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"Gender" –
roles prescribed for women and
men in culture or society
- When sex of provider and client is different,
client may be:
- hesitant to discuss sensitive issues
- uncomfortable having clinical procedures
- In couple counseling, provider may focus
more on
the man than the woman
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Gender affects the interactions between all service delivery
staff and clients. The word “gender” refers to the
roles prescribed for women and men in a particular culture or
society. Providers need to be aware of how gender roles affect
client-provider interactions and to be conscious of using effective
communication skills.
When the provider and client are of a different sex, issues
about gender roles may arise. In some cultures, a woman is not
supposed to talk about sexual issues, and those women who do
discuss such issues are considered “impure” or promiscuous.
A study in Bolivia found that women are often too embarrassed
or ashamed to discuss sexual issues with their husbands, and
find such a discussion even more difficult with a male doctor.
Similar issues can arise for male clients seeing a female provider.
Men may think it is not proper to discuss sexual issues with
women. For example, men considering vasectomy may fear it will
cause impotence but will not raise this concern with a woman.
Providers need to help men voice that fear and then explain
that vasectomy does not affect erection or ejaculation.
Gender roles can also affect the client-provider interaction
during clinical procedures. Many female clients are not comfortable
with a male doctor doing a pelvic exam, for example. If a female
doctor is not available, a male provider should have a female
assistant in the room during the procedure, if possible.
Gender issues also affect couple counseling. A counselor may
primarily address the man, presuming that he knows more about
family planning, controls the use of family planning, or simply
out of traditional styles of showing respect. In many cases,
however, the woman knows more about this subject and may need
the counselor’s encouragement to express her feelings about
using a contraceptive method.
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