JECH Online First, published on November 21, 2013 as 10.

1136/jech-2013-202572
Theory and methods

Central gender theoretical concepts in health

research: the state of the art
Anne Hammarstrm,1 Klara Johansson,1 Ellen Annandale,2 Christina Ahlgren,3
Lena Alx,4 Monica Christianson,4 Soa Elwr,1 Carola Eriksson,1
Anncristine Fjellman-Wiklund,3 Kajsa Gilenstam,5 Per E Gustafsson,1 Lisa Harryson,1
Arja Lehti,1 Gunilla Stenberg,3 Petra Verdonk6
1

Department of Public Health

and Clinical Medicine, Family
Medicine, Ume University,
Ume, Sweden
2
Department of Sociology,
University of York, York, UK
3
Department of Community
Health and Rehabilitation,
Physiotherapy, Ume
University, Ume, Sweden
4
Department of Nursing, Ume
University, Ume, Sweden
5
Department of Surgical and
Perioperative Sciences, Sports
Medicine, Ume University,
Ume, Sweden
6
Department of Medical
Humanities, VU University
Medical Centre, EMGO
Institute for Health and Care
Research, School of Medical
Sciences, Amsterdam,
The Netherlands
Correspondence to
Anne Hammarstrm,
Department of Public Health
and Clinical Medicine, Family
Medicine, Ume University,
901 87 Ume, Sweden;
anne.hammarstrom@umu.se
Received 26 February 2013
Revised 29 July 2013
Accepted 22 October 2013

ABSTRACT
Despite increasing awareness of the importance of
gender perspectives in health science, there is
conceptual confusion regarding the meaning and the use
of central gender theoretical concepts. We argue that it
is essential to clarify how central concepts are used
within gender theory and how to apply them to health
research. We identify six gender theoretical concepts as
central and interlinkedbut problematic and ambiguous
in health science: sex, gender, intersectionality,
embodiment, gender equity and gender equality. Our
recommendations are that: the concepts sex and gender
can benet from a gender relational theoretical approach
(ie, a focus on social processes and structures) but with
additional attention to the interrelations between sex
and gender; intersectionality should go beyond additive
analyses to study complex intersections between the
major factors which potentially inuence health and
ensure that gendered power relations and social context
are included; we need to be aware of the various
meanings given to embodiment, which achieve an
integration of gender and health and attend to different
levels of analyses to varying degrees; and appreciate that
gender equality concerns absence of discrimination
between women and men while gender equity focuses
on womens and mens health needs, whether similar or
different. We conclude that there is a constant need to
justify and clarify our use of these concepts in order to
advance gender theoretical development. Our analysis is
an invitation for dialogue but also a call to make more
effective use of the knowledge base which has already
developed among gender theorists in health sciences in
the manner proposed in this paper.

health science. We do this with the objective of

contributing to greater conceptual stringency and
of providing a coherent and dynamic conceptualisation for gender research in the health sciences.

SIX CENTRAL BUT PROBLEMATIC CONCEPTS

We have identied the following six interrelated
gender theoretical concepts as central but problematic in health science and in need of clarication:
sex; gender; intersectionality; embodiment; and
gender equality and gender equity. Through a
reading of key theorists who employ these concepts
in their work we identify how they can be used to
illuminate health issues. To cover multiple perspectives, the authors of this paper are from several disciplines, including family medicine, midwifery,
nursing, physiotherapy, public health, rehabilitation
medicine, sociology and sports medicine. Four
smaller groups addressed one or two concepts,
according to the following framework:
1. Background, history and importance of the
concepts
2. Basic underlying assumptions
3. Examples of their utilisation within the health
sciences
4. Problems in how the concepts have been used
or the use they lend themselves to
5. Our recommendations for future research on
gender and health.
All texts relating to the concepts were repeatedly
read and discussed by the full author group to
strive for consensus and stringency.

