Today is International Women’s Day (IWD), a global day of recognition of the social, economic, cultural and political achievements of women. IWD has been celebrated since the 1900s and emphasizes the need to accelerate gender parity globally.
The story of women's struggle for equality belongs to no single feminist nor to any one organization but to the collective efforts of all who care about human rights. (Gloria Steinem)
In January of 2017, the World Economic Forum released its annual Global Gender Gap Report, a review of gender parity in 144 countries across the globe, and the results were devastating. Specifically, they examined gender equality within the following four domains: 1) economic participation and opportunity; 2) educational attainment; 3) health and survival; and, 4) political empowerment. Much to my chagrin and surprise, they found that the gender gap is actually widening. The report anticipated that, at the current rate of progress, it will take 217 years to achieve global gender equality.
Much in line with the progress we have seen within the last year, with the #MeToo and #TimesUp campaigns, the theme of this year’s International Women’s Day is #PressforProgress. It is a call to action, and a reminder, that now is not the time to be complacent. In order to achieve change, we must push (often, loudly) not only our political leaders but also our employers, our friends, and our family members to move gender parity forward.
Women’s Mental Health Canada
As we have discussed in many of our Hatching Ideas Hub blog posts, gender impacts mental health in terms of the likelihood of developing particular disorders, the burden to mental disorders and the likelihood of receiving treatment. The figure to the right provides an overview of women’s mental health in Canada.
Setting A Women’s Mental Health Research Agenda
In 1990, Mary Koss conducted a review of the state of women’s health and provided nine recommendations to advance women’s mental health research. These recommendations focused broadly on the need to gather national data on the scope of violence against women, including the mental health implication of violence against women; the need for empirical evidence to support treatment recommendations for women impacted by violence; the need for evidence to support victim services program development; and a deepened understanding of violence against women within the broader social context of gender inequality.
Specifically, in setting an agenda for addressing women’s mental health, Koss (1990) recommended that:
1. Funding opportunities focus on “hidden” violence against women;
2. National data focus on violence victimization, including its incidence, prevalence and mental health impacts.;
3. Violence against women be understood within the context of the lifespan, which includes risk profiles, intergenerational transmission of trauma and the broader social costs of victimization;
4. Cognitive theories be clinically evaluated within the context of violence against women, including an examination of the storage and recall of traumatic memories, the impact of trauma on knowledge structures and coping strategies that minimize the mental health impacts of violence;
5. New clinical instruments, such as history-taking forms and questionnaires, be developed in order to address the impact of violence against women within clinical practice;
6. Treatments offered to address the mental health impacts of violence against women be clinically evaluated;
7. Data collected distinguish between women who have been impacted by violence against women and other women presenting for mental health services;
8. Treatment for the delayed and/or compounded effects of experiencing violence against women be developed and clinically evaluated;
9. Secondary prevention efforts continue to target women at high risk of experiencing violence, while also focusing on primary prevention of violence against women.
Our Successes in Addressing Women’s Mental Health
While it is beyond the scope of this blog post to breakdown each of Koss’s recommendations and assess where we stand in terms of addressing women’s mental health in Canada, it is important to highlight a number of key accomplishments made since the 1990s. Specifically, significant gains have been in the fields of: measurement of violence against women and the development of primary prevention programs to address violence against women.
Measurement of Violence Against Women: The Case of the Canadian Violence Against Women Survey
The proliferation of surveys specific to violence against women were developed in an attempt to address the methodological limitations of larger national surveys. For instance, the 1993 Canadian Violence Against Women Survey (CVAWS) asked a variety of detailed questions pertaining to
different aspects of violence experienced in the context of intimate relationships, including the trauma experienced by victims, their reactions to the violence, and the consequences they experienced as a result of their victimization (Johnson, 1996; Johnson & Dawson, 2011).
Similarly, the Canadian General Social Survey (GSS) was launched in 1985 and is the primary source of victimization data in Canada. The most recent version of the GSS victimization survey took place in 2014 and collected information on the following forms of violence against women:
· Sexual violence committed by non-partners;
· Emotional or financial abuse committed by current and former partners;
· Physical and sexual violence committed by current and former partners;
· Unwanted sexual activity with current and former partners;
· More detailed questions about the most recent incident of violence by current and former partners.
Specifically, the GSS collects data on experiences of victimization, help-seeking behaviours related to these experiences of violence, and whether the respondent sought help from the criminal justice system to address these experiences of victimization.
