GENDER INEQUALITY & ITS IMPACT ON MENTAL HEALTH

INTRODUCTION

GENDER DISCRIMINATION

Gender discrimination is termed as the unfair or unequal treatment of individuals or groups of

individuals on the basis of gender. Discrimination on the basis of gender (or sex) is a
widespread violation of human rights that assumes various layers, including sexual
misconduct, pregnancy discrimination and unequal compensation for women doing the same
work as men. Gender disparity has been a major problem for decades in India.  Equal
treatment  is not only a basic human right, but also a vital cornerstone for a peaceful and
harmonious society.

Patriarchal expectations have always considered women to be subordinate to men. Even

now, a girl child is considered a liability for parents and while, some women experience the
effects of patriarchy all their lives, some aren't even allowed to be born and are killed in the
womb itself.  Even in the 21st century, when women have proven to be powerful leaders in
every position imaginable, these practices still continue and women still aren't treated
equally. Even today amid such development, women face systemic discrimination in most
Indian households. Indian culture has not yet been enlightened to the importance of
empowering women.

CAUSES OF GENDER INEQUALITY

Through the years, society seems to have gotten closer to reaching equality for women.
Despite all of these advancements in the field of employment, healthcare, politics etc. the
World Economic Forum predicts that it will another 108 years before equality between men
and women becomes a possibility in every aspect. Some of the reasons gender inequality is
till so prevalent are as follows:
1. UNEQUAL ACCESS TO EDUCATION: Around the world, women still have less
access to education than men. One-fourth of female children aged 15-24 are likely to
not even be able to complete primary education. These women constitute nearly 60%
of all the people who won’t finish primary school. Women also account for two-thirds
of all the illiterate people in the world, which proves how they are disproportionately
affected by gender inequality. Education provides the basis for future opportunities
and lack of it, in woman, adversely affects their future and employment opportunities
making them prone to poverty.

2. LACK OF EQUAL EMPLOYMENT OPPORTUNITIES: Women have the same

legal working rights as men in just six countries around the world. Women are offered
only three-fourth rights as compared to men in the working arena. Research has
shown that if women were to get equal employment opportunities, it would have a
positive domino effect and they are more likely to experience less gender
discrimination in other areas as well.

3. LACK OF AUTONOMY OF WOMEN’S BODIES: Apart from this, women are

not even given the freedom to make decisions regarding their own bodies, be it on an
individual level or legislations related to birth control or abortions. Birth control is
more often than not, inaccessible. WHO indicates that nearly 200 million women
don’t use any form of contraception, despite their unwillingness to get pregnant. Some
of the reasons for this are unawareness about options, limited access and sometimes,
even cultural or religious oppositions. Around the world, nearly 40% of pregnancies
remain unplanned, out of which, half result in abortions while in 38% of the cases, the
child is born. This leads to women compromising their freedom and they often end up
becoming financially dependent either on another person or on the state

4. LACK OF PROPER HEALTHCARE FACILITIES: All these factors are often

interrelated as lack of access to education leads to inadequate employment
opportunities, which in turn leads to poverty. This is linked to women not being able
to afford better healthcare facilities. Women tend to receive poorer quality of medical
care as compared to men. Sometimes, women often face discrimination and dismissal
 from doctors, which further broadens the gender gap in getting access to proper
healthcare.

5. LACK OF RELIGIOUS FREEDOM: According to the World Economic Forum,

when extremist ideologies enter a community, the gender gap gets worse. In a study
undertaken by Georgetown University and Brigham Young University, researchers
were able to associate religious intolerance with the ability of women to contribute to
the economy. More stability of economy is observed when there is more freedom of
faith, because of increased contribution of women.

6. LESS REPRESENTATION IN POLITICS: In all national parliaments, only 24.3%

of the positions were occupied by women at the beginning of 2019. Only eleven heads
of state were women as of June, 2019. Women remain disproportionately
underrepresented in politics and the electoral sphere, despite some advancement in
this field over the years. This suggests that some concerns that female lawmakers seek
to pose are frequently ignored, such as maternity leave and childcare, pensions,
legislation on gender discrimination and gender-based abuse.

