Mental Health: A Gendered LensVIEW EVENT DETAILS
Wednesday, 14th February, 6:00 p.m. – 7:30 p.m.
Philosopher and gender theorist Judith Butler said that gender is not “something one is – it's something one does.” Our conceptions of what makes someone a man or a woman, and our idea of gender, is a social creation, bringing with it a “slew of expectations,” as Butler said, on what ‘masculinity’ and ‘femininity’ is. A person’s gender identity shapes their experience of the world, their place in society, and, in turn, how they feel and the care they can access. The Lancet Commission on Gender and Global Health identifies that there is a specific gendered component to mental health – the social, political and economic drivers that intersect with mental health, requiring specific intervention and treatment in a health system that is often “gender-blind,” ignoring that gender as a system “predetermines and shapes health systems and outcomes.”
This blindness overlooks many realities. Globally, depression is nearly 50% more common in women than it is in men. In India and most South Asian countries, the patriarchal structure of society places women in an inferior position to men, affecting their access to social opportunity, self-expression, and mental well-being. From an adolescent age, mood and eating disorders and death by suicide, are more common in women than men; in the South Asian diaspora, cultural stereotypes mean that women’s experiences are ignored in medical treatment – depression, for example, being ‘cultural’ rather than individual. Women, in rural and urban South Asia alike, seldom seek medical treatment. Later in life, too, pressures to do with ‘staying in a marriage’ prevent women from voicing their mental health concerns.
Trans persons face an even deeper level of discrimination because of society’s preference for gender as a binary, rather than a spectrum. Mental health professionals find themselves unable to address trans patients’ mental healthcare needs: for instance, doctors hesitate to prescribe gender-conversion hormones. Medical staff at hospitals make trans persons feel scrutinised; a broader sense of societal ostracisation at the healthcare, family and peer level deepens this pressure when seeking help, combined with a higher tendency to experience suicidal thoughts and attempts.
Several solutions have been proposed over time: more women in medical care roles, as this improves the health outcomes for women; self-help and peer support groups; and queer-affirmative therapy and gender-sensitive education for mental healthcare professionals. But how do we get around some fundamental issues, including the fact that women are less likely to seek out mental health care, and trans persons are less likely to receive effective care?
In a conversation with Ayesha Ahmad, Aryan Somaiya, and Anish Gawande, we attempt to explore and think through the topic with a multi-perspective lens. How does the social stigma surrounding women and trans persons affect their access to treatment, and quality of care? What are some solutions to create more inclusive health systems that lead to better outcomes for people across the gender spectrum in South Asia, particularly India? Finally, are there historical precedents or examples of acceptance and celebration of gender diversity from the region that we can draw inspiration from today?
Our series on mental health is now in its third season. This capsule of discussions will focus on mental health and social fabrics, and how our social realities in India shape our sense of self; our identity; and our mental well-being. In the past, we have looked at addiction, disorders, the impact of the pandemic on specific populations, art and creativity – you can learn more here. This series is supported by the Raika Godrej Family Trust.
Ayesha Ahmad holds a PhD in medical ethics and works to integrate ethics and the humanities into global health research and pedagogy. Her research expertise is in transcultural psychiatry and cross-cultural mental health. She particularly works in contexts of conflict and humanitarian crisis resulting from disasters including environmental change. Dr Ahmad develops trauma therapeutic interventions using traditional storytelling and was the co-investigator on an MRC/AHRC funded project in Kashmir (India) and Turkey, in collaboration with Afghanistan, Tunisia, and South Africa (www.shaercircle.com). Dr Ahmad's specialisation is in transcultural psychological trauma and the ethical consequences of concepts that are used in mental health. In her work, Dr Ahmad critically explores the notion of land trauma, as it is juxtaposed with a medicalised and biomedical paradigm of a temporal understanding of post-traumatic stress disorder working as part of Land Body Ecologies, funded by the Wellcome Trust; www.landbodyecologies.com with Indigenous and land-dependent communities in India, Arctic Circle, Uganda, Kenya, and Thailand. Dr Ahmad also works as an Expert Witness providing academic reports on asylum seeker cases related to war, mental health, and gender-based violence.
Aryan Somaiya is a trans man psychotherapist with a background in gender and sexuality training. As a therapist, he is interested in the psychosocial realities of people and the nuances at the edge of clinical material, arts, literature, poetry, politics, and social media. Currently, he works with concerns of gender, sexuality, relationships and trauma. He uses a lens of depth psychology, attachment theory, relational psychoanalysis, intersectional feminism, Buddhism, and postmodern thought in his work with clients. He co-founded Guftagu Therapy, which focuses on ethical and deep psychotherapy as well as relatable, fun and nuanced thought leadership on mental health and related aspects via social media, training, workshops and collaborations. Aryan loves to be with cats and dogs, and listen and dance to 90s Bollywood music.
Anish Gawande is a writer and curator. He is the founder of Pink List India, the country’s first archive of politicians supporting LGBTQ+ rights. Gawande has an undergraduate degree in comparative literature from Columbia University and postgraduate degrees in intellectual history and public policy from the University of Oxford, where he studied as a Rhodes Scholar.