another; families were simply unable to look after members who could not contribute to the household budget. But there was another reason, too: the abhorrent notion of degeneracy, which claimed that physical, mental and moral ‘defects’ (criminality, prostitution etc.) were passed on from one generation to another, creating an increasingly ‘unfit’ population. And this hereditary ‘taint’ was believed to be particularly prevalent in large, overcrowded urban areas, such as London.

Indeed, degeneracy theory fed directly into eugenics, making the early 20th century one of the darkest periods of psychiatric history.

My book looks at the impact of some of the overarching ideologies that were circulating at the time – degeneracy, feminism, socialism, science and the medicalisation of madness – on people in the asylum.

General hospitals had a powerful influence on the faltering discipline of psychiatry. Gradually, a new generation of well-qualified and scientifically-minded physicians, including a handful of women, started to take up asylum posts. Nurses began to receive formal training and gain recognised qualifications. And, perhaps most controversially, female nurses were moved into male wards shaking up these men-only bastions.

As a result, the highly gendered male doctor/female nurse binary was reinforced, marginalising many male attendants and reducing some to little more than nursing auxiliaries.

To return to Gertrude L., the patient experience is an important part of the book. During a period when virtually every aspect of asylum life was intended to act as ‘treatment’, I endeavour to reveal the effects on patients of the admission process, drugs, seclusion and restraint, the ward environment, work and amusements.

Why, for example, were the ‘rougher’ women put to work in the laundry? How were ward interiors designed in order to distract patients from their dark and troubling thoughts? In what way was food rationed according to a patient’s sex? And what were the consequences of forcing pauper patients to wear communal clothes?

There was, of course, no single patient experience. However, my book does, I hope, provide greater insights into how wider social and medical discourses influenced the lives of men and women living and working inside London’s late Victorian asylums at the most quotidian levels.

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Parents in Parliament: The Motherhood Trap

This post was contributed by Dr Rosie Campbell, a Senior Lecturer in Birkbeck’s Department of Politics and Professor Sarah Childs (University of Bristol). It was originally published on the British Politics and Public Life blog.

Men’s over-representation and women’s under-representation in the UK Parliament is pretty well known, even if the public sometimes over-estimates just how many women MPs there are, bedazzled by their bright clothing in the Chamber.[1] In fact, men outnumber women by more than 4:1. (In his 2009 survey conducted by YouGov, Professor Phil Cowley (Nottingham) asked respondents what they thought was the correct percentage of women MPs was. At the time the average response was 26% when the actual figure was closer to 20%.)

Some people may not find this particularly troublesome. Lord Hurd has recently been cited saying that there is a “ludicrous” obsession with ensuring there is equal representation of men and woman in parliament and other areas of public life. We believe very strongly that a diversity of background and experience does matter. And there’s another serious flaw with the Hurd line of reasoning. He says that if voters didn’t want a “good looking chap from a public school” as prime minister they wouldn’t keep choosing them. But the reason feminists have campaigned for All Women Short-lists as a means to get more women at Westminster is precisely because it’s political parties not voters who choose our candidates and party leaders. We the voters don’t get to choose our parliamentary candidates, and therefore who our MPs, are. The reasons there are too few women in politics stems from both a lack of demand for and supply of women candidates: voters don’t punish women candidates. But in the absence of equality measures such as Labour’s All Women’s Shortlists, parties are much less likely to select women in winnable seats, even if fewer women seek selection as parliamentary candidates overall.

Having children is frequently cited as a barrier that holds women back from seeking parliamentary selection. But of course not all women are mothers. And both men and women are parents. So we need to question whether the problem is less about the equal representation of men and women – or parents and non-parents – and perhaps more about the exclusion of mothers?

Until now, the UK Parliament simply did not know how many mothers or fathers sat on its green benches. During the new Labour years, and again since 2010, a number of women MPs have given birth: the latest being the Liberal Democrat Minister Jo Swinson, who is currently facing criticism for wanting to have her child with her in the division lobby. We doubt that the vocal hostility to the needs of a new mother, that her comments have generated, are likely to increase the supply of mothers seeking selection for the 2015 general election.

In our survey (supported by the Speaker of the House of Commons and the Commons Diversity and Inclusion Unit )of MPs in 2012 we found a startling set of facts about mothers and fathers in Parliament:

• 45% of women MPs have no children, compared to 28% of male MPs, and compared to an average of about 20% of the population who remain childless. (According to the Office for National Statistics 20 percent of women born in 1966 remain childless.)
• Of all MPs with children, male MPs have on average 1.9 children, whilst women MPs have on average only 1.2
• The average age of women MPs’ eldest child, when they first entered parliament, was 16 years old ; the average age of men MPs’ eldest child when they first entered parliament was 12 years old
In sum: women MPs are (1) less likely to have children than male MPs; (2) more likely to have fewer children than male MPs; and (3) enter parliament when their children are older than the children of male MPs.

These staggering differences are clear evidence that there are serious barriers to Parliament for those with caring responsibilities, most often mothers.

Reactions to these statistics will likely vary depending on whether you believe that the House of Commons should look like the society it represents for reasons of justice; or whether you think that good-looking public school educated men are equally capable of understanding the complexities of juggling work and family life. There will be those who have no fear that without mothers in Parliament the soaring costs of childcare and the disproportionate effect of the economic crisis on women in low paid and part-time work (mostly mothers) will reach the top of the political agenda. We’re not so sure. And that’s why we want more mothers in Parliament.

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