7. MINDSETS OF THE SOCIETY: This is less concrete than any of the other factors,
but there is a substantial effect on gender disparity because of a society's general
mentality. In every domain, be it work or the justice system or childcare, the
way society defines the importance of men as compared to women plays a starring
role. Gender stereotypes run rampant, and while legislation and systemic reforms will
make improvements, there is also a pushback after periods of significant reform.
When there is advancement such as in the form of greater inclusion for women in
leadership positions, it is often common for both men and women to neglect other
aspects of gender discrimination. These types of ideologies foster gender
discrimination and delay meaningful reform.

EVERYDAY SEXISM
In many apparent ways, patriarchy and misogyny affect women. Women face demographic,
labour and health-care disadvantages, violence at the hand of partners, gender-based violence
in public spaces, and street harassment. Many individuals claim that anti-discrimination laws,
fair wage laws, abortion laws, etc. are all that are required to attain gender equality. Yet in far
more nuanced forms, misogyny pervades in our culture, and its consequences are not
necessarily so tangible. This discrimination is perpetrated not just in the workplace and on the
streets, but in social environments and in our own homes even by those who love us. Sexism
in daily life can take multiple forms. The advocacy of stereotypical gender role biases and
assumptions is one form of discrimination experienced. Women are often met with prejudices
and certain gender roles are propagated by the society that further contributes in sustaining
the patriarchal norms, like “women are bad drivers” or “women are over-emotional”.
Demeaning or degrading treatment, such as sexist jokes and remarks, was another form of
casual sexism women experience. It’s not uncommon for women to witness such remarks
even in their families or friend circles. It does play a role in deterioration of women’s mental
health. Another type of sexism is sexual objectification, such as street harassment and
touching without consent and unwanted sexualisation of women’s bodies.

Women might not always face any formal obstacles to inclusion, but may still be held back
by societal expectations that undermine them.  For instance, women are still forced to take
care of the family along with the children, regardless of whether they are working and that
places undue pressure on them and could impede their job efficiency. This negative
stereotyping can involve being underestimated and delegated with simpler tasks than men. 
Women can also face social alienation and loneliness, such as not being asked to catch-ups
outside of hours. Rules and laws against gender inequality do not prohibit people with sexist
views from treating others differently. This is especially valid when it is unintentionally
perpetrated, as in those forms, it is not observable to everyone.

In the backdrop of our lives, casual everyday sexism is always present at a persistent low
level, creating an additional layer of anxiety for women. These implicit ways of casual
sexism have been related to worse mental wellbeing, predictably. Subtle types can be as
detrimental as more overt forms of misogyny. It may be difficult for those who don't witness
it to understand daily sexism. Research demonstrates that men are less likely than women to
acknowledge indications of gender inequality. This is undoubtedly due to our own
perspectives and our prejudices being limited by perceptions and biases. Perpetrators or
bystanders may not acknowledge everyday discrimination, but it may break women down
and is related to worse physical and mental wellbeing.

GENDER DISCRIMINATION AND MENTAL HEALTH

The prevalence of certain mental illnesses, including anxiety, depression and somatic
symptoms, is associated with gender. Women are more likely to be diagnosed with severe
depression, for instance, while men are more likely to be afflicted with drug addiction and
antisocial personality disorder. The diagnosis levels of disorders such as schizophrenia,
borderline personality disorder, and bipolar disorder do not have significant gender gap. Due
to previous violent experiences such as accidents, warfare, and witnessing someone's death,
men seem to be at the likelihood of suffering from post-traumatic stress disorder
(PTSD), whereas women are diagnosed with PTSD at higher rates due to experiences of
sexual harassment, rape, and child sexual violence. Labels like non-binary or genderqueer
describes people who do not identify as either male or female and exist outside of the gender
binary. Individuals identifying as nonbinary or gender queer exhibit elevated risk of
depression, anxiety or PTSD. Transgender people also show a higher prevalence of
depression, anxiety and PTSD.

