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The Gender Analysis Tool With Topical Questions
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GENDER ANALYSIS QUESTION TABLE
More specifically, to make the GAF more accessible, the tables below offer topical questions to guide the content of research questions for each domain at each level of the health system for gender analysis.
For each level of the health system: 1) individual and household; 2) community; 3) health facility; 4) district; 5) national, there is one table with illustrative questions for each of the four domains.
The first table in each section contains general topical questions that pertain to that level of the health system, and the second table contains topical questions pertinent to a specific area of health (e.g., HIV, FP). The topical questions are both illustrative and descriptive and offer a set of key questions for a range of Jhpiego health areas. They should inform what kind of information should be gathered using a combination of qualitative and quantitative methods, but are not intended to be directly transferred to a survey or interview guide. Instead, the questions should be further adapted for a specific purpose, to a particular context, and to the type of data collection tool.
Sample data collection tools and resources that pertain to each level and set of tables are found at the end of each set. Annotations of the data collection and analysis resources listed appear in Annex III. The citations contain a hyperlink to the full document of each resource. To keep the size of the tool manageable, we focused questions on one health area per level of the health system.
The table below illustrates the level of questions that this Toolkit aims to provide using HIV-related gender analysis and assessment questions. The topical questions in the GAF tables are more specific than broader research questions and less specific than the types of questions that would appear on a survey or as part of a qualitative interview guide, which would have to be adapted and tested prior to their application for the setting and type of tools to be used.
RESEARCH QUESTIONS (BY DOMAIN) |
TOPICAL QUESTIONS |
QUANTITATIVE DATA COLLECTION QUESTIONS | ||
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- Demographic Research
Adapting how we ask about the gender of our survey respondents
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Knowing the gender of our survey respondents is critical to a variety of analyses we do at Pew Research Center. Gender affects how a person sees and is seen by the world. It’s predictive of things like voting behavior , the wage gap and household responsibilities .
On nearly all surveys we conduct in the United States, we ask people, “Are you male or female?” (Or, in Spanish: ¿Es usted hombre o mujer? ) While this wording has been the standard question we’ve used for years, we wondered if we could find a new way to ask about gender that would acknowledge changing norms around gender identity and improve data quality and accuracy, while still maintaining the neutrality that defines the Center.
We organized a research team to answer this question and — if the answer turned out to be yes — determine how we might modify the way we ask about respondents’ gender. Ultimately, we settled on a new version of the question: “Do you describe yourself as a man, a woman, or in some other way?” (Or, in Spanish: ¿Se describe a sí mismo(a) como un hombre, una mujer o de alguna otra manera? )
Here, we detail how and why we came to this decision.
We considered attitudes, laws and best practices in research
Gender is a social construct based on how people see themselves and how others see them. Sex, by contrast, is a biological construct assigned at birth. An estimated 1.4 million U.S. adults are transgender, which is defined in this post as people who identify as neither a man nor a woman (sometimes people in this group use the term “nonbinary”) or those who identify with a gender different from the sex they were assigned at birth . (It is worth noting that some people in this group might use terms other than “transgender” to describe themselves.) Roughly one-in-five U.S. adults know someone who uses a gender neutral pronoun such as “they” instead of “he” or “she,” and 17 states and the District of Columbia have adapted to this evolution in gender identity by adding a nonbinary option to driver’s licenses.
Other survey researchers have also begun adapting their gender questions. Some surveys ask a two-step question to determine both sex assigned at birth and current gender identity. Others ask whether a respondent is male or female and whether they self-identify as transgender. Meanwhile, qualitative research has looked at the best terms to use when asking about gender identity.
Given that many Americans view gender in a way that is more complex than can be captured in just the two response options of “male” and “female,” adding a third option could improve data accuracy by ensuring the data are representative and inclusive of all types of voices. Proponents of a third gender response option may also perceive the lack of such an option as exclusionary. On the other hand, the Center was concerned that adding a third option could possibly alienate the 56% of U.S. adults who said in a 2018 survey that forms or online profiles should not include an option other than “man” and “woman.” If either group stopped participating in our surveys, it would introduce bias and harm data quality. Another consideration was how a third gender response option would translate into Spanish. The Center’s surveys are almost always conducted in both English and Spanish, and little existing research has addressed how to phrase a revised gender question in Spanish.
Prior research informed our new gender identity question
In previous studies , researchers have conducted a variety of tests about the best way to ask about gender. Informed by this research, we decided to make our starting point the question wording used in the National Crime Victimization Survey : “Do you currently describe yourself as male, female or transgender?” We then made two changes based on previous research.
First, we replaced “transgender” with the phrase “in some other way.” Some people who identify as neither male nor female do not identify with the term “transgender,” instead preferring “nonbinary,” “genderfluid” or other terms. “Transgender” also isn’t necessarily mutually exclusive from “male” and “female.” For example, some people consider themselves both male and transgender. In addition, there is no Spanish equivalent of “transgender,” and around three-in-ten U.S. adults do not have a clear understanding of what “transgender” means.
Second, we replaced “male” and “female” with “a man” and “a woman.” The words “male” and “female” refer to a person’s biology or sex , while the words “man” and “woman” are cultural terms that are more consistent with the concept of gender.
We conducted an experiment to address outstanding concerns
In June and July 2020, we conducted an online opt-in survey of 5,903 internet panelists to test two alternative gender question options in English and Spanish. A total of 4,931 responded in English and 972 responded in Spanish. The survey took an average of 12 minutes to complete and included questions about the coronavirus outbreak, political approval and other demographics.
Respondents were randomly assigned to receive one of three sets of gender questions after receiving other demographic questions. One group of respondents (n=1,654) received the standard Pew Research Center question. Another group (n=2,611) received a question about sex, followed by a question about gender:
1. “Were you born male or female?” ( ¿Su sexo al nacer fue masculino o femenino? )
2. “Do you describe yourself as a man, a woman, or in some other way?” ( ¿Se describe a sí mismo(a) como un hombre, una mujer o de alguna otra manera? ) The phrase “some other way” also included a text box for respondent specification.
In asking these questions, it was especially important that we minimized the number of adults who might incorrectly be classified as transgender. Since the U.S. transgender population is small, estimates of the size of this population might be artificially inflated even if a small number of respondents accidentally chose the wrong answer. To minimize this error, we asked a third follow-up question of those whose responses to these two questions did not match:
3. “Just to confirm, you were born [male/female] and now describe yourself [as a man/as a woman/in some other way]. Is that correct?” ( Solo para confirmar, su sexo al nacer fue [masculino/femenino] y ahora se describe a sí mismo(a) [como hombre/como mujer/de otra manera]. ¿Es eso correcto? )
If respondents said their answers were not recorded correctly, they were given the opportunity to re-answer both questions.
A final group (n=1,638) received the same questions as the second group, but in reverse order; they received the question about gender identity before the question about sex assigned at birth. This group was also asked to confirm if their answers to the two questions didn’t match.
At the end of the survey, immediately following the gender/sex questions, we asked all respondents whether they thought our questions were biased (and, if so, why), followed by two questions about their views on transgender rights and offering a third gender option on forms and online profiles.
Unweighted estimates from this experiment are sprinkled throughout the remainder of this post. While opt-in samples are not ideal for creating point estimates, they are useful when comparing experimental wording conditions, as was the purpose here. To further improve comparability and to ensure we had reliable estimates, we also implemented a series of quotas and included an oversample of less-acculturated Hispanics (as determined by a combination of language skills, years living in the U.S., type of media consumption and self-described cultural affiliation).
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Data quality improved with the new gender question
Regardless of the way in which we asked respondents their sex/gender, we observed consistent distributions among men and women, suggesting little effect of the question wording for most people. However, among English-speaking adults who received the new gender questions, 1.5% selected the third, nonbinary response option or chose a gender inconsistent with their sex, suggesting that the inclusion of the third option had the intended effect on being more inclusive and improving data accuracy.
There was some concern that people who consider themselves a man or woman may not wish to be defined by their gender and instead opt for the third option and write in a non-gender term to describe themselves, such as “human” or “mother” or “scientist.” A large number of these types of responses would have suggested that the revised question would introduce error and hurt data quality. Luckily, we only observed four of these types of responses among English speakers, affecting the estimate by 0.1 percentage point and suggesting that it was not a problem.
Providing a third gender option didn’t alienate people
Fewer English-speaking respondents to our 2020 survey said they opposed the inclusion of a third gender response option on forms or online profiles (44%) than in our 2018 survey. However, 44% is still a substantial share of respondents. We were concerned that opponents would find our new, more inclusive question off-putting. This concern did not appear in the data. Fewer than 1% opted not to answer the gender question.
The revised gender question also didn’t cause more people to stop taking the survey before completing it. No more than 0.5% of English-speaking respondents across all experimental conditions opted to stop participating at or after the sex and gender questions.
The revised questions also did not appear to be affecting the Center’s credibility as a nonpartisan research organization. When asked whether respondents thought the survey was politically neutral, about three-in-four English speakers said the survey was not at all or not very biased, regardless of which gender questions they received.
The new gender question worked in Spanish, too
A small proportion of Spanish-speaking respondents (3.6%) opted for the third gender choice or chose a gender inconsistent with their sex. While this was significantly higher than the estimate among English speakers (1.5%), both English and Spanish speakers were asked to confirm their choice if sex and gender responses did not match. Spanish speakers consistently confirmed their answers to both sex and gender. Moreover, when asked if they found any questions confusing, only six Spanish speakers mentioned the gender question wording, and none of the six were coded as transgender.
Similar to English-speaking respondents, Spanish speakers did not seem to be affected by the various question wordings. And the addition of a third option had no perceivable alienation effect. Some 40% of Spanish speakers said they disapproved of the addition of a third gender choice on forms, but the addition of a third response category to the gender question did not cause more people to stop participating in the survey prematurely, nor did it affect the proportion of Spanish-speakers who perceived the survey as somewhat or very biased.
Asking about sex in addition to gender wasn’t necessary
While our experiment used a two-step question to deduce both a respondent’s sex and gender, moving forward, we will limit most of the Center’s U.S. surveys to the single gender question referenced at the top of this post.
Based on comments collected at the end of our experiment, fewer than 1% of respondents mentioned the sex and gender questions in any way. Among those who did, 30% expressed frustration over the presence of multiple questions or concern about the use of the term “born” in the question on sex. Also, the inclusion of a question about respondent’s sex isn’t necessary for most of the Center’s research, which focuses predominantly on gender. And while we do construct weights based on population estimates by sex, the correlation between gender and sex suggests that gender can reliably be used as a proxy for sex for this purpose. Another important consideration is respondents’ time: If we don’t need to ask a question, we won’t.
In conclusion, this change in how we ask about gender was not taken lightly, as we were driven to ensure inclusivity and accuracy while maintaining the rigorousness and neutrality that characterizes the Center.
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- Survey Methods
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Session 11: Using Gender Analysis within Qualitative Research
Gender analysis entails researchers seeking to understand gender power relations and norms and their implications, including the nature of women’s, men’s, and people of other gender’s lives, how their needs and experiences differ, the causes and consequences of these differences, and how services and polices might address these differences. As well as analysing differences between females, males, and people of other genders, gender analysis, by focusing on the nature of power relations, also considers differences among females, among males, and among people of other genders. It includes examining gender in relation to other social stratifiers, such as class, race, education, ethnicity, age, geographic location, (dis)ability, and sexuality, ideally from an intersectional perspective.
Incorporating gender analysis into research should ideally be done at all stages of the research process. It includes considering gender when defining research aims, objectives, or questions; within the development of study designs and data collection tools; during the process of data collection; and in the interpretation and dissemination of results. By including gender into research, researchers can ensure that gender inequities are not perpetuated, collect higher quality and more accurate data, and actively engage in positively changing gender relations and reducing inequities.
Overall, by the end of the session users should be able to:
- Understand what gender analysis is and why it is important for global health research
- Recognize different ways gender analysis can be incorporated into your health systems research, including research content, process, and outcomes
- Understand how gender frameworks can be used to guide analytical process
You can download the powerpoint here .
The information above is taken from the following resource: Morgan, R. et al., 2016. How to do (or not to do)… gender analysis in health systems research. Health Policy and Planning, p.czw037.
Recommended Resources Gender Analysis Hunt, J. (2004). Introduction to gender analysis concepts and steps . Development Bulletin, 64, 100–106. JHPIEGO. (2016). Gender Analysis Toolkit for Health Systems . LSTM. (1996). Guidelines for the analysis of Gender and Health . Morgan, R. et al., (2016). How to do (or not to do)… gender analysis in health systems research . Health Policy and Planning, 31: 1069–1078. RinGs (2016). How to do gender analysis in health systems research: a guide RinGs (2015) How to do gender analysis in health systems research webinar recording
Gender Frameworks Caro, D. (2009). A Manual for Integrating Gender Into Reproductive Health and HIV Programs. JHPIEGO. (2016). Gender Analysis Toolkit for Health Systems . March, C., Smyth, I., & Mukhopadhyay, M. (1999). A Guide to Gender-Analysis Frameworks . Oxfam. RinGs (2015) Ten Gender Analysis Frameworks & Tools to Aid with Health Systems Research Warren, H. (2007). Using gender-analysis frameworks: theoretical and practical reflections. Gender & Development , 15(2), 187–198.