SEX AND GENDER

INTRODUCTION

To cite: Hammarstrm A,
Johansson K, Annandale E,
et al. J Epidemiol
Community Health Published
Online First: [ please include
Day Month Year]
doi:10.1136/jech-2013202572

There is growing recognition within the health

sciences that gender awareness is crucial to avoid
gender bias in research.1 In addition, international
research shows strong and abiding associations
between gender inequality and patterns of morbidity and mortality and there is accumulating evidence that lack of gender sensitivity can negatively
impact the healthcare provided for women and
men.1
Yet, in spite of this increasing awareness, there is
a lack of conceptual clarity and need for more theoretical development.1 2 Self-evidently, theoretical
developments that build on concepts that are confused are likely to be confused themselves.
Therefore, we argue that it is essential to clarify the
use of central gender theoretical concepts within

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A, et Article
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Today the concepts of sex and gender are commonly used to refer respectively to the biological
and the social aspects of being a man or a woman.
In his well-known concept of the one-sex
model, Laqueur concludes that from Aristotle until
the Enlightenment, women were seen as having the
same reproductive organs (and thus the same sex)
as men, but womens organs were envisioned as an
inverted (inside the body) but imperfect version of
mens.3 During the 18th century this model was
replaced by the two-sex model in which the developing academic medicine emphasised the biological
differences between men and women. The concept
of sex came to be used in research about men and
women no matter whether the focus was biological
or sociocultural.1 As a consequence, biological
factors were wrongly attributed to what were actually social and psychological determinants of

BMJ Publishing Group Ltd under licence.

Theory and methods

health. For example, much of womens illness was attributed to
female reproductive anomalies. During the 1970s the concept
of genderreferring to the social processes associated with
being a man or a womanbegan to be used by feminist
researchers to break with the tradition of equating women with
their negatively dened biology.4 Although this feminist critique
was important, it fostered the neglect of biological factors in
favour of gender and the social aspects of health and illness.1
It is now increasingly recognised that sex and gender are
essential to an accurate understanding of health and illness.1
Table 1 shows the conceptualisations of each concept in recent
research. First, the static difference perspective treats sex and
gender as dichotomous variables on an individual level.5 This
perspective is often used in the research tradition of genderspecic medicine6 7 which denes itself as the science of how
men and women differ in their normal function and in the
experience of disease.6 Gender-specic medicines strong focus
on dualisms carries the risk of overemphasising differences
between men and women. Also, there is a risk of essentialism,
that is, the tendency to generalise differences to all groups of
men and women independent of context.8
By comparison, gender can be seen as social and relational
processes in various contexts. Dichotomous views are criticised
and the importance of applying a relational theory of gender (as
dened in table 1) is emphasised. Also, the importance of analysing gender in relation to other power structures (eg, class,
race/ethnicity,
nationality,
sexuality)
is
stressed
(see
Intersectionality below). This perspective has mainly been developed outside of health science and has been adopted principally
in qualitative research on illness experiences.9 10 For example,
research on lay concepts of health has shown that the doing of
health is a form of doing gender.11 Ones identity as masculine
or feminine inuences health status, and health behaviours can
be ways of demonstrating masculinities and femininities.
The sex in interaction with gender perspective focuses on
how sex and gender inuence each other12 (see Embodiment
below for examples). This perspective also opens up the potential for analyses of sex as a continuum with multiple variations
on the X and Y chromosomes, hormonal levels and internal and
external genitals.
Based on these observations, our recommendation for future
research is based on Connells relational theory of gender13 in
which the focus moves from the individual to include the structural level in which gender relations are integrated into arenas
such as the labour market and the healthcare system. This
theory can protably be developed to give further analytical
attention to how sex and gender are interrelated.

INTERSECTIONALITY
Intersectionality is based on the underlying assumption of heterogeneity within the groups of men and women and recognises that individuals are dened by multiple, intersecting
dimensions, such as gender, class, ethnicity, (dis)ability, sexuality,
age, etc. The concept was inspired by postcolonial theory, black
feminism and queer theory, and has its roots in Crenshaws 14 15
argument that legal discrimination against black women can
only be understood if we appreciate that their experience is
greater than the sum of racism and sexism.
The additive perspective developed as a critique of the
static difference perspective (outlined in the section on sex
and gender) as a precursor to intersectionality (as outlined in
table 2). Additive perspectives seek to move beyond the analysis of various gender differences along separate individual
dimensions to instead address the relative importance of gender
2

