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Chapter: Essentials of Psychiatry: The Cultural Context of Clinical Assessment

Culture and Gender

Gender refers to the ways in which cultures differentiate and define roles based on biological sex or reproductive functions.

Culture and Gender

 

Gender refers to the ways in which cultures differentiate and define roles based on biological sex or reproductive func-tions. Because of this link with physical aspects of sex, there is a tendency to view gender differences as biological givens. However, while some distinctions may be closely related to the physiological differences between males and females, most are assigned to the sexes on the basis of specific cultural beliefs and social organization (Comas-Diaz and Greene, 1994).

 

Men and women do have some fundamentally different experiences of their bodies, of their social worlds and of their life course. It has been suggested that women are more in touch with their bodies because of the experiences of menstruation, child-bearing, childbirth, breast-feeding and menopause. These differ-ences may be as substantial as any between disparate cultures. At the same time, there is much evidence that these bodily grounded experiences vary substantially across cultures. For example, the anthropologist Margaret Lock (1993) has shown that Japanese women report fewer bodily symptoms of menopause and do not think of the end of menstruation as a distinctive “change of life” in the same terms as many women in North America.

 

There are also important gender differences in styles of emotional expression, symptom experience, and help-seeking. In epidemiological surveys in the USA, women tend to report more somatic symptoms as well as more emotional distress and they are more likely to seek help for psychological or interpersonal prob-lems. However, the gender difference in symptom reporting var-ies significantly cross-nationally (Piccinelli and Simon, 1997).

 

In North America, important differences have been docu-mented in male and female styles of conversation that are rel-evant to the clinical context (Tannen, 1994). In general, women tend to give more frequent acknowledgments that they are listen-ing to a speaker. They may give signs of assent simply to indicate they are following the conversation. Men tend to be more taciturn and, if they signal assent, it usually means they actually agree with the speaker. These differences in communication style may lead to systematic misunderstandings between men and women that are further aggravated by cultural differences in gender roles and etiquette.

 


In many societies, gender is associated with marked dif-ferences in power and social status. For example, in patriarchal societies, men have specific power and privileges that give them a measure of control over the lives of women. This is often coupled with responsibilities for maintaining family honor and well-being. In recent years, North American society has es-poused social and political equality in gender roles. From this egalitarian point of view, patriarchal families may seem oppres-sive to women. However, women may accept and participate in cultural definitions of their roles that appear restrictive by North American cultural norms but that make family life meaningful. Any judgment as to whether a given family’s relationships are oppressive or pathological must not only take into account social norms and practices but also explore the meaning of issues and events for the individuals involved.

Differences in cultural definitions of gender roles may be-come sources of conflict after migration. Culturally prescribed patterns of marriage and child bearing may be central to the social status, identity and self-esteem of men and women even when they are not given the same importance in the dominant cultures.

 


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