One of the biggest issues with conducting violence against women survey research is that it relies on respondents not only accurately reporting incidents of victimization, but that they also the recognize and name their experiences as violence. This is a chronic issue, especially in terms of sexual violence, which has been so normalized that survivors often have an extremely difficult time naming their experiences of violence. The continued proliferation of myths which excuse male violence against women within the context of sexual relationships has also been found to contribute to this.
One way to address this issue has been the development of questionnaires which minimize the use of jargon and avoid stigma through the use of behaviourally specific questions regarding unwanted sexual experiences (Testa et al., 2004). These measures are designed to increase the likelihood of recalling experiences of unwanted sexual activity. These questionnaires also allow for the consideration of experiences that respondents would not necessarily classify as violence, even though they frequently meet its legal definition (Testa et al., 2004).
Investing in Youth: The Role of Primary Prevention Programs in Preventing Dating Violence
The Fourth R: Strategies for Healthy Youth Relationships, developed by Dr. David Wolfe, is a relationship knowledge program which takes the position that healthy relationship behaviours can be taught much in the same way that reading, writing and arithmetic are taught. The program primarily targets students from grades seven to nine, and seeks to address violence/bullying, unsafe sexual behaviours, and substance use.
To evaluate the effectiveness of this program, a randomized controlled trial was conducted in 2009 which included 1,722 grade nine students aged 14-15. Results showed that students who were exposed to the 21-lesson Fourth R curriculum reported rates of physical dating violence 2.5 times lower than students who received the control condition. Similarly, participants who received the intervention were also more likely to practice safe sex, reporting always using condoms (Wolfe et al., 2009).
What is promising about this program is that it can be delivered at a very low cost, roughly $16 per student, and therefore, has the potential for a very high rate of return on investment. This becomes especially important when we consider that addressing the consequences of spousal violence alone collectively costs Canadians $7.4 billion dollars (Canadian Women’s Foundation).
Challenges yet to be met
Lack of Health Research Funding on Women’s Mental Health
Many organizations, including the World Health Organization (WHO), have highlighted the need to invest in research targeting women’s mental health. So what has been the response of health research funding agencies in moving the women’s mental health research agenda forward? To assess this in the Canadian context, I reviewed all grants funded under the Canadian Institutes of Health Research (CIHR) Institute for Gender and Health from 2008 (earliest available data) to present. The results of this review can be found in Figure 1.
The data shows that, in Canada, of the $153,430,267 invested in gender and health research, a total of 56/749 grants (7.5%) have been awarded related to violence against women. In some cases, especially within the field of biomedical research, the link between the proposal and women’s mental health was tenuous; however, potential impacts could be reasonably expected. For instance, examinations of women’s responses to stress could be understood as related to their experiences of trauma and, as such, were included in this sub-analysis.
However, it is disappointing to see the extent to which a large majority of proposals funded under the Institute of Gender and Health do not meaningfully address the incorporate of gender issues in health research. While significant gains have been made by virtue of having a CIHR institute dedicated to these issues, expectations must be raised in terms of what this looks like in practice.
Context of Gender Equality in Which Violence against Women Occurs
Gender role attitudes have been found to be related to various forms of intimate partner violence (Jenkins & Aubé, 2002; Mahlstedt & Welsh, 2005). In their systematic review, Flood and Pease (2009) consistently found a relationship between endorsing traditional gender roles and intimate partner violence. Gender role expectations for male and female behaviour reflect male-dominated perceptions of how men and women ought to behave and frequently attribute greater status to the roles of men than to those of women (Johnson & Dawson, 2011).
Feminists argue that the link between male violence and gender roles is one where violence against women is not the result of a violent impulse of an individual man against an individual woman, but rather is the result of over-conforming to traditional gender roles (Johnson & Dawson, 2011). In a society in which masculinity is associated with dominance and femininity is associated with passivity and compliance, anything that comes to be defined as feminine is a threat to this masculine ideal (Adams-Curtis & Forbes, 2004). This conception of masculinity and its instability can create a fragile gender identity for men who, in turn, may seek to protect it at all costs (Adams-Curtis & Forbes, 2004). This can lead to hostile and negative attitudes toward women, a need to dominate women, and displays of violence towards women (Adams-Curtis & Forbes, 2004). As such, men are more likely to accept or excuse violence against women if they believe men should be dominant in their intimate relationship and have the right to protect that through physical aggression (Flood, 2010).