compared with other factors. In health research, this leads to

questions such as: Does gender or does class best explain the
male or female excess in a particular health condition? Or, how
do class and gender interact to explain differences in mens and
womens morbidity? In each instance, the underlying question
is, where does the most explanatory power lie? From this perspective, the health of men and women is conceptualised as an
accumulation of advantages and disadvantages.
The additive perspective has been criticised for ignoring that
various axes of power do not necessarily act in unisonbut
operate in complex waysupon health.16 One category, such as
race, takes its meaning from another, such as gender, and a
new uniquely hybrid creation emerges at the intersection
which becomes the unit of analysis.17
For example, with additive perspectives a Canadian study
found that poor self-rated health was related to race, class and
sexual orientation, but not to gender.18 However, further intersectional analyses of the same data showed that each axis of
inequality interacted signicantly with at least one other resulting in the poorest self-rated health among homosexuals with
poor income as well as among South Asian women.18 This
exemplies how the potential to visualise and explain health
inequalities increases when intersecting power dimensions are
seen as more than the sum of additional components. This is
not easily captured by the additive perspective which, in an
analogy drawn from Choo and Ferree19 tends to conceptualise
intersections like street corners where several streets cross
without an appreciation of how each is transformed by the
others.
The place of gender in intersectional analysis has been the
subject of debate. Some, such as Hankivsky20 argue that the
importance of gender should be left open in order to allow a
more effective understanding of the complexities of health
experience to emerge in analysis. Others17 18 argue that as a
social institution, gender constructs and maintains the subordination of women as a group to men. Hence gender is the most
visible and pervasive part of social identity and should always be
the starting point of analysis.17
We propose that the answer to the question of whether
gender should be left open as to its relevance in analysis
(Hankivsky) or always kept as a starting point (Shields) hinges
on the health issue in question and the context of analysis (who
is being studied, where and when). Particular intersections of
interest and the place of gender within them are context
dependent upon the wider social orders, including power relations, of which they are a part. It is therefore important to ask
why a category such as gender is stable or unstable at any point
in time, why it is changing (or not changing), and with what
implications for health and for other life experiences.21
We suggest that intersectionality should go beyond additive
analyses and study complex intersections as well as ensure that
gendered power relations and social context are included.

EMBODIMENT
Embodiment is a concept focusing on how the body interacts
with the environment. It originated in phenomenology and is
based on a view of the body-mind as a dialectic and holistic
unit, in contrast to the Cartesian split between body and
mind.22 23 The strive for holistic models of body, health and
disease within the health sciences24 has led to a number of different perspectives on the concept of embodiment and how to
use it, from among which we will describe three (table 3).
First, the phenomenological conceptualisation is based on
philosopher Merleau-Pontys notion of lived experience,

Hammarstrm A, et al. J Epidemiol Community Health 2013;0:16. doi:10.1136/jech-2013-202572

Theory and methods

Table 1 Conceptualisations of sex and gender
Sex
Perspectives
Origins

Underlying
assumptions

Potential
problems
Strengths

As static difference

Gender
As sex in interaction with
gender
12 40

As static difference

As social process

Theories of role differences and more

recently in gender-specific medicine6

Relational theory of gender

Relational theory, social constructivism,

beyond dualisms, agency within
structures
Relational theory usually understands
gender as multidimensional: embracing
at the same time economic relations,
power relations, affective relations and
symbolic relations; and operating
simultaneously at intrapersonal,
interpersonal, institutional and
society-wide levels25
Needs deeper analyses of sex and the
biological body

Biomedicine and more

recently in gender-specific
medicine6
Individual traits, Dualistic
the classification of living
things as male or female
based on their reproductive
organs and functions 7

Feminist biologists

Interplay between sex and gender

Social and biological processes
feminists must accept the body as
simultaneously composed of genes,
hormones, cells, and organsall of
which influence health and
behaviorand of
culture and history12

Individual traits, Dualistic

gender, a uniquely human concept, as
a persons self-representation as male
or female, which is rooted in biology
and shared by environment and
experience7