Intersectionality Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health . American Journal of Public Health, 102(7), 1267–1273. Hankivsky, O. (2014). Intersectionality 101 . The Institute for Intersectionality Research & Policy, SFU. Larson, E., George, A., Morgan, R., & Poteat, T. (2016). 10 Best resources on... intersectionality with an emphasis on low- and middle-income countries . Health Policy Plan., czw020–. http://doi.org/10.1093/heapol/czw020
We want these sessions to be useful and respond to users needs, so please contact us if you would like to see additional materials. We also have a dedicated page for users to share any thoughts or experiences of using these research approaches. You can also use these pages to ask questions or seek clarification. Click here for discussions.
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- Published: 22 October 2022
The impact of gender diversity on scientific research teams: a need to broaden and accelerate future research
- Hannah B. Love ORCID: orcid.org/0000-0003-0011-1328 1 , 2 ,
- Alyssa Stephens 2 , 3 ,
- Bailey K. Fosdick ORCID: orcid.org/0000-0003-3736-2219 2 ,
- Elizabeth Tofany 2 &
- Ellen R. Fisher ORCID: orcid.org/0000-0001-6828-8600 1 , 2 , 4
Humanities and Social Sciences Communications volume 9 , Article number: 386 ( 2022 ) Cite this article
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Multiple studies from the literature suggest that a high proportion of women on scientific teams contributes to successful team collaboration, but how the proportion of women impacts team success and why this is the case, is not well understood. One perspective suggests that having a high proportion of women matters because women tend to have greater social sensitivity and promote even turn-taking in meetings. Other studies have found women are more likely to collaborate and are more democratic. Both explanations suggest that women team members fundamentally change team functioning through the way they interact. Yet, most previous studies of gender on scientific teams have relied heavily on bibliometric data, which focuses on the prevalence of women team members rather than how they act and interact throughout the scientific process. In this study, we explore gender diversity in scientific teams using various types of relational data to investigate how women impact team interactions. This study focuses on 12 interdisciplinary university scientific teams that were part of an institutional team science program from 2015 to 2020 aimed at cultivating, integrating, and translating scientific expertise. The program included multiple forms of evaluation, including participant observation, focus groups, interviews, and surveys at multiple time points. Using social network analysis, this article tested five hypotheses about the role of women on university-based scientific teams. The hypotheses were based on three premises previously established in the literature. Our analyses revealed that only one of the five hypotheses regarding gender roles on teams was supported by our data. These findings suggest that scientific teams may create ingroups , when an underrepresented identity is included instead of excluded in the outgroup , for women in academia. This finding does not align with the current paradigm and the research on the impact of gender diversity on teams. Future research to determine if high-functioning scientific teams disrupt rather than reproduce existing hierarchies and gendered patterns of interactions could create an opportunity to accelerate the advancement of knowledge while promoting a just and equitable culture and profession.
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Introduction.
Diversity in scientific teams is often a catalyst for creativity and innovation (Misra et al., 2017 ; Smith-Doerr et al., 2017 ), and numerous studies have documented that gender diversity, the equitable representation of genders, is important for the development, process, and outcomes of scientific teams (Bear and Woolley, 2011 ; Hall et al., 2018 ; Misra et al., 2017 ; Riedl et al., 2021 ; Smith-Doerr et al., 2017 ; Woolley et al., 2010 ). Furthermore, research has found evidence that a higher proportion of women on a team increases collective intelligence (Riedl et al., 2021 ; Woolley et al., 2010 ), and that gender-balanced teams lead to the best outcomes for group process (Bear and Woolley, 2011 ; Carli, 2001 ; Taps and Martin, 1990 ). When scientists hear that the proportion of women influences team performance, they often ask “What proportion is needed, and why does the proportion of women impact team success?”
The answers to these questions remain unclear. To date, most research on the impact of gender composition on scientific teams only uses quantitative metrics (e.g., comparing team rosters and bibliometric data) (Badar et al., 2013 ; Lee, 2005 ; Lerback et al., 2020 ; Pezzoni et al., 2016 ; Wagner, 2016 ; Zeng et al., 2016 ). Although these quantitative metrics provide a reasonable starting point, they emphasize the presence of women rather than their levels of integration or participation, which may perpetuate tokenism on scientific teams. As Smith-Doerr et al. ( 2017 ), reported
Our journey through the literature demonstrated a critical difference between diversity as the simple presence of women and minority scientists on teams and in workplaces, and their full integration (p. 140).
Similarly, Bear and Woolley ( 2011 ) conducted a meta-analysis of the literature from multiple disciplines and found that when diverse team members were integrated holistically, team diversity contributed to innovation. Conversely, in studies where teams had diverse membership but failed, these teams were often relying on token members and did not have authentic and full integration of those diverse members. Bear and Woolley ( 2011 ) suggest that the proportion of women on a team roster should be studied as follows:
It is not enough to simply examine the number of women in a particular institution or role. … In order to be truly effective, the role that women play in scientific teams should also be taken into consideration and promoted in order to yield the substantial benefits of increased gender diversity (p. 151).
These recent studies signal a paradigm shift in literature in the perceptions of diversity on teams because historically, diversity on teams was perceived as negative. In 1997, Baugh and Graen ( 1997 ) described teams with women and minorities were perceived to be less effective. Benschop and Doorewaard ( 1998 ) described how teams simply (re)produce gender inequality and they did not see a future in teams providing opportunities for women. Guimerà et al. ( 2005 ) claimed that while diversity may potentially spur creativity, it typically promotes conflict and miscommunication. Today, it is well accepted in the literature that to create new knowledge and solve complex global problems, studies in the science of team science (SciTS), knowledge innovation, creative, and more have documented that diversity in teams is important for the process, interactions, and outcomes (Bear and Woolley, 2011 ; Hall et al., 2018 ; Misra et al., 2017 ; Riedl et al., 2021 ; Soler-Gallart, 2017 ; Ulibarri et al., 2019 ; Woolley et al., 2010 ).
Numerous researchers have called for varied approaches to the study of women on teams. Madlock-Brown and Eichmann ( 2016 ) wrote that we “need a multi-pronged approach to deal with the persisting gender gap issues” (p. 654). Bozeman et al. ( 2013 ), explained that we understand collaboration from a bibliometric standpoint, but much more qualitative research is needed about the meaning of collaboration and the more informal side of collaboration, including mentoring, ingrained biases, and balancing collaborations (Reardon, 2022 ). Further, many of these studies about women on teams were conducted with undergraduate students within curricular settings, not with real-world scientific teams. Fundamentally, to understand gender patterns in scientific collaborations, qualitative and mixed methods research approaches are needed that study the process of scientific team development and not just team outcomes (Keyton et al., 2008 ; Wooten et al., 2014 ).
This study focused on 12 interdisciplinary university scientific teams that were part of an institutional team science program from 2015 to 2020 aimed at cultivating, integrating, and translating scientific expertise. Team science is research conducted collaboratively by small teams or larger groups (Cooke and Hilton, 2015 ). The program included multiple forms of evaluation, including participant observation, focus groups, interviews, and surveys at multiple time points. More specifically, gender diversity was explored by using mixed-methods data from team interactions to investigate two primary research questions: (1) what is the role of women on scientific teams? and (2) how do women impact team interactions?
Members of the 12 teams completed social network surveys about their relationships including who they seek advice from, who is a mentor, who serves on student committees, who they learn from, and who they collaborate with. Social network analysis studies the behavior of the individual at the micro level, the pattern of relationships (network structure) at the macro level, and the interactions between the two (Stokman, 2001 ). In the context of team science, social network analysis provides insights into how interactions are related to team success and how the social processes teams use supports the knowledge-creation process (Cravens et al., 2022 ; Giuffre, 2013 ; Granovetter, 1977 ; Love et al., 2021 ; Zhang et al., 2020 ). Utilizing these data, we calculated the indegree for each team member’s relationship with other team members. Indegree quantifies the number of other team members that stated they had the selected relationship with the given individual. For example, the advice indegree counts the number of other team members that reported receiving advice from that person. To compare results across the teams, the indegree and outdegree measures were scaled by the number of respondents to account for the total number of possible connections for individuals. These social network measures allowed us to test five hypotheses based on the current team science literature and other disciplines about how women impact team interaction and collaboration.
Hypothesis 1 : Women faculty will have a higher indegree than men faculty within the mentoring and student committee networks. Men faculty members will have a higher indegree than Women faculty members in the advice and leadership networks.
Hypothesis 2 : Men at all career stages will be more likely to be considered a leader on the team than women, measured by having a higher average scaled indegree in the leadership network.
Hypothesis 3 : Various networks will be correlated as follows:
Leadership and advice networks will be positively correlated.
Mentoring networks will not be positively correlated with leadership or advice networks.
Mentoring and student committees will be correlated.
Hypothesis 4 : The social and collaboration relations will be more positively correlated for women than for men.
Hypothesis 5 : Non-faculty team members will have more social connections on teams with a senior woman relative to those on teams without a senior woman.
These hypotheses are grounded in the literature on the persistent, latent, and subtle ways gender inequality is reproduced within organizations (Acker, 1992 ; Benschop and Doorewaard, 1998 ; Cole, 2004 ; Fraser, 1989 ; Gaughan and Bozeman, 2016 ; Madlock-Brown and Eichmann, 2016 ; Sprague and Smith, 1989 ). Many theories regarding the impact of gender diversity assume that teams reproduce socialized patterns of behavior. Zimmerman and West ( 1987 ) wrote that gender is not a biological concept, but it is a social construction that “involves a complex of socially guided perceptual, interactional, and micropolitical activities that cast particular pursuits as expressions of masculine and feminine ‘natures’” (West and Zimmerman, 1987 ). Gender is thus created by social organization and performed in our everyday lives and the ways we interact with one another (Butler, 1988 ). Gender, albeit a social construct, is an influential schema that impacts behaviors and interactions in society (West and Zimmerman, 1987 ).
According to Zimmerman and West ( 1987 ) and Butler ( 1988 ), the process of gender socialization includes ideas about who is a leader, how leaders should act, and even what leaders should look like. Many studies have found that women may not be perceived as leaders even when their status or contributions to the team are high (Bunderson, 2003 ; DiTomaso et al., 2007 ; Humbert & Guenther, 2017 ; Joshi, 2014 ). Other studies have found that men were more influential in groups, even when they were in the minority (Craig and Sherif, 1986 ), and that teams with women and minorities were perceived to be less effective (Baugh and Graen, 1997 ). Furthermore, although leadership responsibilities often become attached to specific roles, they can also be conferred and performed based on the perception of the individual qualities or capabilities of team members (Butler, 1988 ). For example, if a woman is a principal investigator (PI), a man on the team may also be considered a leader and vice-versa. These conferred roles may impact individual responsibilities and further solidify the perception of who is the team leader .
Perceptions about the roles of women and men can also impact the responsibilities they are assigned during meetings and the duties they are expected to perform in the workplace. In academia, faculty are frequently expected to engage in service work to support the university, the discipline, and the community. Service work may include mentoring, advising, and serving on committees. Recent studies suggest what has been long perceived within academia, that when controlling for rank, race/ethnicity, and discipline, women spend significantly more hours on service work when compared to their male colleagues, (Guarino and Borden, 2017 ; Misra et al., 2011 ; Urry, 2015 ). In STEM disciplines, women spend a higher percentage of their time on mentoring than their male counterparts (21% for women vs. 15% for men) (Misra et al., 2011 ). Researchers have not yet explored whether team science exacerbates or mitigates this disparity in service work.
Literature has documented that collaboration patterns are different for women and men. Women faculty and students participate in more interdisciplinary research in almost all fields at every career stage (Rhoten and Pfirman, 2007 ). In addition, women tend to have more collaborators than men (Bozeman and Gaughan, 2011 ), and studies have found that being well-connected correlates with success for women (Madlock-Brown and Eichmann, 2016 ). Is it possible that having a senior woman on the team creates a culture of collaboration, such that non-faculty, which might be traditionally marginalized on a team, are more well-connected? We evaluate this here by comparing the connectedness of non-faculty on teams with and without a senior woman.
In part, the lack of understanding about why gender diversity matters on scientific teams result from primarily studying member demographic profiles rather than studying how teams are functioning, including exchanges of knowledge, power dynamics, and the team development process which is critical to team success (Smith-Doerr et al., 2017 ). This study moves beyond team composition to expand and examine real-world scientific teams through analysis of relational data to answer the questions: What is the role of women on scientific teams; and How do women impact team interactions?
This study was conducted at a land grant, R1 University in the western region of the United States. The primary sample for this study was 12 self-formed, interdisciplinary scientific teams with varied research foci, who were participants in a competitive university-funded team science program from 2015 to 2020. To apply for funding, each team submitted a written application and competed in a pitch fest (a brief oral presentation of their proposed project) that was followed by an intensive question and answer session by the review team. The topics for the interdisciplinary teams that were selected were broadly defined across STEM-related fields. The teams were expected to contribute to high-level program goals, which included:
Increase university interest in multi-dimensional, systems-based problems
Leverage the strengths and expertise of a range of disciplines and fields
Shift the funding landscape towards investing in team science/collaborative endeavors
Develop large-scale proposals; high caliber research and scholarly outputs; new, productive, and impactful collaborations
These overarching goals were measured by having the teams report on a variety of outcome metrics, including publications, proposals submitted, and awards received.