Even though, gender bias might seem harmless to others, it can have a permanent, serious and
lasting effect. Discrimination against women has an effect on all facets of women's lives,
including unequal access to employment and better healthcare services, which can contribute
to adverse health outcomes. In places with even less resources where numerous
disadvantages overlap, this power disparity is extremely alarming. In addition to sexism,
shame, social isolation and abuse (eg. 'honour killings') can be met by women who refuse to
meet their gender socio-culture expectations. Women can have many dimensions of minority
status, due to ethnicity, colour etc. When there is an intersection of these minority statuses,
women can be discriminated against from an infinite range of angles, adding together to more
distress and poorer mental health consequences. Gender-based isolation, social alienation,
intimidation and bullying are all increasingly recognised as adding to the burdens of
discrimination and inequality.
Discrimination can be implicit or overt, aware or unaware and can infiltrate all aspects of
society. Gender discrimination in the workplace involves harassment, unfair pay and the
enforcement of laws that disadvantages one gender. While in many countries gender
inequality is unlawful, it remains apparent. Several psychological disorders, including severe
depression and post-traumatic stress disorder, have been associated with perceived gender
inequality. Women that earn less than men are considerably more likely than their male peers
to suffer from major depression.

These results give tentative but conclusive evidence that discrimination against women plays
a significant role in affecting their mental health.

Greater attempts need to be made to eliminate discrimination against women across all of
society by raising awareness, creating innovative and implementing current strategies,
increasing women's representation in positions of authority, and promoting gender equality
across systems and societies.

AIM: TO STUDY THE CORRELATION BETWEEN GENDER DISCRIMINATION

AND MENTAL HEALTH OF GENDER MINORITIES TAKING INTO ACCOUNT
VARIOUS DIMENSIONS SUCH AS SOCIO-ECONOMIC STATUS, EDUCATION,
AGE, OCCUPATION, ETHNICITY ETC.

REVIEW OF LITERATURES
Rueda and Artazcoz (2009) examined gender disparities among aged persons by addressing
three dimensions of health determinants worldwide: social and economic status, family
environment and social assistance. A sub-sample of people aged 65–85 years without paying
jobs was chosen (1,113 men and 1,484 women). The health outcomes examined were self-
perceived health status, poor mental health status and long-standing limiting illness. The
health status amongst elderly women was observed to be much worse than among men for
the three outcomes examined. The findings highlighted the importance of using a holistic
approach for the study of inequalities.

Kira et al. (2010) studied the effects of gender discrimination (GD) on refugee torture
survivors and its potential role in the development of cumulative trauma disorders (CTD) and
symptoms of post-traumatic stress disorder (PTSD). There were 160 female survivors of
torture from over 30 countries in the sample for the study. Structural Equation Model (SEM)
was used to test multiple possible models for the direct and indirect impact of GD on PTSD
and CTD. The findings suggested that the impact of identity trauma on CTD and PTSD are
mediated by GD. GD has a direct impact on CTD but the development of PTSD did not seem
specifically to be affected by GD.

Axinn et al, (2013) examined the impact of gender, traumatic events, and mental health
disorders in a rural Asian setting of Nepal that experiences a decade-long armed conflict.
Over 400 adult interviews were conducted and data was extracted from them. The measures
come from World Mental Health survey instruments clinically validated for this study population
to measure depression and post-traumatic stress disorder. The findings suggest that in this
setting, traumatic life events substantially increase the risk of mental health problems, and
that these stressful experiences have a greater impact on women's mental health than men.
These results give valuable insight about the potential mechanisms that lead to gender
disparities in mental health in a variety of settings.

Landstedt and Persson (2014) researched in real-life (IRL) and cyberbullying related
influences to investigate their associations with the mental health of Swedish boys and girls
13 to 16 years of age. The data was derived from a web-based cross-sectional analysis of 13-
16-year-old students from northern Sweden. Non-supporting school climate and negative
body image were shown to be associated with both genders' vulnerability to bullying, but the
association was more distinguishing in girls. All forms of bullying were correlated with
depressive symptoms in both the genders but it was found that girls were more likely to suffer
from psychosomatic problems. It’s important to understand gender implications of bullying.

Satyanarayana et al. (2015) studied the mental health implications of abuse against women
and girls. Recent studies were reviewed in numerous contexts for the same . A variety of
prospective studies have found that children sexual abuse (CSA) and depression are highly
correlated. Certain groups of women such as adolescents, migrants, the homeless, and women
in the perinatal period were specifically at higher risk. The prevalence of depression and post-
traumatic stress disorder (PTSD) among women with bidirectional violence was even higher.