Risk for essentialism

Exaggerates differences
between men and women
A critique of the male norm

A risk of confusion of sex and

gender

Focus only on the individual level

Exaggerates differences between men
and women
A critique of the male norm

Goes beyond a static and

dichotomous view on sex and
gender

focusing on how perceptions and consciousness are linked to

the body.23 Among many others, the physiotherapist and philosopher Bullington has developed Merleau-Pontys concept of
the lived body in medical rehabilitation. She has shown that
chronic pain is a bodily and an existential phenomenon.22 In
order to be successful, rehabilitation must be holistic and
address the material body and the diminished sense of self as
well as the withdrawal from the surrounding society. The lived
body is thus viewed as a fundamentally intertwined unity of
mind-body-world.23
Second, the concept of social embodiment13 places greater
emphasis on social processes and gender relations. Using a
social constructionist perspective, Connell emphasises that
bodies are at the same time agents in and objects of social practices.13 Bodily practices affect the formation of social structures,
which in turn generate new practices which involve and affect
bodies in continuous processes where embodiment concerns
what bodies do and what is done to bodies.25 Anorexia is an
example of a gendered form of social embodiment.25 Anorexia
among young women, who live in a gender order in which they
are dependent on being attractive to men exemplify such a
social/bodily feedback loop: in response to societal norms about
attractiveness, women can starve themselves far beyond the
norm, and then their bodies and lifestyle are pictured as the
ideal goal for other women, through for instance Pro-ana
websites.13 25
Third, in the epidemiological framework of ecosocial theory,
embodiment is conceptualised as the biological incorporation of
the material and social world, or in other words, how bodies
are changedtemporarily or permanentlyby environmental
and behavioural factors.26 Krieger emphasises the multilevel
nature of embodiment by integrating the soma, the psyche and
society in various historical and ecological contexts24 26 and
views the health impact of gender relations as one example of
embodiment.24 27 Although she acknowledges that human
beings have individual agency, the main focus is on the role of
societal conditions in the production of population health

Process-oriented, aware of the

importance of context
Focus on structural level

inequalities24 and on biomedical formulations of health/

disease. Fausto-Sterling and coworkers,28 refer to Kriegers
notion of embodiment in their integration of embodiment
with developmental systems theory in order to illuminate how
sex/gender differences emerge during the rst years of life.
While enormous individual variability in behaviours exists at
birth, the authors show how cultural gendered practices lead
to different treatment of boys and girls and that this treatment
may have tangible and long-term effects on their bodies and
brains.28 29
Embodiment is a promising concept for analysing how sex
and gender become interwoven as part of life, but health
researchers seldom address the different usages and meanings of
the concepts. Our recommendation is that we need to be aware
that embodiment has been developed within different traditions,
with various degrees of integration of gender and health perspectives as well as with different levels of analyses.

GENDER EQUALITY AND GENDER EQUITY

The concepts of gender equality and gender equity are based on
the assumption that the distribution of opportunities, resources
and responsibilities between women and men should not disfavour either group. To simplify, gender equality concerns equal
rights (absence of gendered discrimination) while gender equity
concerns needs-based approaches.3032 What rights/needs
means in practice is strongly disputed.33 34 We analyse two perspectives on this dispute (sameness/difference and fairness) in
relation to the rights/needs perspective (table 4).
Sameness-difference: The concept gender equality originated in
social science and feminism.31 33 At the Beijing Conference on
Women (1995), it was criticised, primarily by conservative
groups, for ignoring that women and men sometimes differ.3335
However, this is a misunderstanding since the concept of gender
equality acknowledges similarities and differences between
women and men.3234 Instead, gender equity was suggested as a
concept acknowledging that women and men sometimes have
different needs, for social and biological reasons.33 34 But the

Hammarstrm A, et al. J Epidemiol Community Health 2013;0:16. doi:10.1136/jech-2013-202572

Theory and methods

Table 2

Conceptualisations of intersectionality

Perspectives

Additive

Intersectional

Origins

Critique of unitary experience of genderthat is,

of the static difference perspective (see table 1)

Underlying
assumptions
Limitations

The addition of other axes of inequality to gender

to identify where most explanatory power lies
Factors of interest for example, gender, social
class, are still conceptualised independently.
Tendency to conceptualise gender in relation to
an accumulation of advantages and
disadvantages
Goes beyond sex/gender as static difference to
draw attention to differences within and
similarities across the group of men and women

In antidiscrimination debate as well as in postcolonial theory, black feminism and queer theory.
Crenshaw14 argued for a move away from single-axis analyses of race and gender towards an
appreciation that black womens intersectional experience is greater than the sum of racism and
sexism.
Strengthened by poststructuralist emphasis on the deconstruction of binary sex and gender as
primary categories of experience15
Dimensions of inequality do not simply accumulate. Instead one category such as race takes its
meaning from another such as gender
Decentres gender, that is, gender is not necessarily in focus of analyses
Challenges of identifying and developing (mainly quantitative but also qualitative) methodological
techniques to study complex intersections
Focus on new social groups identified at various intersections can lead to context specialisation
to the neglect of the wider social relations of gender that construct experience at intersections19
Promotes the analysis of new hybrid structures and identities which emerge at the intersections of
inequality17