Participation in the team science program occurred through two cohorts and lasted 24–30 months for each cohort. However, a team in the second cohort left the program after 12 months. During the program, teams met with administrative leadership, the team science research team, and some external partners every 3–4 months to provide progress updates on stated milestones and receive feedback and mentorship. Additional support was provided through individualized trainings/workshops approximately every few months throughout the program. These sessions provided additional instruction on team science principles, social network analysis interpretation, marketing/branding, diversity and inclusion, opportunity identification, philanthropic fundraising, technology transfer, visioning, and team management/leadership. Some of the training was attended by multiple teams, but often these were specifically designed for the needs and developmental stage of each team. An additional team volunteered to participate in the study but was not part of the formal program. This team, also self-formed, was an interdisciplinary team that had received a large award through a federal grant. The 13 teams were randomly assigned a number from 1 to 13 to maintain anonymity and are referred to in this study by their team number. Team 2 was excluded from the study altogether because two of the authors were members of this team.
Data collection
Multiple types of evaluation data, at multiple points in time, were collected throughout the university-based team science program including participant observation, focus groups, turn-taking data, rosters, interviews, and surveys. This study utilized the resulting data from rosters, participant observation, field notes, and responses to a social network survey. Data for this article is from social network surveys at the conclusion of the program or the closest associated data point. Selecting data from a similar timepoint follows the recommendations of Wooten et al. ( 2014 ) who differentiated between development, process, and outcome metrics for scientific teams.
Teams submitted rosters with demographic information including name, email, self-identified gender, title, college, department, and role on the team (i.e., PI, member, graduate students, etc.). Rosters were updated annually during the program and provided the data to define senior woman and junior faculty and other demographic categories.
Social network survey
Each team member on the roster was sent an email after the program end date and was asked to complete an online social network survey that had two sections: demographic and social network relational questions (see Appendix Table 2 ). Following IRB protocol #19-8622H, participation was voluntary, and all subjects were identified by name on the social network survey to allow for the complete construction of social networks. Names were deleted prior to data analysis and result reporting.
To ensure that respondents had the option to select a self-identified gender, the social network survey included a demographic question that asked participants to self-identify their gender by filling in a blank space rather than choosing from a prescribed drop-down list. This was the gender attribute used for analysis in this article. Two respondents did not answer the gender demographic survey question, and the roster data was used for these participants. There was no variability in the level of missingness across questions. Respondents either completed the survey or did not.
The network survey’s relational questions asked about the presence and absence of interactional mentoring, advice, leadership, and collaborative relationships with other members of the team. The first set of questions was developed by the research team primarily to collect information about scientific collaborations since joining the team. The survey asked, who have you:
talked about possible joint research/ideas/concepts/connections
worked on research, collaborations, tech projects, or consulting projects
worked on joint publications presentations, or conference proceeding
worked on or submitted a grant proposal; and sat on a student’s committee together (or is a member of your thesis/dissertation committee)
The second set of questions focused on social relationships within the team, including:
I learn from [ this person ]
I seek advice from [ this person ]
I hang out with [ this person ] for fun
[ this person ] is a leader on the team
[ this person ] is a mentor to me
[ this person ] is a friend
[ this person ] energizes me
Participant observation and field notes
A researcher attended two to six team meetings for each team to collect observational data. There were two exceptions to this as Team 1 did not have face-to-face team meetings, precluding participant observation; and Team 5 did not consent to observation at their meetings. After the meetings, the researcher recorded field notes to provide qualitative insights into the progress of the team development, their patterns of collaboration, and gender interactions as suggested by Marvasti ( 2004 ). The field notes supported the development of the senior women classification (see Appendix Table 1 for classification definitions). In addition to roster information, many teams had separate leadership teams that met and determined the scientific direction of the team. If a team had a woman on the leadership team, as recorded in field notes, then they received the designation of having a senior woman .
Statistical analysis
RStudio (R Studio Team, 2020 ) was used to analyze the social network data. The data were summarized using outdegree, indegree, and average degree. The outdegree of an individual is a measure of how many other team members they indicated receiving advice, mentorship, etc. from on the team. Alternatively, the indegree of an individual is a measure of how many other team members reported receiving advice, or mentorship, from that person. Average degree is the average number of immediate connections (i.e., indegree plus outdegree) for a person in a network (Giuffre, 2013 ; Hanneman and Riddle, 2005 ). To compare results across the teams, the indegree and outdegree measures were scaled by the number of respondents to account for the total number of possible connections for individuals (which is a function of both team size and response rate). The scaled indegree is thus the proportion of the team that named that team member for a given category. For example, if a team member has a scaled mentor indegree of 0.10, then 10% of the responding team members consider this individual to be a mentor. Confidence intervals for scaled indegrees were calculated using a t -distribution due to limited sample size.
The social relation question set responses were also analyzed separately and then combined for further statistical analysis. Three measures were created: collaboration, social, and professional support. To create the measure called collaboration , the following questions were combined: worked on research, collaborations, tech projects, or consulting projects; worked on joint publications presentations, or conference proceedings; worked on or submitted a grant proposal. To create the measure called social , the measures: I hang out with [this person] for fun and [this person] is a friend were combined. Finally, to create the measure called professional support , the measures: I seek advice from [this person], [this person] is a mentor to me, and sat on a student’s committee together (or is a member of your thesis/dissertation committee) were combined (see Appendix Table 2 for Terms and Associated Survey Questions).
In addition, data from the social network relational questions were used to construct multiple social network diagrams, wherein nodes represent the team members, and an edge exists from participant A to participant B if A perceived a relation with B. For example, in the mentorship network, a link from A to B signified that A considered B to be a mentor.
Field notes were analyzed using a constant comparative method (Mathison, 2013 ) to provide qualitative insights into the progress of overall and individual team development, patterns of collaboration, and gender interactions as suggested by Marvasti ( 2004 ).
Classifications
For analysis purposes, three classifications were created from the demographic data. Senior woman indicates there was a woman PI or a woman on the leadership team. Faculty was defined as an assistant, associate, and full professor. Non-faculty were defined as undergraduate students, graduate students, postdocs, research associates, community partners, and project managers. In the study, 78.5% of faculty, and 77.6% of non-faculty completed the survey (see Appendix Fig. 1 for more details on response rate and Appendix Table 1 for terms and definitions).
Demographic data
Over half of the 204 team members, 160 (78.2%), completed the survey. Out of 160 respondents, 84% of women and 73% of men completed the survey. Table 1 provides demographic data by team number. Team size ranged from a low of 6 and a high of 30 members and the average number of team members was 15. The university had seven colleges, and all teams had representation from three to seven colleges.
Hypotheses testing
Test results of the five study hypotheses are presented below.
Hypothesis 1 : Women faculty will have a higher indegree than men faculty within the mentoring and student committee networks, and men faculty members will have a higher indegree than women faculty members in the advice and leadership networks.
The first hypothesis was designed to investigate if women were perceived to be doing more service work and emotional labor (mentoring and student committee networks), and men were perceived as being leaders (leader and advice networks) (Guarino and Borden, 2017 ; Misra et al., 2011 ; Urry, 2015 ).
Figure 1 compares the average indegree values of men and women on each team in four social network diagrams (mentoring, student committees, leader, and advice). The data in Fig. 1 do not support the hypothesis that more team members went to women faculty for mentoring and for serving on student committees. Further, the data did not support that more team members went to men faculty for advice or reported viewing them as leaders.
![qualitative research questions about gender figure 1](https://media.springernature.com/lw685/springer-static/image/art%3A10.1057%2Fs41599-022-01389-w/MediaObjects/41599_2022_1389_Fig1_HTML.png)
These are plotted against one another, where the size of the dot reflects the number of team members that completed the survey. When the number of respondents is low (a small dot), the scaled indegree is expected to be more variable, whereas when the number of respondents is high (a large dot), the scaled indegree is expected to be less variable and more representative of the whole team’s perceptions. Each graph reports a different social network question (mentor, student committee, advice, and leader).
The Fig. 1 mentoring network does, however, illustrate that teams in the study either engaged or did not engage in mentoring. On teams where women had a high mentoring indegree, men also had a high indegree in the mentoring network. This indicates that mentoring was team-specific rather than gender-specific. This aligns with other studies about team processes that found team norms (like mentoring) impact the behaviors and processes of teams (Duhigg, 2016 ; Winter et al., 2012 ).
Hypothesis 2 : Men at all career stages are more likely to be considered a leader on the team than women, measured by having a higher average scaled indegree in the leadership network (Table 2 ).
Literature in business, political science, and sociology report that men are more likely to be perceived as leaders (Baugh and Graen, 1997 ; Bunderson, 2003 ; Craig and Sherif, 1986 ; DiTomaso et al., 2007 ; Humbert and Guenther, 2017 ; Joshi, 2014 ). Based on this, we hypothesized that these perceptions would also be present in scientific teams (Table 2 , Fig. 2 ). In the study, both men faculty and men non-faculty were more likely to be reported as a leader on the team; however, this finding was not statistically significant based on a 95% confidence interval (CI) (Table 2 ).
![qualitative research questions about gender figure 2](https://media.springernature.com/lw685/springer-static/image/art%3A10.1057%2Fs41599-022-01389-w/MediaObjects/41599_2022_1389_Fig2_HTML.png)
The values for men and women for each of the faculty types are plotted against one another. Faculty were more likely to be considered leaders than non-faculty, but there were no significant differences between reporting men or women as leaders on scientific teams.
Figure 2 illustrates the scaled indegree for women and men faculty and non-faculty, which shows faculty are more likely to be considered leaders than non-faculty. Nevertheless, there were no significant differences in whether team members reported men or women as leaders on scientific teams.
Hypothesis 3 : Based on socialized gendered perceptions various networks will be correlated as follows:
The third hypothesis focused on whether gendered perceptions resulted in certain network diagrams being correlated. Previous studies have found that men are more likely to be perceived as leaders (Baugh and Graen, 1997 ; Bunderson, 2003 ; Butler, 1988 ; Craig and Sherif, 1986 ; DiTomaso et al., 2007 ; Humbert and Guenther, 2017 ; Joshi, 2014 ) and women are more likely to be perceived as mentors or caretakers (Guarino and Borden, 2017 ; Misra et al., 2011 ; Urry, 2015 ). These perceptions are sedimented in the language used to describe men and women (Sprague and Massoni, 2005 ).
![qualitative research questions about gender figure 3](https://media.springernature.com/lw685/springer-static/image/art%3A10.1057%2Fs41599-022-01389-w/MediaObjects/41599_2022_1389_Fig3_HTML.png)
We see the advice, leader, and mentor networks were highly correlated but only weakly correlated with the student committee network.
Based on this literature, we hypothesized that the leadership and advice networks would be correlated because both leading and giving advice suggest a greater power differential. Second, the mentoring network would not be correlated with leadership or advice networks because mentoring is more closely aligned with caregiving activities, which are considered more feminine. Third, the mentor and student committee networks would be correlated because these acts are associated with caretaking. Here, we tested if the networks related to leadership were correlated and if networks related to mentorship and service work such as serving on student committees were correlated.
Figure 3 illustrates the correlations for four of the network diagrams (mentoring, student committee, advice, and leadership) and reports the significance. The first gendered perception, that the leadership and advice networks would be correlated, was validated by the data. In the study, the leadership and advice networks were correlated (0.83). However, the hypothesis that the mentoring network would not be correlated with leadership (0.82) and advice (0.84) was not supported. These network diagrams were correlated, indicating team members who reported other team members as being leaders also reported that they received advice and mentoring from them. Finally, the hypothesis that mentoring and student committee diagrams would be correlated was also not validated by the data (0.32). One factor that could be contributing to these results comes from studies that show perceived organizational support, as well as perceived leader support, correlate with creativity and satisfaction in the workplace (Handley et al., 2015 ; Moss-Racusin et al., 2012 ; Smith et al., 2015 ). On the teams, members that are perceived as leaders are likely to provide support to others on the team. Notably, these studies did not explicitly examine gender in their findings.
A growing body of literature seeks to understand the connection between interpersonal relationships and knowledge innovation (Reference Blinded). We investigate this by considering how three types of interactions collaborative, social, and professional are intertwined on scientific teams. The purpose of this hypothesis was to closely examine the collaboration patterns of men and women and the connection between interpersonal relationships and knowledge creation. To create the measures in this hypothesis, social network survey questions were combined. For example, the measure social is a combination of: I hang out with [this person] for fun and [this person] is a friend (see the Analysis section for descriptions of all the measures).
To test what proportion of team members collaborate, given that they are also social with these individuals, we identified the team members that the person was social with and then calculated what proportion of those members they were also collaborating with. The results for this measure are given in Table 3 as proportion collaboration given social . Other items in Table 3 were developed in a similar manner.
Although our results indicate no statistical differences between men and women, we found that both men and women have intertwined relationships. If a team member is in one network (e.g., collaboration), it is likely that the person is also in another one of their networks (e.g., social). Furthermore, the overall proportion of men who have intertwined relationships in their collaboration, social, and professional support networks were higher in all proportions except proportion social given professional support (Table 3 ).