Sutter and Perrin (2016) analyzed the trends of discrimination, mental well-being, and
suicidal ideation among LGBTQ people of color. Two hundred lesbian, gay, bisexual,
transgender and queer (LGBTQ) people of color (POC) were polled in a US-based
nationwide online sample on their experiences of LGBTQ-based discrimination, racism,
mental health, and suicidal ideation. A structural equation model (SEM) was developed and
showed that discrimination based on LGBTQ exerted an indirect impact across suicidal
ideation through mental health. The impact on mental health of LGBTQ-based discrimination
may be a critical focus for strategies to minimize suicidal ideation among LGBTQ POC.

Seidler et al. (2016) studied the role of masculinity in men’s help-seeking patterns for
depression. Conformity to conventional male gender roles can discourage the help-seeking
patterns of men. Six electronic databases were searched using terms associated with
masculinity, depression and help-seeking. Titles and abstracts were analysed and information
for analytical accuracy was routinely collected and evaluated. Findings suggest conformity to
traditional masculine norms has a threefold effect on men experiencing depression,
impacting: i) their symptoms and expression of symptoms; ii) their attitudes and actual help-
seeking behaviour; and, iii) the management of their symptoms. Overall, results suggest that
adherence to conventional male expectations has a problematic influence on how men
perceive and seek treatment for depression.

Easton et al. (2017) examined the long-term effects of childhood sexual abuse (CSA) on
mental health for men. The purpose of the research was to examine: (a) long-term trajectories
of symptoms of depression in men with and without a history of CSA and (b) moderating
impact of social care over time. Numerous waves of Wisconsin longitudinal data were
investigated by the researchers. The sample (N=2,451) was composed of men with CSA
history and a randomly sampled comparison group. Men with histories of CSA displayed
larger signs of depression than men without a CSA experience. Depressive symptoms
diminished over time for both participants, and the association between the CSA and
depressive symptoms was greatly moderated by social reinforcement.

Yu (2018) evaluated how gender discrimination has a worldwide effect on mental health.
Women are about twice as likely to suffer from mental disorders as men are. This gender
disparity in depressive disorders can be related to socio-economic inequalities and living
conditions across countries. The research examined the correlation between the ratio of
female to male depressive conditions, the gross domestic product, the GINI index, and the
gender inequality index for 122 countries. Research yielded that there is a strong link
between gender inequality and gender disparities in mental health.

Honda et al. (2018) examined the influence of sexual intimate partner violence (IPV) on
mental health amongst Japanese women and explored the extent to which sexual IPV is an
important contributor to the severity of mental health. A cross-sectional study was carried out
in consideration with the participants' medical histories that aimed to compare mental health
problems including anxiety, depression, suicidality, and post-traumatic stress disorder
(PTSD). The study consisted of about 62 women who experienced IPV without sexual
violence and 83 women who experienced sexual IPV.  The research concluded that
individuals who experienced sexual IPV had higher prevalence and intensity of insomnia,
social dysfunction, severe depression, suicidality and PTSD than those who faced IPV
without sexual violence.

Chiang et al. (2018) examined the mental health challenges and supports faced by Chinese
sexual/gender minority youth in New Zealand. Sexual and/or gender minority young people
who are also members of an ethnic minority, thus belonging to a 'double minority,' may face
certain unique challenges. Semi-structured interviews were conducted with 11 Chinese
sexual/gender minority participants aged between 19 and 29 years and living in Auckland,
New Zealand.   First, respondents indicated mental health challenges due to racism,
misogyny, cis-heteronormativity and intersecting identities. Second, Chinese culture and
community relations, family and support groups, appeared to promote resilience. However
there were certain hinderances to getting proper mental health care including the lack of
desire to report anxiety during poor health caused by the apprehension of 'losing face,' and
the lack of cultural and linguistic expertise of providers of mental health care.

Kiely et al. (2019) evaluated evidence on how and why the mental health of older individuals
differs due to their gender. The researchers rely on international literature on gerontology and
population mental health along with important studies from global health institutions for the
purpose of the study. The findings showed that older women have higher risk of common
psychiatric illnesses like depression and anxiety than older men. In comparison, the
mortality-related effects, including suicide, of poor mental health on older men are worse.
These results encompass factors such as societal and social values, gender stereotypes and the
coping styles of the older men.