Strengths

concept gender equity was strongly opposed by feminist and

human rights groups, arguing that this concept was open for subjective interpretations and could be used to justify discrimination.33 34 As a consequence, UN policy documents generally use
the concept gender equality.33 But in policy documents on
health, gender equity is still used, since it is generally accepted
that in relation to health, men and women can have similar needs
and different needs.33 The difference perspective on gender
equity increases the risk of overemphasising health differences
between women and men.33
Fairness: With the fairness perspective the concept gender
inequalities has been assumed to refer to differences that are
not necessarily unfair while gender inequities refer to unfair
differences between women and men.33 34 The perspective
may have emerged because some denitions of gender equity
emphasise the word fairness,30 32 to clarify that fairness of
policy can require a needs-based approach, thus giving more
resources to one group (eg, allocating substantial resources to
womens pregnancy/delivery-related health).30 32 The fairness
perspective is in accordance with the well-established broader
(ie, not related to gender) denition in public health research36
of health inequity as avoidable and unfair health differences
(eg, across social groups) and health inequality as health differences that are not necessarily unfair (eg, between young and
old people). However, to disconnect the concept gender equality from assumptions of fairness is problematic, as the concept

Table 3

Conceptualisations of embodiment

Perspectives

Phenomenology

Social embodiment

Epidemiological

Origins

A dialectic and holistic body philosophy. The body

is an object that I have and a subject which I am23

Underlying
assumptions

The lived body describes the daily experiences of

having and being a body. Mind-body-world is
intertwined in a wholeness and cannot be
separated from each other22
Lacks the gender and the structural perspectives

Gender relational theory: concerns

patterned relations between and among
women and men that form gender as a
social structure13 25
The interplay between bodies, social
relations and social structure is a collective
and reflexive process25

Ecosocial theory: emphasises the multilevel and

dynamic interplay between processes and structures
relevant for health and the production of population
health inequalities24
The material and social world changes the body,
thereby creating population patterns of health and
disease24 26

A general framework which needs further

contextualisation
Acknowledges individual agency and
societal structures. Analyses various levels
such as individual, group and societal

Dominant focus on structures rather than on agency

Limitations
Strengths

inherently refers to fairness and is widely used that way.

In health science and social science, a commonly used denition of gender equality is Susan Moller Okins which emphasises fairness between women and men in all spheres of life.31
In policy, the concept gender equality has strong foundations
in international human rights law,34 and calls for the absence
of discrimination30 or absence of limitations set by stereotypes, rigid gender roles and prejudices,32 thereby relating this
concept to fairness.
We argue that gender equality should be dened as absence of
discrimination and gender equity as meeting the needs of
women and men, whether similar or different. To illustrate what
this can mean in practice for research, we describe below how
the research focus can determine which concept should be
applied, as suggested, for instance, by Payne and Doyal.33
Gender equality can refer to the societal power relations
between men and women as possible social determinants of
health. For example, gender equality in marriage/cohabitation
(measured as shared household duties) has been shown to be a
determinant of mental health for women and men.37 Gender
equity can be an adequate concept for research on needs-based
prevention, treatment and rehabilitation.35 38 One example is
research on gender inequities in unmet needs for hip/knee
surgery, which shows that though a majority of those receiving
the treatment are women, there are also more women than men
who need treatment but do not get it.39

Offers an explicit holistic meaning of the

embodiment concept in clinical practice

Uniquely developed for epidemiological research

Hammarstrm A, et al. J Epidemiol Community Health 2013;0:16. doi:10.1136/jech-2013-202572

Theory and methods

Table 4 Conceptualisations of gender equality and gender equity
Gender equality
Perspectives

Sameness/
difference

Gender equity
Fairness

33

Policy definitions

30 32

Origins

Policy debates

Underlying
assumptions

Assumed to denote
exact sameness
between women and
men33 34

Sees inequalities as
differences that are
not necessarily
unfair33 34

Potential
problems

Can disfavour one

gender by treating
them exactly the
same even when
they have different
needs34
Is easier to measure
since it asks for
exactly the same
level of resource
allocation for
women and men

Ignores the strong

human-rights and
fairness background of
the concept gender
equality34

Strengths

Sameness/
difference

Rights/needs

Is in accordance with
one well-known
definition of health
equality36

Social science and

feminism31 33
Absence of discrimination,30
or of limitations set by
stereotypes, rigid gender roles
and prejudices32
More complex and can be
difficult to interpret what this
means in practice, but our
suggestion is to use this
concept for social determinants
of health
Has a strong human-rights
basis. Is considered relatively
measurable and objective. Is in
accordance with how the
concept is mainly used and
defined