Numerous studies have attempted to tease apart gendered approaches to different collaboration styles and whether this has any impact on scientific collaborations (Bozeman et al., 2013 ; Madlock-Brown and Eichmann, 2016 ; Misra et al., 2017 ; Zeng et al., 2016 ). To build on this body of literature, this hypothesis tests the impact of senior women’s leadership, if any, on the collaborations of senior women and their impact on the network.
Figure 4 illustrates the scaled average indegree on the whole team when there are women in senior positions. A high average indegree for the team indicates that more team members and interacting and socializing on the team. The average scaled indegree on teams with a senior woman was 0.28 and without a senior woman was 0.20 ( t -test p = 0.44; Cohen’s D effect size 0.51). The second graph in Fig. 4 illustrates the scaled average indegree on non-faculty when there are women in a senior positions. The average scaled indegree on teams with a senior woman was 0.27 and without a senior woman was 0.16 ( t -test p = 0.42; Cohen’s D effect size 0.55). Thus, there was no evidence to conclude that senior women influenced the social interactions on the team.
![qualitative research questions about gender figure 4](https://media.springernature.com/lw685/springer-static/image/art%3A10.1057%2Fs41599-022-01389-w/MediaObjects/41599_2022_1389_Fig4_HTML.png)
These average scaled indegree measures were then separated based on whether there was a senior woman leader on the team, and the average across all teams was marked by a black horizontal bar. Based on these data, there appears to be no systematic difference in the social interactions of teams with a woman in a senior position and teams without a woman in a senior position. Average scaled indegree of non-faculty on teams without a senior woman = 0.16. Average scaled indegree of non-faculty on teams with a senior woman = 0.27. ( t -test) p -value = 0.42.
This study explored the impact of gender diversity on 12 scientific teams by analyzing team development and process data. It investigated two primary research questions: What is the role of women on scientific teams? and How do women impact team interactions? We initially believed that the primary reason previous research had been unable to adequately explain the role of women on scientific teams and how women impact team interactions were in part due to the lack of qualitative and mixed methods studies. We based our initial hypothesis on the assumption that scientific teams reproduce existing patterns of inequality (Butler, 1988 ; West and Zimmerman, 1987 ). However, it was through the development of the five hypotheses for this study and the subsequent analysis of relational data, that we learned that our assumption was in large part not supported.
Numerous studies have found evidence of systematic discrimination and bias in awarding grants (Ginther et al., 2011 ), acceptance of publications (Lerback et al., 2020 ; Salerno et al., 2019 ), language to describe women (Ross et al., 2017 ), promotion decisions (Régner et al., 2019 ), rewards (Mitchneck et al., 2016 ), and access to resources for research (Misra et al., 2017 ) in addition to other obstacles and forms of marginalization that are invisible and unacknowledged (Rhoten and Pfirman, 2007 ; Urry, 2015 ). Why did our data not replicate these findings? We conclude with the following possible explanations.
Preliminary studies in the SciTS literature have found that team science principles may simultaneously support the advancement of women in scientific fields; and complementarily, the inclusion of women on scientific teams may increase the success of these teams (McKean, 2016 ; Woolley et al., 2010 ). Further, including women and underrepresented populations on scientific teams has the potential to “serve as a strong entry point into scientific studies for women” (Rhoten and Pfirman, 2007 , p. 72). Similarly, in sociology, Soler-Gallart ( 2017 ) found positive benefits for the whole team when scientists engaged in dialogic relations and interaction with the intention of overcoming gender barriers and discrimination. Could team science advance women in their scientific careers? If high-functioning scientific teams disrupt rather than reproduce existing hierarchies and gendered patterns of interactions, it increases the possibility that team science is a tool not only for accelerating the creation of knowledge but for the advancement of a more empowered, just, and equitable profession.
Literature has documented how including historically underrepresented identities in the ingroup changes attitudes and behaviors (Soler-Gallart, 2017 ). Allport et al. ( 1954 ) found that when members of an ingroup were in close contact and built connections with members of an outgroup, prejudice decreased. Initially, the theory about ingroups and outgroups was devised to describe race and ethnic relations; however, recent studies have generalized the findings to other topics including gender bias and discrimination (Pettigrew and Tropp, 2006 ). Today, numerous studies have documented that intergroup contact and connections can improve intergroup attitudes (Allport et al., 1954 ; Brewer, 2007 ; Dovidio et al., 2012 ; Pettigrew and Tropp, 2006 ). Is it possible that scientific teams create ingroups that include rather than exclude women?
The teams in this study were not created nor did they develop in isolation. These teams had access to team development resources like SciTS literature, team science training, and access to administrative expertise and support. The promotion and tenure package of the selected university for this study allowed faculty to include interdisciplinary and team accomplishments. Structures were in place to fund, train, build, and reward these teams. Many of these resources, interventions and structures were designed and led by a group of nine women and one man. The women, especially, emphasized diversity, equity, and inclusion from team formation to building and rewarding successes. In addition, many of the sessions were customized to meet the needs of individual teams. Did these facilitators create an ingroup ? Although we did not test the impact of these interventions and structures, other studies have previously hypothesized that modifying existing and often outmoded structures will positively impact outcomes for women (Gibbons et al., 1994 ; Hansson, 1999 ; Rhoten and Pfirman, 2007 ). Another study found that when team members participate in dialog relations and interactions instead of using prestige to gain power they were more willing to rethink concepts when presented with new information (Soler-Gallart, 2017 ). Specifically, in terms of women in science, Rolison ( 2000 , 2004 ) developed a hypothesis recommending explicitly applying Title IX principles to support women in academia. She posited that providing equal funding opportunities and resources for women would result in equal opportunities for success. Another study attributed the key to their team’s success was the inclusion of women, the community, and other diverse perspectives from the community (Soler-Gallart, 2017 ). Our findings suggest that the handful of women on our teams may have joined the ingroup in academia albeit if only for a short time.
It is important to note that we do not believe our results accurately reflect the university of study as a whole or academia in general. Team observations and resulting field notes documented numerous accounts of gender inequality and inequity where women were disempowered and had limited opportunities to contribute to the team. Moreover, we are confident that women on these teams have had individual experiences that would contradict our findings. A lack of evidence does not indicate that there is equality. Nevertheless, these results do suggest that scientific teams, developed with intention, may provide greater opportunities for women to amplify their contributions to science (McKean, 2016 ; Rhoten and Pfirman, 2007 ; Woolley et al., 2010 ).
Limitations
Previous studies on gender and scientific teams have used bibliometric data to understand patterns of collaboration. Other studies on teams have created teams in the lab using students and other volunteers. Although this study is unique and contributes to the literature, as the data are based on real-world scientific teams, we identified six limitations.
First, several teams had apprehension about participating in SciTS research, and one team left the program after year one resulting in limited data from those teams. Second, teams may have experienced the so-called Hawthorne effect (K. Baxter et al., 2015 ) and performed differently because they were part of a research study, and a researcher regularly attended team meetings. All participant observations related to the positionality of the researcher were well-documented in field notes (P. Baxter and Jack, 2008 ; Greenwood, 1993 ; Marvasti, 2004 ).
Third, we defined senior women in a manner that would be inclusive to women with and without formal titles. The senior woman designation was given based on both formal titles and field notes. Some of the teams in our study had women who were the PI or in a designated leadership position with formal titles, and other teams had women on the leadership team. It is possible that the women on these teams were seen as leaders because of their position on the team, but that their leadership came without titles, awards, and recognition that might have been associated with those titles.
Fourth, it is possible that study participants had varying definitions of mentor , advice , and leader . We anticipated different interpretations in our study plan and as a result combined data in hypothesis four to detect and account for potential differences in definitions. Nevertheless, we acknowledge that lived experiences, in general, give individuals different perspectives. Literature in political science has found that when people imagine a leader , many of the traits are more masculine (e.g., wearing a suit, being tall and bigger) (Butler, 1988 ). Fifth, we did not measure the success of the teams in this study; thus, we were unable to translate how different interaction patterns translated into team performance. Ongoing funding was, however, contingent on performance as measured by pre-determined metrics including numbers of grants, publications, invention patents, and other markers of success.
Finally, a limitation of all social network studies is that data are collected at a single point in time. Thus, temporal changes in team interactions cannot be accounted for in our sample. For example, we cannot discern whether social relationships or scientific collaborations came first. We only know that they were both happening at the time the survey was administered. Further, at the time the survey was completed, it is possible that a person had not yet established a relationship, or they had forgotten about a previous relationship.
Conclusion, recommendations, and future research
We offer three key recommendations for future research. First, scientific results that are statistically insignificant are rarely shared in the literature. Therefore, it is critical that all efforts to expand research be published to broaden and accelerate the understanding of the role of women in scientific teams (Bammer et al., 2020 ; Oliver and Boaz, 2019 ).
Second, the landscape of science is changing rapidly as a result of private and federal funders requiring the inclusion of the science of team science experts as PIs in grant applications. We recommend that researchers expand their focus and examine how scientific teams change the culture of science. Research questions might include: How do support diverse teams translate to culture changes in science and the academy? Do scientific interdisciplinary teams provide more access for historically marginalized and disenfranchised groups? Finally, to create a comprehensive understanding of elements that contribute to expertise in scientific teams, we recommend that research be conducted with a theoretical focus on team development and processes. This would include studies that explore science facilitation, learning-by-doing, and other tacit forms of expertise that lead to integration and implementation of knowledge (rather than a focus on recruitment and demographics).
Third, existing studies define gender as a binary (man/woman). This short-sighted perspective is no longer relevant in society. Gender is not a biological concept, but a social construct, “It involves a complex of socially guided perceptual, interactional, and micropolitical activities that cast particular pursuits as expressions of masculine and feminine ‘natures.’” (West and Zimmerman, 1987 , p. 125). Gender is thus created by the social organization of our everyday lives and the way we interact with one another. People often see this difference as natural , and society is structured as a response to these differences in terms of men and women. Because of this, researchers like us continue to expend time and resources asking research questions rooted in binary gender. Future research should broaden definitions of diversity and gender including non-binary definitions of gender, expand how we measure inclusivity, explore how power imbalances block expertise, and study how a balance of power promotes expertise.
In conclusion, the lack of evidence for gender impacting team roles and behaviors in our study aligns with other SciTS studies that found team composition is not the silver bullet that automatically leads to knowledge creation and innovation (Duhigg, 2016 ; Oliver and Boaz, 2019 ). Numerous SciTS studies have documented the importance of processes over team composition and relationships to build successful teams (Boix Mansilla et al., 2016 ; Gaughan and Bozeman, 2016 ; Hall et al., 2018 ; Zhang et al., 2020 ). Perhaps the reason scientific teams produce more citations and have a greater impact than siloed investigators (Wuchty et al., 2007 ) is that they are leveraging the available expertise through the authentic integration of all members.
In the future, when scientists ask, “What proportion of women is ideal on a team?” consider responding with “It is not about the number of women, but rather how women on teams are integrated and empowered.”
Data availability
Data are available upon request to protect the privacy of our study participants. Parts of the larger data set have been made publicly available via the following links: https://doi.org/10.25675/10217/214187 and https://hdl.handle.net/10217/194364 .
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Acknowledgements
We thank Professor Jeni Cross, the Department of Sociology, and the Institute for Research in the Social Sciences (IRISS) at Colorado State University for helpful discussions and preliminary data collection. We also thank Professor Sue VandeWoude, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, for helpful discussions and support. The research reported in this publication was supported by Colorado State University’s Office of the Vice President for Research Catalyst for Innovative Partnerships Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Office of the Vice President for Research. Additional funding and support were provided by grants from the National Science Foundation’s Ecology of Infectious Diseases Program (NSF EF-0723676 and NSF EF-1413925).
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Love, H.B., Stephens, A., Fosdick, B.K. et al. The impact of gender diversity on scientific research teams: a need to broaden and accelerate future research. Humanit Soc Sci Commun 9 , 386 (2022). https://doi.org/10.1057/s41599-022-01389-w
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Gender Research and Feminist Methodologies
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This chapter is structured around the issue of gender research and what it means to conduct research with a gender perspective. Thus, it discusses research methodologies inspired by feminist ontological and epistemological approaches. Drawing on feminist standpoint theory, situated knowledge, feminist poststructuralism and intersectionality, the chapter shows how feminist scholars, especially feminist legal scholars, have adopted feminist epistemologies in challenging gender inequalities in law and society. The chapter draws on legal methods combined with feminist social theories that have assisted feminist scholars to go about legal reforms. Furthermore, focusing on qualitative methods, the chapter explains some of the methods of data collection and data analysis in gender research which have been applied interdisciplinarily across social science and humanities studies. The last part of the chapter concentrates on practical knowledge about conducting gender research that is informed with feminist epistemologies and methodologies. Finally, through some exercises, the students are given the opportunity to design and outline a gender research plan with a socio-legal approach.
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To the Journal, the American Sociologist
Gender research
- Situated knowledge
- Discursive construction of law and gender
- Feminist legal methodologies
- Intersectionality
- Research design
1 Introduction
Feminist scholars have been conducting research criticizing traditional and male dominated research and knowledge production. Therefore, feminists have proposed alternative methodologies which are informed by a variety of epistemological and ontological approaches across different disciplines including law and sociology. This chapter draws on feminist methodologies including feminist critical legal studies through a gender sensitive lens, in other words, feminist socio-legal approach in gender research (aims, objectives, outcomes).
