Gender/Sex Disparities in COVID-19 Outcomes
A Guide and Toolkit by Harvard University’s GenderSci Lab
Materials & Downloads
*The Google Slides presentation can be downloaded in .ppt and .pdf format. Please do not alter the slides after download. If you use just a portion of the presentation, please retain the GenderSci Lab logo and cite appropriately.
Goals & Objectives
Data suggest that, in aggregate, men are dying from COVID-19 at higher rates than women. How can we interpret and make sense of this disparity? This analytical toolkit provides resources for unpacking and understanding apparent sex disparities in COVID-19 outcomes. Students are challenged to think critically about the causal primacy granted to biological sex in attempts to explain the gender/sex gap in COVID-19 mortality. Additionally, the toolkit offers a variety of social and demographic factors as alternative ways of understanding, investigating, and talking about inequities in the COVID-19 pandemic.
Intended Audience
Introductory-level gender studies, feminist science studies, and health sciences courses.
Geopolitical Scope
Data and case examples are drawn from the United States, but the analytical principles can be applied to query sex disparities in COVID-19 outcomes in other contexts.
Why teach about sex disparities in COVID-19 outcomes through a critical lens?
A focus on biological sex may underplay the contribution of gender-related and other social factors to COVID-19 disparities, misdirecting public health efforts. By the same token, decontextualized statistics about sex differences in cases and deaths from COVID-19 can reinforce biological sex-essentialist stereotypes.
Both biological and social factors, and interactions between the two, may play a role in shaping the observed patterns of COVID-19 outcomes. Discussions of sex disparities in COVID-19 outcomes often emphasize biological factors, even suggesting that differential treatment avenues or vaccine regimes for individuals of different sexes should be pursued. This toolkit emphasizes that evidence from prior infectious disease epidemics, including closely-related coronaviruses, demonstrates that gendered factors such as occupation, lifestyle, and comorbidities, along with interacting social variables such as racism and socioeconomic class are likely the primary contributors to apparent sex disparities in COVID-19.
How to use the toolkit
Interested in having a member of the GenderSci Lab join your virtual classroom?
For the 2020/2021 academic year, the Lab will consider invitations to do 20-minute Q&A sessions to discuss gender/sex disparities in COVID-19 outcomes and the wider work of the Lab with your class, via Zoom.
To inquire about availability, please contact us at genderscilab@fas.harvard.edu.
The toolkit has been designed to allow for adaptation to different classroom contexts and is written for introductory and interdisciplinary audiences across the humanities, social sciences, and sciences. The slide presentation consists of an introduction and three self-contained units (Part 1, Part 2, and Part 3) that can be taught together or independently of each other. The introduction should always be covered in class. Once the introduction is covered, instructors can choose to focus on any of the three self-contained units without losing internal consistency.
The toolkit also suggests a number of small-group breakout activities to promote active learning and participation. This structure encourages critical thinking about the interpretation of scientific data and social categories. The breakout activity slides are clearly flagged: instructors are encouraged to select the breakout activities that best suit the needs of their students or the structure of their course.
Language Guide
Talking about Sex, Gender, and Gender/Sex
The toolkit discusses public health data that categorizes people as “female” or “male”, or “woman” and “man.” In presenting this material, it will be important to clarify terminology for your students and make clear that analyses of data collected in this manner do not appropriately capture COVID-19 outcomes for trans, intersex and non-binary individuals. These data refer to COVID-19 among people categorized as female and male, or woman and man, and the nuances of their sex-linked biology and gender identities are not known.
Relevant terminology
In addition to the terms “sex” and “gender”, the teaching toolkit makes frequent use of a third term, “gender/sex”.
Sex : the biophysical attributes of individuals, typically their genes, gonads, and genitals.
Gender : an umbrella term that refers to behaviors, roles, appearances, and identities of individuals. As a concept, gender is a way to linguistically acknowledge that these factors that we associate with sex are not synonymous with or determined by it.
Gender/Sex : Sari van Anders coined gender/sex as “an umbrella term for both gender (socialization) and sex (biology, evolution) and reflects social locations or identities where gender and sex cannot be easily or at all disentangled.”