Studies have shown that men who endorse sexist attitudes towards women are also more likely to use violence against women (Anderson & Umberson, 2001; Archer & Graham-Kevan, 2003; Brownridge, 2002; DeKeseredy & Kelly, 1993; Nabors & Jasinski, 2009; Reitzel-Jaffe & Wolfe, 2001). These violence-supportive attitudes may serve to “justify, excuse, minimize, or hide physical or sexual violence against women” (Flood, 2010, p. 15). For instance, Brownridge (2002) found that men who endorse traditional gender roles, as demonstrated by acts such as limiting a partner’s access to income and controlling or socially isolating a partner, were found to be more likely to physically victimize their intimate partners than their more egalitarian counterparts. This is consistent with previous cross-cultural research which has linked female physical victimization to lower levels of gender equality at the societal level (Archer, 2000).
While the majority of this research focuses on the link between gender role expectations and male violence against women, there is also evidence that women who are hostile toward or generally distrustful of other women are also more likely to endorse traditional, and therefore rigid, gender role expectations for women (Forbes, Adams-Curtis & White, 2004). It is therefore possible that these gendered expectations serve different purposes for men and women. For instance, Bohner, Siebler and Schmelcher (2009) found that while these attitudes may serve to justify men’s sexually violent behaviour, for women these attitudes may allow them to distance themselves from the threat of sexual violence. This, in turn, may increase the likelihood that these women will also endorse other attitudes that are harmful to women and contribute to a culture that legitimizes violence against women. Moreover, in their longitudinal study of 1,291 adolescents from North Carolina, Foshee, Benefield, Ennett, Bauman and Suchindran (2004) found that girls’ endorsement of traditional gender role expectations was associated with past sexual victimization.
The Canadian Federal Budget was released on February 27, 2018 and, on paper, took leaps forward in addressing issues of gender inequality. The highlights include:
· $1.4 billion over the next three fiscal years to be invested in the Business Development Bank of Canada specifically for women entrepreneurs;
· $70 million commitment over the next five years to the BDC Women’s Technology Fund for women-led tech firms;
· Funding and loans available for women-led business through Export Development Canada and Farm Credit Canada;
· $100 million over the next five years to Status of Women Canada, which will move from a federal agency to a federal department for the first time in its history;
· $1.2 billion over five years to provide five extra weeks of parental leave for two-parent families, to be implemented in June 2019;
· $7.5 billion over 11 years for early learning and childcare through the creation of subsidized childcare spaces;
· $2 billion over five years invested in additional foreign aid under the Feminist International Assistance Policy;
· $10 million over five years to the RCMP to review 25,000 “unfounded” sexual assault cases;
· $30 million over three years to promote women and girls’ participation in sports;
· $6.7 million over five years to create a Gender, Diversity and Inclusion branch of Statistics Canada; and,
· $8 million for legal-aid funding to support charges of sexual harassment in the workplace.
I am cautiously optimistic that these investments will lead to shifts in addressing gender equality; however, I also understand how much work there is to be done and am aware of the numerous issues not yet addressed by federal spending. I look forward to checking back on the progress of these investments over the next five years.
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3. Archer, J., & Graham-Kevan, N. (2003). Do beliefs about aggression predict physical aggression to partners? Aggressive Behavior, 29, 41-54.
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6. Canadian Women’s Foundation - https://www.canadianwomen.org/the-facts/gender-based-violence/
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16. Mahlstedt, D., & Welsh, L. (2005). Perceived causesof physical assault in heterosexual dating relationships. Violence Against Women, 11(4), 447-472.
17. Nabors, E. L., & Jasinski, J. L. (2009). Intimate partner violence perpetration among college students. Feminist Criminology, 4(1), 57-82.
18. Reitzel-Jaffe, D., & Wolfe, D. A. (2001). Predictors of relationship abuse among young men. Journal of Interpersonal Violence, 16, 99-115.
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20. Wolfe, D.A., Crooks, C.V., Jaffe, P.G., Chiodo, D., Hughes, R., Ellis, W., Stitt, L., & Donner, A. (2009). A universal school-based program to prevent adolescent dating violence: A cluster randomized trial. Archives of Pediatric and Adolescent Medicine, 163, 693-699.