Learning Goal
The first learning objective of the chapter is to elaborate on how feminist research methodologies are developed in order to contribute to the production of knowledge about social reality; a production of knowledge that is not based on male dominated perspectives. Thus, it stresses the distinctiveness of feminist methodologies from traditional and patriarchal mainstream methodologies. In the process of knowledge production, feminist researchers have attempted to make connection between the idea of gender, gender equality, experience, and the reality of intersectional gender discrimination. Consequently, feminist research methodologies move from the mainstream scientific methods, from only collecting data for objective purposes, towards gender sensitive data collection and analysis. Feminist methodologies aim to produce knowledge through ethical and political perspectives, which focus on the critique and overcoming of gender blind scientific approach, in addition to the articulation of gender equality contents, concepts, conceptions, aims, objectives and outcomes. Feminist methodologies also aim at producing a so-called situated knowledge, which encompasses active role of the subject of creating the knowledge in the process of knowledge production.
The second objective of the chapter is to show diversity among feminist epistemologies that opt for challenging power structure in various ways which capture complexities of gender and gender relations. It shows how feminist methodologies have developed from focusing on the category of women to moving beyond emphasizing women’s commonality, which risks suppressing important differences existing among women who live life differently. There is a diversity of experiences in different social positions; white, black, heterosexual, lesbian, poor, privileged, colonized.
The third objective of the chapter is to put an emphasis on qualitative methods in feminist research based on the feminist epistemologies presented in the chapter. Qualitative research method is thought to be the most appropriate to investigate the complex socio-historical, political, relational, structural and material existence of gender. Thus, qualitative methods of data collections such as interviews and documents are described. Qualitative methods of analysis including thematic analysis, document analysis and discourse analysis in conducting socio-legal research are also included.
Finally, the fourth objective of this chapter is to provide the necessary knowledge and practical skills on academic writing. Writing an academic paper is challenging when it is based on research. Feminist writings are grounded on gender sensitive approach to political and ethical reflections which stand out across disciplines. Such reflections ought to be weighed more in educational purposes.
The key concepts that are covered in this chapter are:
Epistemology and ontology in feminist research
Situated knowledge and women’s experiences
Reflexivity and positionality
Feminist standpoint theory
Discourse and discursive construction of power
Feminist legal methods
Feminist intersectionality research
Research design and research strategy
Thematic analysis, critical discourse analysis and document analysis
2 Gender Research
This section introduces the notion of gender research, and conducting research from a gender perspective. It explains why it is important to conduct gender research and how methodologies are adopted to carry out research within the field of law and sociology with an emphasis on gender. Applying gender perspective in research refers to the analysis of gender as a social construct that impacts all aspects of people’s lives with regards to social interactions and extends to intimate relations. Gender perspective in research questions unequal power relations in social structures. Moreover, gender perspective in social and legal research pays careful attention to the process of knowledge production in relation to power structure and contributes to development of gender equality within law and society.
The kind of research that only documents differences between the sexes offers no understanding of gender relations and gender practices, neither does it elaborate on the gendering process of laws and policies. Therefore, legal scholars have adopted methodologies with gender perspective to show an approach that recognizes multiple dimensions of gendered relations and power structure in the legal system. Gender research in sociological studies problematises hierarchical power relations between genders in everyday life and integrates diversity of social structures such as race, class, ethnicity, sexuality, socioeconomic status, age, and disability into analysis of structural inequalities. Footnote 1 What’s more, Gender researchers have addressed traditional bias by adopting alternative methods of qualitative and quantitative data collection, that not only pay attention to gender differences, but also captures the complexity of gender relations. Footnote 2
2.1 Gender Research in Law and Society
Why is it important to conduct gender research through analysing the interaction between law and society?
The emergence of gender studies as a field of research has contributed to critical study of law as being a rule of the state. Gender studies have explored law as a social process that is discursively constructed. Understanding law as a social phenomenon challenges the mainstream ‘black letter’ definition of law as fixed and immutable. Gender research that is conducted by sociolegal scholars have attended to the lack of gender sensitivity in law using critical social theories. Examples of such are matters of sexual harassment and domestic violence.
Legal policies are constituted in interaction with social norms and realities that are often gendered. Gendered social relations and practices have taken shape through historicity of sociocultural, political, and economic processes. Therefore, gender research helps to tease out the ways in which legal and social policies and practices shape people’s lives. Law is an important and constitutive element of social life and gender is an important and constitutive element of human being. Together, the two are important in such research and more pressing in educational practices of law and gender.
Studying a social phenomenon with an emphasis on gender at interplay between law and society is important in many ways. It analyses law in terms of its power, potential and actual shortcomings in society. It investigates social realities of gender relations and constructions within law. It explores gendered social and legal process, and practices of legislation, judgements, jurisprudence and advocacy among legal professionals and institutions.
3 Feminist Research Methodologies
This section covers the ways in which feminist epistemologies as opposed to traditional and objective epistemologies have been developed to adopt methodologies for gender research. Feminist methodologies emerged from feminist politics, being feminist theories and practices. This section reflects on three feminist methodological approaches in studying gender and gender relations, which will be explained in the following subsections.
Feminist research does not stem from a unified set of thought and perspective. However, feminist perspectives do share common ideas. These common ideas imply that feminist research reflects on marginalization of women in social and political life. Footnote 3 Moreover, feminist research criticizes dominant norms of science which maintain male superiority by problematising hierarchical gender power relations and by establishing research approaches that are based on equal grounds. Footnote 4
Methodology concerns the use of theories and methods in conducting research, which are informed by different epistemological and ontological approaches. In criticizing traditional and male dominated research, feminists have proposed alternative methodologies which are informed by their epistemology and ontology; the ways in which one understands the world and the knowledge produced about the world.
Feminist methodologies claim that knowledge is produced within a context in which meanings and experience cannot be simply distinguished. Footnote 5 In the process of knowledge production, feminist scholars and researchers have tried to make connection between idea, experience, and reality. Footnote 6 Moreover, feminist research is based on, and feeds, feminist theoretical perspectives which are a considerable part of feminist politics, challenging male-biased knowledge production and power. Thus, feminist researchers have consciously developed theories based on practice. Therefore, most researches that are conducted by feminists draw on experiences, especially women’s experiences. Footnote 7
Feminist epistemologies identify how gender influence our conception of knowledge and practices of inquiry. Footnote 8 Feminist epistemologies problematize how dominant conceptions and practices of knowledge production exclude and subordinate some groups of people, including women. Thus, feminist epistemologies offer diverse accounts of how to overcome this problem by developing new theories and methods. Central to this endeavour is situated knowledge, a kind of knowledge that reflects a particular position of the knower. Situated knowledge means that the situatedness of the subject in relation to the power structure produces a type of knowledge that problematizes the ‘universal’ male-dominated knowledge. Footnote 9 Donna Haraway reminds researchers how to tell the truth rather than proving how objective is the truth, by introducing the concept of situated knowledge. She encourages feminist researchers to hold on to the notion of partial visions instead of struggling to reduce their research to patriarchal knowledge. Footnote 10
Feminist epistemologies focus on how the social location of an individual affects everyday life experiences, and how social structures are based on factors such as; gender, sexuality, ethnicity, race, age, place and socioeconomic status. These factors are imbued with power which ultimately results in situated knowledge. Thus, feminist epistemologies have opted for various ways to understand social phenomena and the ways in which knowledge is produced. This chapter explains standpoint theory, poststructuralism and intersectionality. However, it should be mentioned that feminist methodologies are developed across disciplines, adopting different approaches including; critical realism, historical materialism, new materialism and social structuralism to name but a few. Footnote 11
Feminist researchers in various disciplines, including feminist legal scholars, have discussed how to incorporate feminist theories, women’s experiences and knowledge production through gendered social relations into their analyses. That is to say, the following methodological approaches: standpoint theory, poststructuralism, intersectionality have also been employed by feminist researchers in legal studies. It should be mentioned that the following methodologies are chosen for students to understand how only some feminist methodologies are applied due to the limited scope of this chapter. Therefore, it does not imply rigid classification of these methodologies nor does it suggest they should be prefered in conducting gender research.
3.1 Feminist Standpoint Theory
This approach emerged in the 1970s out of discussions among feminists regarding masculinist science defining ‘women’ based on biology. Sandra Harding and Nancy Hartstock are known to be pioneer of this approach. Feminist standpoint theory finds out how knowledge production is entrenched with power relations. Feminist standpoint varies as different approaches are taken among feminists, which itself informs variety of feminist epistemological positions.
Feminist standpoint’s central conception is that women’s experiences speak the truth, resulting in the creation of knowledge that is situated in relation to power. Footnote 12
In privileging women’s standpoint, this epistemological stand presents strong reasons for how women understand the world differently from men in social division of labour. Feminist standpoint essentially adds gender to the already existing class analysis in scientific research.
Taking a feminist standpoint approach means to emphasize women’s lives as they experience life differently from men. This is required to fully understand the relationship between experience, reality and knowledge, meaning it would be possible to remedy the kinds of misrepresentation and exclusion of women from dominant knowledge. According to Patricia Hill Collins, making knowledge claims about women must involve women’s concrete experience to make that knowledge claim credible. Women’s experiences refer to activities in everyday life including emotions and embodiment. Footnote 13
For feminist standpoint theorists, knowledge is partial and does not implicate universal truth. Instead, it indicates the relations between power and knowledge. Empirical study is needed to investigate the specific forms of power, social relation and social positionality. Footnote 14
Knowledge is constituted through everyday life. The everyday life of people is authoritative knowledge, as Dorothy Smith describes through ‘work knowledge’. Footnote 15 A woman’s standpoint begins to unravel the underpinnings of gender. However, experience must be spoken or written for it to come in to existence, meaning it does not exist before its entry to language as authentic. Therefore, experience is already discursively determined by the discourse in which it is spoken. Footnote 16
Feminist legal scholars have adopted feminist standpoint theory to draw on women’s point of view and experiences of matters in life which have been systematically excluded from legislations and supportive legal mechanisms. (Please see all the other chapters of the Textbook especially Sociology of Law chapter).
3.2 Feminist Poststructuralism
Influenced by literary criticism, poststructuralism emerged in the 1960s in France. Many thinkers of this philosophy such as Jacque Derrida, Michel Foucault and Julia Kristeva were initially structuralist thinkers who became critical to structuralism and abandoned the idea. Therefore, poststructuralism was created. It is fair to say that the work of thinkers who were initially known as structuralists, was developed to a more fluid and complex kind of idea called poststructuralism.
Poststructuralism upholds that language produces meanings which constitutes subjects. Poststructural theories explain how discourse produces subjects. How do discourses function and what are their effects in society.
The lines between postmodernism and poststructuralism are blurry and many have argued that the two cannot be assumed separately. Postmodern theory emerged in response to the limitation of modernism and the metanarratives produced by modernists. Footnote 17 Poststructuralism (i.e. Derrida) is usually associated with a theory of knowledge and language, while postmodernism (i.e. Foucault and Lyotard) is often linked to theory of society, culture and history. Footnote 18
Feminists allied with postmodern and post-structural themes on fluidity of identities, and some have opted for deconstruction of identities, such as category of woman. Furthermore, the rejection of epistemology altogether is also said to be taken by postmodern feminists who aim to abandon any attempt to claim knowledge. Footnote 19
Feminist poststructuralism transcends situatedness by stressing on locality, partiality, contingency and ambiguity of any view of the world. Footnote 20 Feminists started to revise the standpoint theory. Hartstock, for example, made a revision to her original presentation of standpoint approach, in which she says that emphasizing women’s commonality will risk suppressing important differences existing between women and their life experiences in different social positions; white, black, heterosexual, lesbian, poor, privileged, colonized and so on. Footnote 21 According to poststructuralism, reality is socially and discursively constructed. Thus, feminist poststructuralists do claim that gender is socially and discursively constructed as a result of the effect of social regulations.
Postmodern feminist researchers criticize feminist standpoint and feminist empiricism for being essentialists in the ways they use identity categories such as women, due to their focus on gender differences that are portrayed as essential and universal. Footnote 22 Poststructuralist scholar Joan Scott criticizes standpoint theory and its focus on women’s experience which she argues exists in language and discourse, hence the discourses of women’s experiences are constructed beyond the speaker or writer’s intention. Footnote 23 In poststructuralist epistemology, power is understood as discursive and not the property of one gender. Thus, agency of the subject, according to feminist poststructuralist view is not free from discursive power.
Feminist poststructuralism, usually known as third wave feminism, problematizes the binary category of male and female, and argue that language and discourse create gendered subject through interactive process of everyday life. Footnote 24 It shows how relations of power are produced and reproduced. Thus, it subscribes to knowledge being produced discursively through particular social and historical contexts. According to feminist poststructuralism, the subject is basically dead, one’s subjectivity and understanding of self is constructed through discourse. Hence, the agency of the subject is limited, as Judith Butler holds that ‘the subject is not just a product a constitutive force of her discursive practices, it rather is a disruptor of the process through which she is constituted’. Footnote 25
Feminist legal scholars’ approach to law as a social phenomenon, seeing law as being discursively constructed, has led them to decentralize the states’ power and push forward for gender equal legal reforms. (please see Sociology of Law chapter).
