Gender and sex are key drivers of health outcomes and experiences of health services. Best practice when developing policies and delivering services includes consideration of gender and sex. Differences in health outcomes and experiences can be driven by social factors such as gender-based violence, medical misogyny and transphobia. They can also be a result of biological differences between people because of their sex characteristics.
Examining a policy, program or service with gender and sex in mind can enable tailoring of services to meet unique needs.
Develop policy guidance to support our staff to conduct intersectional gender and sex analysis in our policies, programs, services, infrastructure, and research
Lead: Ministry of Health – Strategic Reform and Planning
Review, enhance, and promote intersectional gender and sex analysis training
Lead: Ministry of Health – Strategic Reform and Planning; Health Education and Training Institute
Identify and develop processes that support our staff to apply intersectional gender and sex analysis, including in making policies, service planning, grants, and research funding
Lead: Ministry of Health – Strategic Reform and Planning; Legal and Regulatory Services
Analyse how gender and sex are reflected in medical research, including grant recipients, research design, and research outputs to formulate steps to improve gender equality
Lead: Ministry of Health – Office for Health and Medical Research; Cancer Institute NSW
Develop accountability measures and mechanisms to strengthen how we account for gender in policies, programs, and services
Best practice in developing policy or reviewing a service includes both gender and sex considerations. This recognises that people can be impacted in different ways by both these factors.
A comprehensive approach also includes analysis of how gender and sex interact with other characteristics. A person's individual experience is influenced by all their characteristics, such as religion, geography or cultural background. Policies, services, infrastructure and research are more effective when they consider this complexity.
Applying intersectional gender and sex analysis might include reviewing data that is broken down by gender and sex and by other characteristics or considering how different populations are included in consultation processes and how their experiences have been impacted by their gender.
The Centre for Population Health funds ACON to provide a range of services to prevent HIV and sexually transmitted infections in Gay and Bisexual Men who have sex with men. Activities and services include multilingual resources and a specific testing service for Mandarin-speaking clients.
NSW Health funds non-government services to deliver specialist residential alcohol and other drug treatment services for parents and carers with children, recognising the importance of people continuing to reside with their children during treatment. Most facilities that accommodate children are specifically for women and children, recognising that women continue to carry higher childcare responsibilities, which can limit their access to services. Women-only facilities also respond to women’s needs around family violence, with a greater sense of safety reported by women in women-only facilities. There are also services for people of all genders with children to ensure men, women with partners and gender diverse people can access services.
Justice Health Forensic Mental Health’s Peer Support Program in the Towards Zero Suicides in Custody Initiative targets men’s needs. Inmates provide peer-to-peer support through having conversations while doing an activity, like haircuts or exercise. This approach was introduced as it was identified that shoulder-to-shoulder conversations made men feel more comfortable than the traditional face-to-face arrangement.
“While in gaol, it can be difficult to feel like you are heard, and it can be hard to know who you can trust and open up to. The Peers offer support that is informal, non-official and less invasive. They have walked in my shoes and understand what it can be like in here which means they can provide genuine support.” Adam (he/him), patient
“While in gaol, it can be difficult to feel like you are heard, and it can be hard to know who you can trust and open up to. The Peers offer support that is informal, non-official and less invasive. They have walked in my shoes and understand what it can be like in here which means they can provide genuine support.”
Many areas across NSW Health already consider the impact of gender in the work that they do. However, more centralised support is needed to promote consistency and drive improvement.
“More centralised direction and strategy would assist us to avoid each LHD repeating the same work or having to come up with their own strategy when it applies across the state.” regional local health district
“More centralised direction and strategy would assist us to avoid each LHD repeating the same work or having to come up with their own strategy when it applies across the state.”
NSW Health organisations self-assessed their maturity level on implementing actions to improve gender equality outcomes using the Workplace Gender Equality Agency framework. This information helped us better understand system readiness to assess and address gender equality in our workforce, policies, programs and services.
Support can be aligned with the rollout of the Single Digital Patient Record, enabling staff to use this system, including collecting information from patients respectfully and using more detailed data about gender.
Gender and sex have been underexamined in medical research and clinical practice globally. For example, females have historically been underrepresented in clinical trials and gender and sex differences in outcomes have generally been underreported.13 If a clinical trial only accepts male participants, this can limit access to potentially lifesaving treatments for people of other genders.
NSW Health can use its position as a funder of medical research to improve the evidence base and embed gender and sex as a key consideration for designing research.
There is an opportunity to drive further improvements across NSW Health by improving capability and using measurable indicators and targets to enable greater accountability.
Since 2023-24 the NSW Government has released a Gender Equality Budget Statement to accompany each budget. These statements show the investments made to improve gender equality and advance economic outcomes for the people of NSW. They highlight how the budget is advancing gender equality outcomes in health and wellbeing, economic opportunity and advancement, and participation and empowerment.
As part of gender responsive budgeting in NSW, all government agencies are required to prepare gender impact assessments for New Policy Proposals. The proposals must identify how they support progress on NSW Government key gender equality indicators.