Thoma et al. (2019) analyzed suicidality disparities between transgender and cisgender
adolescents. These disparities in suicidality were examined across the full spectrum of
suicidality between TGAs and CGAs and examined risk for suicidality within TGA
subgroups. Adolescents aged 14 to 18 completed a cross-sectional online survey. Participants
reported sex assigned at birth and current gender identity (categorized as cisgender males,
cisgender females, transgender males, transgender females, nonbinary adolescents assigned
female at birth, nonbinary adolescents assigned male at birth, and questioning gender
identity). Lifetime suicidality (passive death wish, suicidal ideation, suicide plan, attempted
suicide) and non-suicidal self-injury were measured. TGAs had better chances of all
outcomes as compared with CGAs. Within transgender adolescent subgroups, transgender
men and transgender women were at greater risks of suicidal ideation and attempt than
cisgender adolescents.

Vigod and Rochon (2020) examined the association between gender inequality and women's
depression symptom ratings. Researchers were more focused on how subtle aspects of
implicit gender inequality that are observed in daily life can also adversely affect a woman's
sense of well-being, along with the overt aspects. Gender discrimination was measured by the
following question: "In the last one year, has anyone treated you differently because of your
gender? ”. Women were asked this question on three occasions, in mid-term pregnancy, and 7
and 11 years after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to
measure depressive symptoms at each time stage. The results found that more than 1 in 10
women-who were all pregnant or raising small children at the time-responded yes to
perceived gender discrimination. Women who answered "yes" had higher depression ratings.
This clearly indicates that perceived gender inequality is a significant element in women's
mental health.

Andersson and Harnois (2020) analysed impact of educational attainment on

women's perspectives of discrimination in the workplace as well as its health implications.
National data from the 2002-2014 General Social Survey was reviewed. Research reveals that
women with higher levels of education are more likely to work full-time and in well paid,
male-dominated professions than women with lower levels of education, and it is in these
ways that women are more likely to be discriminated against. Despite this, women with
higher educational levels tend to have reduced negative health impacts. For women with
lower levels of education, perceived gender discrimination is associated with worse mental
health, lower quality sleep, less happiness, and lower job satisfaction, but these particular
health tolls vanish at higher levels of education.

DISCUSSION
The aim of this secondary research was to establish a correlation between discrimination
against gender minorities and the impact on their mental health. Gender equality is not just a
basic human right, but also a significant tool to pave the way for a more harmonious and
prosperous world. After looking at numerous researches, it can be said that there is an
influential association between gender discrimination and the mental health of gender
minorities. In most of the researches, women seemed to have an adverse effect on their
mental health as a result of systemic discrimination.

It was majorly found that women are twice as likely to suffer from mental disorders as
compared to men. In a research by Shoukai Yu, a strong interrelation was indicated between
gender disparities and mental health, which can be utilized to study the ways in which
optimal health can be improved at a global level. Child sexual abuse and depression were also
found to have a direct impact on each other, especially in the case of adolescent, migrant and
homeless women (Satyanarayana et al., 2015). We looked at how everyday sexism or subtle
forms of sexism are interlinked with deterioration of mental health in women, sometimes
even unconsciously. In a recent research by Vigod and Rochon, more covert aspects of
gender discrimination were looked at, with respect to pregnant women or women with
younger children. Results demonstrated that women who had witnessed sexism in any form,
over a period of time were found to have higher depression ratings.