3.3 Feminist Intersectionality
The concept of intersectionality is said to be developed by Black feminism in 1980s, particularly by Kimberlé Crenshaw who focused on the intersection of gender and race. She defined the concept of intersectionality as a different way in which the factor of race, along with gender, affect the ways black women experience employment and social life. The experiences of women of colour were excluded and lost in forms of multiple discrimination and marginalization. Footnote 26 It is worth noting that long before the inception of the concept of intersectionality, feminists had already been analysing gender at intersection with other structures of dominations such as class. For example, US feminist anti-slavery movement in the nineteenth century. Footnote 27 Therefore, we can say that the early use of the concept of intersectionality in feminist practice was based on the intersection of at least two axes of domination. This included gender and race, or gender and class, yet was not considered in either politics or research. Intersectionality has brought a conceptual shift in feminist philosophy and research through which scholars understand social actors.
Feminist intersectionality focuses on multidimensional and multi layered understandings of power and knowledge. To understand power relations in production of knowledge, it is important to know how subjects are situated; the situatedness or social location of people in the intersections of power. Situatedness engender knowledge from specific circumstances where power struggle is immediately at work, and when a particular type of knowledge is generated.
The recent work of feminists on intersectionality focuses on multiple forms of systems of dominations and privileges. Thus, in intersectionality research, the perspective of multiple marginalized groups is included in analysis, including the social experiences of privileged groups. The consequence here is to problematise and challenge universalisation. Footnote 28 For example, the category of woman as a universal aspect is challenged. Furthermore, intersectionality research illustrates that no one single factor is the reason for marginalisation and dominance; they are part of a broader pattern. According to Kathy Davis, “intersectionality is the interaction between gender, race, and other categories of difference in individual lives, social practices, institutional arrangements and cultural ideologies and the outcomes of these interactions in terms of power”. Footnote 29
Power is an important element in intersectional analysis. Feminist studies, together with anti-racist, postcolonial, queer studies, masculinity and disability studies, continue to enhance how norms are constructed and how power relations interact with each other. “Intersections of power can be found in all relations, at all levels of social structure from individual actions to institutional practice”. Footnote 30
The aim of employing intersectionality in feminist research is not to simply add as many categories as possible to our analysis, but to broaden the perspective and reflect on what factors may be relevant in a particular context, with specific socio-historical and spatial context. “An intersectional approach goes beyond just identifying power patterns. It is applied to problematizing the underlying social categories and see how these are reinforced or challenged”. Footnote 31
Feminist legal scholars have critically analysed the one-dimensional approach of law through intersectional perspective. Intersectional analysis has enabled feminist legal scholars in their legal analysis and judgments to scrutinize the multiplicity of underpinning social structures of both oppression and privilege at macro, meso and micro levels. Thus, relationality of social structures of gender, sexuality, class, race, ethnicity, religion, age, (dis)ability is being analysed with respect to socio-historicity of the context.
The formation of intersectionality has not been without criticism. Scholars often remain critical towards the use of intersectionality as an additional component of research. The critiques extend to debate that in trying to present multiple forms of discrimination and oppression, the grounds of intersectionality are used as additive and multiplicative approaches. This often reduces oppression to discrete categories of sexism, racism, heterosexism, classism. Footnote 32
4 Feminist Legal Methodologies
This section provides an overview of the development of feminist legal methods in doing and making laws. This extends from asking the woman’s question, to addressing other genders and multiple forms of gender inequality approach, through methods such as feminist judgments and gender mainstreaming applying intersectional analysis (i.e., gender, race, class, sexuality etc.).
4.1 Feminist Legal Methods
What are feminist legal methods? Feminists have long been criticizing law and what the law should entail. Therefore, they have proposed legal reforms which recognize women and other marginalized groups, including provision for, and protection of, their needs and rights in different areas of law.
In order to challenge power structures, feminists have defined their own methods of legal analysis; without having methods, feminists claims about law would have been dismissed. Footnote 33 Bartlett explains that “feminists like other lawyers use a range of methods of conventional legal reasoning such as deduction, induction, analogy and general techniques”. However, what distinguishes feminist legal methods from the traditional legal methods is that feminist legal methods try to “unveil legal issues which are overlooked and suppressed by traditional methods”. Footnote 34
Feminist legal methods are strongly imbued with feminist theoretical and methodological approaches. The following sections explain how feminist legal methods have adopted standpoint theory, by including women’s and other ‘marginalized’ genders into law making and legal reasonings adopting feminist intersectional approach. Furthermore, the section explains how feminist socio-legal scholars have adopted poststructuralist methodologies to problematize gendered power relations. This is achieved through discursive analysis and active engagement with practices of law and society, to rewrite judgments and policies through gender perspective.
4.1.1 From women’s Question to Multiple Gender Inequality
Feminist legal methods are seen as contributor to the modification of traditional legal methods, dominated by heterosexual male perspective. Legal methods were first initiated and adopted by feminists for practical reasoning and consciousness raising on issues experienced by women. Feminist legal methods, according to Bartlett, is about discussions over what kind of methodology feminist legal theory should adopt to identify and problematize the existing legal structure. Footnote 35 Feminist legal methods started to develop by problematising those parts of law that are discriminatory towards women. In other words, including women’s perspectives into legal methods and ask questions from women’s point of views.
Feminist legal methods, three methods as explained by Bartlett, are as follows. The first method is about asking the question of women, which is applied to expose how the substance of law subtly excludes the perspectives of women. So, feminist legal method considers the experience of women and asks the women’s question in law.
The case of Myra Bradwell vs. State of Illinois in 1873 asked the United States Supreme Court about why women are excluded from practicing law and why women are not included in the privileges and immunities of citizenship according to 14th amendment. This led to Illinois legislation prohibiting gender discrimination in occupation. Footnote 36
The second method regards feminist practical reasoning that is applied to move beyond the traditional notion of legal relevance in legal decision making. Practical reasoning is more sensitive to the cases, instead of simply reflecting already established legal doctrine. In this method, the reasoning is dependent on women’s context and experiences, which are unique.
The issue of abortion among teenagers is contingent on specific situations. Actual and specific circumstances might not be in favour of pregnant children who ought to obtain their parents’ consent, as it might lead to abusive behaviours of parents forcing pregnancy on the child.
The third method covers consciousness raising, which is applied to examine how legal principles correspond directly with people’s personal experience. Footnote 37 Consciousness raising is a process through which one reveals experience for collective empowerment. Personal experience becomes a political matter.
Women employ consciousness raising method when they share their experiences of rape and sexual assault publicly through MeToo campaign.
Critiques have raised some shortcomings with regards to the practicality of feminist legal methods focusing on women only. They have argued that the focus on the elimination of bias against women is limiting and such methods will be used by legal professionals who are not necessarily feminists, and certainly not all legal decision makers are concerned about the women’s question. Moreover, feminist legal method is criticized for its biased focus on women and women’s way of thinking, which is discussed to be elevating women over other issues such as disability, racism, poverty and ethnicity to name but a few. It is argued, as a consequence, this would ultimately lead to privilege of women’s experiences over other groups of people. Footnote 38
4.1.2 Intersectional Perspective in Law
Previously, the dominant kind of civil society activism within the EU had usually focused on one particular identity category when acted against discrimination which resulted in a way that, “the EU equality and anti-discrimination policies addressed specific groups of people as being subject of inequality and discrimination. For example, women, ethnic minorities, sexual minorities were only targeted in relation to one single dimension of inequality and discrimination such as either gender or ethnicity or sexuality”. Footnote 39 Instead of foregrounding one category over others for addressing discrimination, Hancock has proposed academic researchers should adopt multiple approach to inequality. This approach recognizes that people are not one-dimensional with grounds of inequality being manifold and multiple. In turn, this demands recognition of multiple discriminations in law. Footnote 40 However, an intersectionality approach has been argued to replace ‘multiple discrimination’ approach in research, because the multiple discrimination approach might lead to focusing on inequality grounds at individual level, rather than accounting for discrimination at structural level.
Intersectionality and intersectional perspective in law and policies concerning European institutions has not yet been adequately used to deal with intersectional violence and discrimination. Intersectionality within law reveals and tackles violence against women who are marginalized due to the interplay of different structural and individual reasons. Footnote 41 Intersectionality in law is not just about understanding the ways in which discrimination is experienced on grounds of race, ethnicity, gender, sexuality and so on. Intersectional perspective in law also unveils the structural barriers that produce social inequalities.
Intersectionality in law has been discussed in relation to antidiscrimination laws and gender-based violence in Europe. The problem with law is that it does not acknowledge fluidity and intersecting elements of people’s lives. It often focuses on one element of a human being. Most laws tend to adopt a one-dimensional approach. For example, in law on violence against women, the law usually addresses violence as crime that occurred on one ground and that is usually identity. Footnote 42 Other grounds of inequality such as sexuality, class, age, ethnicity, disability in protecting violence against women are rarely considered by legal policies.
Although the legal framework of the Council of Europe’s Convention for Protection of Human Rights and Fundamental Freedoms (ECtHR) allows lawyers and judges to have an intersectional perspective, Footnote 43 it has remained less practiced on the ground among legal professionals and within legal culture. Namely, given the behaviour and attitudes of legal professionals towards law, it is rare to examine, for example, the intersection of heterosexism or patriarchy in relation to sexist or racial behaviour. To demonstrate this, the cases of forced sterilization of Muslim Roma women in the Czech Republic, Slovakia and Hungry at ECtHR which were either settled or declared inadmissible in 2016 Footnote 44 did not involve intersectional analysis of gender, age, class, ethnicity and religion. Bello discusses how the application of intersectionality within legal reasoning can contribute to protection of Roma women’s rights. Footnote 45
An Intersectional approach is also hugely missing within European national and international laws with regards to LGBTQIA+ groups of people who are immigrants, refugees, sex workers, domestic workers, and disabled. The EU policies have not adequately taken an intersectional approach addressing inequalities among and within LGBTQIA+ groups who experience violence and discrimination differently. Moreover, laws and policies often homogenize lesbian, gay, bisexual, transgender, queer, and intersex people as one identity category, lumping them altogether into one cluster of entity. This has often overlooked people’s different needs. An inequality ground for a gay person may not be a concern for a trans persons. The intersectional approach within and among each group would allow for specific and common policy objectives. Footnote 46
4.2 Feminist Socio-Legal Methods
The term socio-legal has a broad definition that might differ in different contexts. The main component of socio-legal study is that it acknowledges the law is not just the product of the state. Rather, it is a product of social processes and practices. Footnote 47 Feminists have adopted social theories in combination with legal methods to criticize the role of law, not as law in the books, instead law in the context in creating and reinforcing gendered relations and practices. During the past few decades, feminist socio-legal scholars have worked with feminist methodological approaches, including poststructuralism and intersectionality, to highlight the “the implications of gendered power relations in law and society”. Footnote 48 (see chapter on Sociology of Law).
4.2.1 Feminist Judgements
As part of critical legal scholarship and legal reforms, feminist legal scholars, judges, lawyers and activists have engaged in specific cases to provide critical analyses of law in construction of gender. In their attempt to re-write judgments, they tackle power relations and problematise judicial and legal norms embedded in society. Footnote 49 Feminist judgements have impacted legal understanding and gender equality policies through socially engaging with matters such as marriage, parenthood, sexual consent, rape, and domestic violence. Moreover, feminist judgements consider the concept of judging as a ‘social practice’ which does not take place in isolation. Footnote 50 (Please see chapter on Feminist Judgement).
4.2.2 Gender Mainstreaming
Feminists have defined and debated gender mainstreaming differently, although the transformative potential of gender mainstreaming, that is revealing patriarchal structures and bringing marginalized issues into the centre of policy and law making, has been consistently valued.
Gender mainstreaming became the focus of international attention through adoption of the Beijing platform for action at the UN conference in 1995. The Amsterdam treaty imagined gender equality within all activities in the EU in 1997. The Council of Europe defined gender mainstreaming as a way to call for “incorporation of gender equality perspective into all policies at all levels and stages of policy making”. Footnote 51 Gender mainstreaming involves discursive analysis of the process and practices, through which laws and policies are created. Dragica Vujadinović emphasizes the necessity of gender mainstreaming to a gender sensitive approach within legal education. Vujadinovic shows how this is mostly non-existent in universities across the globe, including universities in developed ‘Western countries’ and the European Union. Footnote 52 Introducing gender mainstreaming projects in different countries depends on their approach to gender equality. For example, a broader approach to gender equality rather than conceiving it in terms of equal opportunities and equal treatment, allows for incorporating gender mainstreaming or a gender sensitive approach in educational practices.
Moreover, gender mainstreaming has provided opportunities for feminists to problematize ‘gender blindness’ at an institutional level, in public services and private matters.
5 Feminist Empirical Methods of Gender Research
This section describes the steps in conducting empirical sociological and qualitative research with a gender perspective. It explains the process of research including research design, research plan, research methods and method analysis. It should be noted that feminist research can be based on empirical as well as theoretical studies.