CONCLUDING REMARKS
Our recommendations for future research on health and gender
are that:
The concepts sex and gender can benet from a gender relational theoretical approach (ie, a focus on social processes
and structures) but with additional attention to the interrelations between sex and gender
Intersectionality should go beyond additive analyses to study
complex intersections as well as ensure that gendered power
relations and social context are included
We need to be aware of the various meanings given to
embodiment, which achieve an integration of gender and
health and attend to different levels of analyses to varying
degrees.
Gender equality concerns absence of discrimination between
women and men while gender equity focuses on meeting
womens and mens health needs, whether similar or
different.
An appropriate use of these concepts helps to address the problems associated with static, dualistic perspectivessuch as
sameness/difference, body/mind, men/women and social/biologicalas well as the need for contextualisation of research
questions and justication of theoretical standpoints, and therefore holds the potential for more nuanced and higher quality
research.
Gender research in the health sciences is a complex eld with
great potential to make important theoretical contributions to
the wider scientic community. Thus, gender researchers in
health science can take leadership in a way we have not done
before. Although theory development is relatively uncommon in
the health sciences compared with other disciplines, it is vital to
have clear and well-developed concepts in order to develop
well-specied and appropriate research questions. Thus, health
science has much to learn from gender research in relation to
reexive approaches, theoretical development, urge for conceptual clarity and epistemological knowledge.
The history of these six concepts shows that they are constantly evolving in response to changes in society, as a

Policy debates

Fairness
33

Women and men

are sometimes
similar and
sometimes
different33 34
Risk of emphasis on
health differences
between women
and men33

Acknowledges
differences between
women and men

Policy definitions

Rights/needs
30 32

Policy definitions

30 32

Sees inequities as
unfair and avoidable
differences33 34

Meeting the needs of

women and men,
whether similar or
different30 32

Is not compatible
with common usage,
where both concepts
refer to fairness

Risk of subjective
assessment of what
are the needs of
women and men

Is in accordance with
one well-known
definition of health
equity36

Clarifies the
importance of
needs-based
approaches to gender
in health, without
focusing on
differences

consequence of new research ndings, and as part of ongoing

theoretical developments within the health sciences and the
eld of gender studies from which they generally derive.
They are powerful tools which, if used more systematically
and with greater precision than has been the case to date,
could signicantly advance our understanding of experiences
and determinants of illness and disease. Thereby they could
make a difference to health science and health policy. Hence,
the analysis in this paper is an invitation for dialogue and a
call to make more effective use of the knowledge base which
has already developed among gender theorists in health
sciences.

What is already known

In spite of increasing awareness of the importance of gender
perspectives in health science, there is a conceptual muddle
within the eld.

What the manuscript adds to the literature

Clarication and development of key concepts in gender
research in health science, namely: sex and gender,
embodiment, intersectionality, gender equity and gender
equality. By addressing the problems associated with static,
dualistic perspectivessuch as sameness/difference, body/mind,
men/women and social/biologicalas well as the need for
contextualisation of research questions and the justication of
theoretical standpoints, an appropriate use of these concepts
holds the potential for more nuanced and higher quality
research in health sciences.

Hammarstrm A, et al. J Epidemiol Community Health 2013;0:16. doi:10.1136/jech-2013-202572

Theory and methods

Acknowledgements The authors would like to thank Professor Raewyn Connell
for encouraging them to write a state of the art paper about how to use gender
theories in health research as well as for valuable comments on their manuscript.
Contributors All authors participated in designing the article and deciding on the
analytical framework. AH, KG and CA wrote the section on sex and gender. AL, CE,
LA, MC, AH and EA wrote the section on intersectionality. AF-W, GS and PEG wrote
the section on embodiment. LH, SE, KJ and PV wrote the section on gender equality
and gender equity. AH initiated and led the work process. Together with KJ she
compiled the full manuscript and wrote the introduction, and conclusions. EA read,
commented and developed the nal draft. All authors have read and approved the
nal manuscript.

18
19

20
21
22
23

Funding The project was nanced by the Swedish Research Council, grant numbers
344-2006-7280 and 344-2011-5478.

24

Competing interests None.

25

Provenance and peer review Not commissioned; externally peer reviewed.

26

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Hammarstrm A, et al. J Epidemiol Community Health 2013;0:16. doi:10.1136/jech-2013-202572