The relation between gender discrimination (GD) and mental health was studied from an
intersectional viewpoint. It was studied across different age groups, cultures, ethnicities,
genders etc. While examining the effects of GD in older age groups, it was found that the
health status among women was much worse than men. Older women were also found to be
more prone to depression and anxiety than their male counterparts. However, suicidal
ideation was found to be higher in older men (Kiely et al., 2019).
Traditional gender role socialization and experiences of external and internalized oppression
negatively impacts the mental health and wellbeing of both the genders. Mental health in
men is deeply stigmatized which further leads to them not opening up and affects their help-
seeking patterns. While mental illnesses like depression and anxiety remain common among
women, men are more likely to die by suicide. This may be because of the similar gender
roles imposed by patriarchal norms on men which imply that showing emotions is an
inherently a feminine trait. This discourages men from seeking psychological help. Several
researches have been conducted to study men’s mental health on a deeper level. In a research
by Easton in 2017, child sexual abuse (CSA) seemed to play an important role in determining
the mental health in adult men. Men with a history of CSA displayed larger signs of
depression than others. Seidler carried out a research in 2016 to study if conforming to
traditional gender roles impacted men’s mental health. It was found that adherence to
conventional male expectations had a problematic influence on how men seek treatment for
depression. In order to improve help-seeking, and successful self-management among men
suffering from depression, future studies exploring variables correlated with men's access to
and engagement with depression services would be crucial. In early, middle and late
adulthood, practitioners and researchers should assess for CSA and strengthen support
resources for male survivors.

Cultural and intersectional aspects were also inculcated in some studies while studying the
impact of GD. GD was found to be closely related and interface with mental disorders,
providing evidence of the Intersectionality perspective. Mental health challenges were more
prevalent when there was an intersection of minorities. In a cross-sectional study among
Japanese women pertaining to intimate partner violence (IPV), it was found that women with a
history of sexual IPV experienced higher intensity of insomnia, depression and suicidal
ideation than others. Education also played a crucial role in assessing the correlation. Even
though, women who are more educated are met with increased discrimination in workplaces,
the effects on mental health seem less pronounced as compared to less educated women who
are more likely to experience lower quality sleep, less happiness and lesser job satisfaction.
(Andersson and Harnois, 2020). Apart from women, people belonging to other gender
minorities were also analyzed. Findings showed that people from the LGBTQ+ community
are even adversely affected because of GD. There’s an immense suicidal disparity between
transgender and cisgender adolescents. These disparities were examined across a full
spectrum of suicidality among adolescents, and it was found that transgender adolescents are
greater risks of suicidal ideation than cisgender adolescents. (Thoma et al., 2019).

The results presented here revealed a close association between high gender disparity
and depressive disorders for both genders, but more intensely for women.. This critical
association can be partly explained by gender discrimination. Either explicitly or implicitly,
gender inequality may place women under intensified constraints to accessing social
resources, including mental healthcare, that leads to improved health.

CONCLUSION
It is evident from the above discussion that gender discrimination (GD) and mental health
should be studied from an intersectional viewpoint for a better understanding of how it’s all
interconnected. Everyday sexism finds it roots in the reinforced gender stereotypes and gender
roles that have been there for many a centuries; and it contributes to the rampant
objectification, sexualisation of women, enormous amount of undue pressure (which society
refuses to acknowledge) on women while at the same time a lot of things they do are highly
underappreciated and thrown under the societal label of ‘womanly duties’. It’s almost
tragically contradictory and largely affects mental health of women; they experience low
quality of sleep, lesser job satisfaction, low self-esteem issues etc. The same reinforced gender
roles and conditioning makes society see almost everything, even abstract and materialistic
things from a binary viewpoint. Research provides strong evidence of the stable negative
effects of GD across different cultures with different intensities of GD.

Empowering women and promoting gender equality in all societal, civil, economic, and
teaching institutions, as well as within households and the media, are necessary to combat
this disparity and change the epigenetics of gender discrimination. Mental health promotion
and prevention interventions can be used to address the negative social and health outcomes
of gender discrimination. Targeting patriarchal cultures ideologies, using media and
globalization dynamics to spread awareness and promote international culture of gender
equality is a successful means of addressing the social determinants of mental health.

Research must continue around the world to resolve overt gender inequality issues that
impact women overwhelmingly, from poverty to harassment. At the same time, many of the
biases that enable a women to be treated differently on the basis of their gender exist
everyday and are implicitly troublesome. Because these subtler manifestations of alleged
discrimination against women are so profoundly embedded in our cultural structures, it would
be difficult to overcome them, implying the need for international cooperation from health
professionals and social movements, as well as by government and decision makers.
Evidence additionally reflects the need to advocate for equal and fair representation of
women and other intersecting identities on an international scale. We have a responsibility to
raise awareness of these issues, ensuring that our structures and policies create a working
environment and service that promotes gender equality and women's mental health.

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