5.1 Feminist Positionality and Reflexivity
Feminist researchers study power relations, and yet unequal power relations are always present between the researcher and the subjects of research. Therefore, it is crucial to reflect upon the existing unequal power relations between the researcher and the research participants throughout the process of knowledge production. One should begin by clarifying one’s own positionality in relation to the research, as well as one’s position in relation the research participants. Conducting qualitative study based on fieldwork and sharing the findings collected from people, would be best done through destabilising power hierarchies. This is a task that feminist researchers have achieved by applying reflexivity into their theory and methods. Feminist researchers tend to define their positionality within research to avoid claiming objective truth in the process of knowledge production. Footnote 53
Feminist approaches to mainstream methodology vary, because they try to discover reliable accounts of socially constituted ‘reality’ rather than reproducing the ‘objective’ truth. Feminists have taken different approaches to challenge mainstream scientific methods of knowledge production, which aim to criticize universal criteria for knowledge claim. The feminist approaches that are elaborated in this chapter are: feminist standpoint theory or epistemology, feminist post-structuralism and feminist intersectionality.
As for research ethics, conducting empirical research based on interviews, for example, require researchers to obtain ethical approval; the practical aspect of research ethics. Ethical considerations in research are not limited to obtaining permissions. Ethics involve the ways in which the researcher relates to the research participants, and the data and information gathered from the research participants. Feminist research ethics emphasizes on the coproduction of knowledge with the research participants. Footnote 54 Researchers need to address ethical issues in qualitative research with regards to informed consent, privacy, and protection of information and lives of research participants, during and after the fieldwork.
5.2 Qualitative and Quantitative Research
Due to feminists’ criticism of traditional research being reliant on quantitative methods in the social sciences, increased use of qualitative research is suggested to better understand people’s social life. The dialogue between quantitative and qualitative researchers has continued for decades, as to which method better captures complexities of social issues. The use of quantitative data in conjunction with qualitative material is encouraged by feminist researchers to develop feminist theories.
Quantitative research has a numeric and statistical approach. It employs strategies and methods of data collection such as surveys and other statistical instruments through which information can be quantified. Footnote 55 Quantitative research consists of experiments that either test or confirm the existing theories. Therefore, the research is independent of the researcher in a quantitative method, tending to give an objective account of reality.
Three broad classifications of quantitative research are identified: descriptive, experimental, and causal comparative. The descriptive approach examines the current situation as it exists. The experimental approach investigates an independent variable in a study and then measures the outcome. The causal comparative approach examines how an independent variable is affected by a dependent variable, before analysing the cause-and-effect relationships between the variables. Footnote 56 Moreover, different methods of examination are used in quantitative research such as correlational design, observational studies, and survey research.
Qualitative research has a holistic approach. It does not entail a fixed definition, as the nature of qualitative research is deemed ‘ever-changing’. This is due to the variety of frameworks and approaches within which researchers conduct qualitative inquiry. Footnote 57
Common characteristics of qualitative research are: (1) it is conducted in a natural setting, (2); directed by the researcher; (3) involving inductive and deductive reasoning; (4) it focuses on participants’ views; (5) conducted in a specific context; (6) involves flexibility and creativity during the research process and; (7) is based on the researcher’s complex interpretation of the issue, but involves reflexivity. Footnote 58 Qualitative research engages with matters in everyday life, discourses, experiences and practices in a variety of dimensions. Poststructuralists have shown particular interests in qualitative research. Feminist research has had a significant impact in developing qualitative research as exists today. Qualitative methods, particularly face-to-face in-depth interviews, have become definitive of feminist qualitative research. Here we focus on interviews and documents as methods of data collection in qualitative research.
5.3 Research Plan, Design and Strategy
Before going through the steps of planning research, the following aspects need to be addressed:
In order to conduct the research, there are a few fundamental matters that the researcher needs to address. First, the researcher should know about the nature of the phenomenon, entities or the social reality that are in question. What is the research about? Second, the researcher must have an ontological and epistemological position as to how the researcher thinks the world exists, how knowledge about the world is produced and what social reality is made of. These are the epistemological questions: how social phenomenon can be known and how knowledge can be demonstrated.
If the researcher thinks that social reality is constituted of people, relations, institutions, structures, social process, discourses, practices, and rules, the researcher ought to establish how to investigate the social phenomenon in question, within this framework of understanding of social reality.
The answers to such questions form the strategy of the research. Research strategy is about how the researcher outlines the epistemological and ontological approaches to investigate the subject matter of their research. For instance, a socio-legal approach is a way to strategise research.
The next step is to clarify the aim of the research, that is to find out exactly why the researcher wants to conduct the research. It should be noted that the research objectives are less broad than the research aims and they basically pave the way to achieve the research aims.
If the aim of a research is to reduce violence against women in the workplace, the research objectives to achieve this aim would be: (1) understand how violence in workplace is perceived by employers, (2) explore all forms of violence experienced by women during their employment, and (3) investigate employment laws and policy.
The next step is to design the research. Designing research starts after ascertaining the position and approach in conducting the research. Research design is a kind of planning that maps out the ways through which the researcher conducts a study; helping the researcher to conduct an organised and coherent study. Footnote 59 In qualitative research, designing starts from the moment the researcher starts to formulate the research questions, problems or hypotheses. A qualitative research design consists of research questions, methods of data collection, methods of analyses and findings. After investigating the topic and reading the literature, the researcher drafts research questions. The questions can be refined later during the research process. After defining the questions, the researcher maps out relevant information for each question. This information concerns the sources of data and material, how to gather data and how to analyse the data.
In studying violence against women in the workplace, one research question could be how violence against women in the workplace is defined by law and policy makers? To answer this question, the researcher needs information or data from specific sources that can answer the question. The sources of data collection to answer the questions would be legal documents and interviews with stake holders. How to collect data from these sources could be gathered through documents and interviews. After gathering the data, the analysis could be done by applying critical discourse analysis and/or policy analysis. This outline is called research design.
5.3.1 Socio-Legal Research Strategy
How to design research which investigates the subject matter through a socio-legal approach? One way is to examine how policies and practices of gender at individual, meso and macro levels are influenced by, and influence the subject matter in question, within a specific context that is also contingent on socio-historical background.
Studying ‘law in context’ Footnote 60 as one of the approaches within social-legal research contributes to the production of knowledge that is informed by people’s experiences and existing social issues. In turn, these are tied to the processes of making and implementing law.
The policy research approach to socio-legal research is concerned with issues related to social policy, regulations, implementation, and enforcement. For example, examining how efficient implementation of law can affect access to justice, can be a policy research. The use of survey to evaluate a piece of legislation is another common policy research. Footnote 61
5.4 Methods of Data Collection in Qualitative Research
Based on the methodological approaches explained in previous sections, the following methods of data collection have been adopted by feminist researchers cross disciplines, including socio-legal scholars.
5.4.1 Interviews
An interview is understood to be a simple conversation that constitutes everyday life. It is a valuable method for gathering knowledge from an individual’s experience. An interview constitutes a further way to collect intellectual information in a social process from people. Footnote 62 As Kvale and Brinkmann suggest, the act of interviewing is a craft, which means it is based on practical skills and the decisions made by the interviewer during every step of the process. Footnote 63 Interview in social research is a guided, informal conversation through which the interviewee and the interviewer contribute to the process of knowledge production. The two sides interact with each other ethically and politically. Footnote 64
Learning how to conduct interviews for social research can be achieved only through engaging in actual interviews. In other words, one learns by doing. However, it is important to consider that interviewing is composed of several general steps. The interviewer logically follows these steps, including; identifying the population, classifying the questions, reaching out to the population, designing the interview guide, determining the location of interviews, recording interviews, transcribing interviews and analysing interviews. Footnote 65
It is up to the researcher to determine what type of interviews are deemed more suitable for answering the research questions; either structured interviews or semi-structured interviews. Semi-structured interviews involve the researchers asking a set of questions from each interviewee. The nature of these interviews, however, allows the interviewee to raise ideas and issues about which the researcher has not thought. This type of interview is flexible and gives the opportunity for the researcher to receive new questions or change the existing ones.
5.4.2 Documents
What are documents? Documents contain texts and sometimes images that have been produced without the researcher’s involvement. Footnote 66 Documents in social research could include a variety of materials, from personal journals to official organisational records or state datasets. Researchers have also identified other documents for social research, such as maps, photographs, newspaper reports, autobiographies, and even social media or SMS conversations. Electronic and digital documents constitute a significant part of documents in our world today, especially within organizations and institutions.
Documents can also be the sort of data and evidence through which people, groups, institutions, and organizations are accounted for. Documents here are tools to enable understanding of social and organizational practices. Footnote 67 Documents exist in many varieties such as legal, medical, financial, personal and so on. In terms of their form, documents can be literary, textual, or visual devices that create information. Therefore, documents are artifacts produced for a particular purpose, representing social conventions, being the analytical component of documents. Amanda Coffey maintains: “documents are social facts which means they are produced, shared and used in socially organized ways”. Footnote 68 Policy documents, legislations, strategic plans, press release, annual reports, newspaper articles are included as such.
5.5 Methods of Analysis in Qualitative Research
Based on the methodological approaches explained in previous sections, the following methods of data collection have been adopted by feminist researchers cross disciplines including socio-legal scholars.
Analysis is a process of generating, developing and verifying concepts. Footnote 69 The process of analysis begins even before starting the research project, as researchers choose a topic in which they have prior ideas. Footnote 70 Researchers require to have some ideas while collecting information about their studies; these ideas continue to develop during the research process and might modify along the way, by going back and forth between ideas and collected information. Analysis is not the last phase of research, as some might think. It is rather a process that actively involves information gathering. Footnote 71 Nevertheless, no consensus is achieved among scholars on what analysis means. Despite this lack of consensus, there are common characteristics to all methods of qualitative analysis. These are; reflexivity of the researcher, systematic but not rigid analytical approach, organizing the data, and inductive (that is data led) analysis. In addition, methodological knowledge is required. This does not mean that one should subscribe to one approach only and follow through the entire process. Flexibility and reflexivity should be counted. Footnote 72
Analysis involves interpretation where qualitative researchers translate other people’s acts and words. It is not straightforward to convey exact meanings, and therefore, some details may be lost in translation. Footnote 73 Interpretation consequently becomes a never-ending process, as researchers must always consider their data; reflect, reinterpret or amend interpretations. This may lead the researcher to new ideas. The process of analysis according to Denzin and Lincoln, is neither terminal nor mechanical. It is an ongoing emergent unfinished, changeable process. Footnote 74
5.5.1 Thematic Analysis
As a method of analysing data, thematic analysis searches for themes that emerge from the data or information to describe the phenomenon. “The process of analysis involves identifying themes through reading of the data. These themes become categories of analysis for the researcher”. Footnote 75
Thematic analysis can be applied within many ontological and epistemological frameworks. The researcher should make their theoretical approach explicit to the reader, as thematic analysis is a theoretical independent method of analysis. Footnote 76 Thematic analysis does not concern counting predetermined words or phrases, rather, it identifies implicit and explicit ideas in the data.
Thematic analysis is ‘a method for identifying, analysing and reporting patterns (themes) within data’ inductively or deductively. Footnote 77 Due to its flexibility, thematic analysis is suitable for analysing a wide range of data types, for instance; interviews, focus group discussion, textual data (i.e., qualitative surveys, diaries), online discussion forums and other textual and visual media sources. Footnote 78
Applying this method in research requires the identification of patterns, paying particular regard to important issues in relation to the research questions and theoretical framework, which must form some level of prevalence across the whole data. Similar to many other qualitative methods, thematic analysis is not a linear process. The researcher moves back and forth between different phases of the process of analysis. A six-phase analytic process is introduced by Terry et al., which are: “1) familiarising with the data, 2) generating codes, 3) constructing themes, 4) reviewing potential themes, 5) defining and naming themes, and 6) producing the report”. Footnote 79
5.5.2 Document Analysis
In qualitative research, document analysis is applied to close examination of documents to understand how they are authored or produced, including how they are used. Much of the organizational knowledge is stored in documents. Social actors are the authors of documents, and the examination of those documents is one way of understanding how social structure operates. Footnote 80 Documents also represent reality, albeit in a distorted and selective fashion, and can be used as a medium through which the researcher can find correspondence with the subject of study. However, they cannot be read separately from the social, historical and political contexts. Footnote 81
‘Document analysis is a systematic procedure for reviewing and evaluating both printed and electronic materials. Footnote 82 Document analysis starts with finding the documents, selecting and synthesizing information in the documents, which then can be organized into themes or categories and interpretation. This process involves content analysis that entails identifying meaningful and relevant passages of the text. Scholars have discussed applying thematic analysis to analyse documents, involving the recognition of patterns within the data and consequently exposing emerging themes. Footnote 83
Document analysis involves data selection instead of collection . Content information in documents is what the researcher analyses without being involved in gathering it, which is said to be unaffected by the research process. Many documents are publicly available, making it easier for the researcher to access.
Document analysis is used as a single method, in a triangulation, or mixed-methods, where two or more methods are used in research. For example, questionnaires and interviews in research are used in combination with document analysis. Footnote 84 As an illustration, gathering and analysing documents such as state laws and institutional regulations, as a stand-alone method provides the researcher in-depth knowledge about the purpose and intentions of the creators of the documents, and how they are used to shape people’s lives.