“Gender/sex” is a central construct for the GenderSci Lab’s work on COVID-19 disparities between women and men. Even in cases where it is theoretically possible to do so, we currently lack the data needed to disaggregate gender and sex. Without such disaggregation, the term gender/sex is more appropriate than sex (or gender) to describe these findings.
Learning Objectives
Primary Learning Objectives
Appreciate the social dimensions of inequities in the distribution of COVID-19 outcomes.
Understand the distinction between sex and gender and appreciate how sex interacts with gender and other social and demographic factors to produce sex disparities in health outcomes.
Gain applied, practical experience analyzing scientific claims about biological sex differences in an intersectional framework in the context of the current pandemic.
Recognize that data do not speak for themselves and that theory, language, and social positionality influence our interpretation of data.
Secondary Learning Objectives
Gain awareness of the assumptions that are commonly made about the causes of sex differences, namely about the primacy of biological sex over other biological and social factors.
Analyze and critically evaluate public discourse and news reporting of COVID-19 inequities.
Evaluate public health and public policy priorities for addressing social and gendered vulnerabilities in the COVID-19 epidemic.
Structure & Timing Estimates
Given the adaptable nature of this toolkit, timing estimates are provided separately for lecture slides and breakout activities. The total speaking length of the presentation is approximately 40 minutes. Each of the four break-out activities can be completed in approximately 15-20 minutes.
Introduction (~6-8 minutes)
Part 1: Are there sex-disparities in COVID-19 outcomes? (~16-20 minutes)
Breakout activity: Question the sex and gender binary in health research (~15-20 minutes)
Section 1a: Does the sex disparity hold true across localities?
Breakout activity: Explore the US Gender/Sex COVID-19 Data Tracker (~15-20 minutes)
Section 1b: Does the sex disparity hold true across social groups?
Section 1c: How reliable, complete, and valid is the available data on sex disparities in COVID-19 outcomes?
Part 2 : How can we theorize the role of gender-related factors in COVID-19 outcomes in men and women? (~12-14 minutes)
Section 2a: Gender, Sex, and Gender/Sex
Section 2b: The role of gender in past infectious disease outbreaks and coronaviruses
Section 2c: Theorizing the role of gender in male-female disparities in COVID-19 outcomes
Breakout activity: Speculate about plausible gender-related factors that might contribute to sex disparities in COVID-19 outcomes (~15-20 minutes)
Part 3: What is at stake? (~4-5 minutes)
Breakout activity: Discuss how the causal framing of apparent sex disparities in COVID-19 outcomes might influence policy and public health strategies (~15-20 minutes)
Suggested Assigned Readings
Heather Shattuck-Heidorn, Meredith W. Reiches, and Sarah S. Richardson. “What’s Really Behind the Gender Gap in Covid-19 Deaths?”, New York Times, June 24, 2020, https://www.nytimes.com/2020/06/24/opinion/sex-differences-covid.html
Ann Caroline Danielsen and Nicole E. Noll. “Communicating about COVID-19 and Sex Disparities: A Guide for Media, Scientists, Public Health Officials, and Educators,” GenderSci Blog, June 24, 2020, https://www.genderscilab.org/blog/covid-communication
Chotiner, Isaac. Interview with Dr. Nancy Krieger. “The Interwoven Threads of Inequality and Health.” The New Yorker, April 14, 2020, https://www.newyorker.com/news/q-and-a/the-coronavirus-and-the-interwoven-threads-of-inequality-and-health
Nazrul Islam, Kamlesh Khunti, Hajira Dambha-Miller, Ichiro Kawachi, and Michael Marmot. “COVID-19 mortality: a complex interplay of sex, gender and ethnicity.” European Journal of Public Health, August 25, 2020, https://academic.oup.com/eurpub/advance-article/doi/10.1093/eurpub/ckaa150/5879989
Citing the Presentation
General citation
GenderSci Lab (2020) “Gender/Sex Disparities in COVID-19 Outcomes: Guide and Toolkit by Harvard University’s GenderSci Lab”. Retrieved from insert link
For citing selected slides only
GenderSci Lab (2020) Slides number x, y, z in “Gender/Sex Disparities in COVID-19 Outcomes: Guide and Toolkit by Harvard University’s GenderSci Lab”. Retrieved from insert link
Questions?
Please contact us at genderscilab@fas.harvard.edu.
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