5.5.3 Discourse Analysis
Discourse analysis is a method which investigates how meanings are produced within narratives of, for example, conversation, newspapers or interviews. Discourse analysis refers to a set of approaches that can be used to examine the ways in which power relations are reproduced, through the function of language within texts and narratives. Discourse analysis is the result of Foucault’s work on discursive construction of power. Hence, it focuses on how power relations are constructed by means of language. Within social science research, discourse analysis takes a political approach by finding out who is constructed as marginalized and who gains hegemony in social relations. Thus, discourse analysis pays attention to the socio-political context of discourse and conveys how people are positioned by dominant discourses. Footnote 85
Discourse analysis method aims to move away from finding truth, instead working towards the functionality of discourse critically. Critical discourse analysis is an interdisciplinary type of discourse studies, examining how ‘social practices become contextualized as they are represented in discourse in instances of communication’. Footnote 86 Furthermore, critical discourse analysis concentrates on the role of language and communication in discursive construction of social domination, discrimination and social injustice. Footnote 87 The analysing process of research, focuses on the use of language to understand how people, practices and processes are represented, and what the underlying forces of such representations are. However, critical discourse analysis does not simply regard texts, rather, establishing what connects the text to a social context where people and events are produced. Footnote 88
Identifying discourses vary among researchers as there is no one way. In common, discourse analysis involves general steps, as any other qualitative methods, such as; formulating research questions, selection of sample, gathering data (i.e., records and documents etc.) and transcribing, coding data before writing up.
Critical discourse analysis of legal documents such as judicial opinions, statutes, constitutions, procedural laws and administrative laws can reveal the subtle and invisible nature discrimination based on gender, sexuality, race, ethnicity, class, religion, nationality etc.
Discourse analysis of a supreme court’s judgement on refusing a request of a trans woman to gain the custody of her child or visitation, unravels the discrimination based on discursive practices and policies of creating gendered subjects, gendered roles, womanhood and parenthood.
6 Writing a Research Paper
This section elaborates basic knowledge on how to write a scholarly paper; a paper that is the result of either an empirical or conceptual/theoretical research on gender.
Feminist researchers have published extensively on writings of research, especially research based on fieldwork. Feminist writings have paid special attention to reflexivity or reflection, by emphasizing the complex relationship between the researcher and the research participants in the process of knowledge production in various contexts. Writing on issues related to gender requires critical engagement and more of an explanatory than descriptive writing.
Essential skills for writing rationally and effectively are discussed in many textbooks. Footnote 89 These skills include using arguments, building arguments, understanding the cause-and-effect relations, making comparison, using references and describing visual and textual materials.
6.1 Structuring a Paper
The structure of the paper is proven to be the most difficult part of writing for writers. The main and few substantial components of a research paper are basically comprised of the introduction, the main text (theory, methods, analysis), the conclusion and references.
The purpose of the introduction in a research paper is firstly, to provide a rationale for the paper and explain why a particular question within the topic of the paper is being investigated. Secondly, it is important to illuminate on why it is interesting for the reader to know about the topic of the paper, particularly the issue in question.
The theory section describes the theoretical tools and concepts that are used to interpret and analyse data. The method section in the main text of the paper elaborates on what kind of data have been gathered for the purpose of this paper and how. It further draws on the methodological approach that has been adopted.
The section on analysis in the paper discusses the interpretation of data within the adopted theoretical framework.
The conclusion is the final section of the paper. The purpose is to summarize the main points of the paper, restates the thesis of the paper and makes final comments of the arguments of the paper.
To write a clear and organized paper, the writer should be especially confident about the ideas contained within. Moreover, it is important that the topic is written with passion.
Some general strategies are suggested for writing which focus on how to manage an academic paper in a timely manner. Planning and revising are the two general strategies that have been found in writing research.
6.2 Referencing and Plagiarism
Since writing a scholarly paper depends on the research and studies conducted by others, it is crucial for the writer to indicate the used sources. Providing references and citations are important as it shows that first, the writer has read other people’s work on the subject and is aware of the existing literature. As a second function, it allows the reader to find further sources on the topic. Lastly, it prevents plagiarism. Footnote 90
The use of the sources in a research paper can be presented as a citation, summary/paraphrasing or quotation. A list of references including all sources cited in the paper is provided at the end of the paper. There are various referencing systems in academia. Therefore, it is important to know which system to use, and thereafter maintain consistency in referencing throughout the paper.
Plagiarism happens when someone uses an intellectual property that belongs to another without acknowledging or referencing accurately. For example, copying or paraphrasing of texts, images or any other data without correct citation, or acknowledging the source, is plagiarism.
7 Exercises
The aim of these exercises is to encourage students to use the knowledge they have acquired in the course and deepen their understanding about feminist methodology and gender research in a practical way.
Understanding feminist Epistemologies in research
Formulate a research question that investigates a matter in relation to violence and law. Explain the problem and how you understand the problem and why you have chosen to explore it? In your explanation elaborate on your epistemological and ontological approach for carrying out this research.
Designing research
Following previous exercise, in a structured manner, map out how you plan to investigate the research question. Specify the data and material, sources, place and time, methods of data collection as well as methods of analysis for each material or data. You are required to justify your choices.
Structuring a scholarly paper
Following the last two exercises, write a disposition (no longer than 1 page) where you elucidate how you are about to write this paper based on your research. Explain how each section unfolds in the paper including theory, methods, and analysis.
Further Reading
Callaway H (1992) Ethnography and experience: gender implications in fieldwork and texts. Anthropol Autobiogr 29:29–49
Carastathis A (2014) The concept of intersectionality in feminist theory. Philos Compass 9:304–314
Conaghan J (2008) Intersectionality and the feminist project in law. Routledge-Cavendish, London
DeVault ML (1996) Talking back to sociology: distinctive contributions of feminist methodology. Annu Rev. Sociol 22:29–50
McEwan C (2001) Postcolonialism, feminism and development: intersections and dilemmas. Prog Dev Stud 1:93–111
McLeod J (2020) Beginning postcolonialism. Manchester University Press, Manchester
Mills J, Birks M (2014) Qualitative methodology: a practical guide. SAGE Publications, New York
Nash JC (2008) Re-thinking intersectionality. Fem Rev 89:1–15
Wolf DL (2018) Situating feminist dilemmas in fieldwork. In: Wolf DL (ed) Feminist dilemmas in fieldwork. Routledge, London, pp 1–55
Verloo M (2005) Displacement and empowerment: reflections on the concept and practice of the Council of Europe approach to gender mainstreaming and gender equality. Soc Polit Int Stud Gender State Soc 12:344–365
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Saeidzadeh, Z. (2023). Gender Research and Feminist Methodologies. In: Vujadinović, D., Fröhlich, M., Giegerich, T. (eds) Gender-Competent Legal Education. Springer Textbooks in Law. Springer, Cham. https://doi.org/10.1007/978-3-031-14360-1_6
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Why sex and gender matter in implementation research
Cara tannenbaum.
1 Insitute of Gender and Health, Canadian Institutes of Health Research, Ottawa, Canada
2 Université de Montréal, Montréal, Canada
Lorraine Greaves
3 British Columbia Centre of Excellence for Women’s Health, Vancouver, Canada
Ian D. Graham
4 University of Ottawa, Ottawa, Canada
Associated Data
All data generated or analysed during this study are included in this published article.
There has been a recent swell in activity by health research funding organizations and science journal editors to increase uptake of sex and gender considerations in study design, conduct and reporting in order to ensure that research results apply to everyone. However, examination of the implementation research literature reveals that attention to sex and gender has not yet infiltrated research methods in this field.
The rationale for routinely considering sex and gender in implementation research is multifold. Sex and gender are important in decision-making, communication, stakeholder engagement and preferences for the uptake of interventions. Gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why. There is emerging evidence that programme theories may operate differently within and across sexes, genders and other intersectional characteristics under various circumstances. Furthermore, without proper study, implementation strategies may inadvertently exploit or ignore, rather than transform thinking about sex and gender-related factors. Techniques are described for measuring and analyzing sex and gender in implementation research using both quantitative and qualitative methods.
The present paper describes the application of methods for integrating sex and gender in implementation research. Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. The result has potential to strengthen both the practice and science of implementation, improve health outcomes and reduce gender inequities.
Electronic supplementary material
The online version of this article (doi:10.1186/s12874-016-0247-7) contains supplementary material, which is available to authorized users.
Efforts to integrate sex and gender throughout all phases of the health research cycle have been rising sharply over the past two decades [ 1 – 4 ]. Since 2010, the Canadian Institutes of Health Research has been requiring researchers to indicate whether their research protocol accounts for sex or gender, using the term “sex” to refer to the biological attributes that distinguish male from female, and the term “gender” to refer to men and women’s socially constructed roles, identities and behaviors [ 5 , 6 ]. As of 2016, the U.S. National Institutes of Health Research asks applicants to explain how they plan to factor consideration of sex as a biological variable into their research design and analysis [ 7 , 8 ]. The Gender Advisory Group to the European Framework Program for Research and Innovation also mandates the Gender Dimension across all sectors [ 9 ]. Journal editors are encouraged to increase accountability around sex and gender reporting requirements, by using the Sex and Gender Equity in Research (SAGER) guidelines [ 10 , 11 ]. These events beg the question: how have research methods in implementation science addressed sex and gender? For the purpose of this article, we will use the term implementation research and practice (IRP) to include knowledge translation, implementation research and practice.
The opening argument for this debate article is that to date, despite the evidence on the impact of sex and gender on health, research methods in the field of implementation have neglected sex and gender considerations. An analysis of selected literature in IRP supports this proposition. For example, a review of the tables of contents and indexes of three popular implementation science texts [ 12 – 14 ] reveals that none devote a chapter to the role of sex and gender in implementation science. Only one includes gender in the index [ 14 ], which refers to a chapter in the text with a few lines describing how many sexually transmitted infection interventions targeting racial/ethnic minorities are gender specific and how the strategies to reach men and women may differ [ 15 ].
Searching the top 10 articles of 2015 as reported by Implementation Science (see Additional file 1 : Appendix 1) for the words sex or gender shows that only one makes a minor mention of gender as it relates to controlling for ‘clinician gender’ in a modeling exercise [ 16 ]. Sex and gender also do not appear to play a prominent role in implementation theories. For example, in Nilsen’s review [ 17 ] of implementation theories, models and frameworks, only 2 make minor references to gender [ 18 , 19 ]. One simply includes ‘gender’ as one of the barriers to optimal clinical practice under the category “health care professional/physician barriers” [ 18 ] and the other includes a footnote about a study they were citing, that “a fourth factor, gender of participants, was also related to program outcomes but was not included in their subsequent analysis” [ 19 ]. Furthermore, neither of the germinal papers on the Theoretical Domains Framework [ 20 , 21 ], a widely used and influential framework [ 22 ] that guides assessment of barriers to implementation, makes any reference to sex or gender. There is a domain in the framework that focuses on ‘social/professional role and identity’, which could capture elements of sex and gender, but usually tends to be limited to assessing professional roles and almost never identity, let alone sex or gender identity.
Turning to the knowledge synthesis literature on implementation, the Cochrane Collaboration’s Methods Equity group [ 23 ] is active in increasing awareness of the need and methods for sex and gender analysis in systematic reviews [ 23 – 25 ]. Both the Effective Practice and Organisation of Care (EPOC) and Consumers and Communication review groups have official guidance in their resources for authors on equity [ 26 , 27 ]. A recent assessment of a sample of systematic reviews from these two groups however, reveals limited consideration of sex and gender in the written report. For example, of 12 EPOC and seven Consumer and Communication reviews published between July 2014 and May 2015, none addressed sex or gender in the analysis or implications sections of the report (Personal Communication, Jennifer Petkovic, Peter Tugwell and Vivian Welch on behalf of the Campbell and Cochrane Equity Methods Group, April 13, 2016). It is possible that the review authors did consider sex and gender in their analyses and determined it was unimportant. However, they failed to report this.
Little research has been undertaken or reported to inform how sex and gender impact IRP, as evidenced by this analysis of key texts, well-used conceptual models, and Cochrane reviews on implementation strategies. The objective of this paper is to describe the rationale for why and how sex and gender should be considered in IRP.
What is sex? What is gender?
A first step for understanding how to integrate sex and gender in IRP involves operationalizing the two terms, and recognizing different components of gender. The term sex refers to a biological construct, whereby an individual is defined as being male or female according to genetics, anatomy and physiology [ 6 , 7 , 11 , 28 – 32 ]. Researchers should use the term sex when describing the number of male or female patients or committee members, or when stratifying outcomes by male versus female participants or health care providers. It is more appropriate to say what the distribution by sex of a sample or target audience is, than to use the term ‘gender distribution.’ This is because gender is a multifaceted and fluid construct, influenced in a temporal manner by social and cultural contexts and environments to create gender norms [ 6 , 7 , 11 , 28 , 30 – 35 ]. Gender norms influence commonly accepted ways of how people behave, how they perceive themselves and each other, how they act and interact, and the distribution of power and resources in society [ 6 , 28 , 31 – 35 ]. Gender can be structured by, and operating within ethnicity, indigenous status, social status, sexuality, geography, socioeconomic status, education, age, disability/ability, migration status, and religion, requiring an intersectional approach to implementing practices, programs and policies [ 36 , 37 ]. The acronym “PROGRESS” can be used to remember these variables: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital [ 38 ]. Researchers often understand gender as a function of gender roles (e.g. child care, housework), gender identity (e.g. personality traits such as being sensitive to the needs of others or having leadership abilities), gender relations (e.g. social support), and institutionalized gender (e.g. career opportunities, personal income, educational background) [ 6 , 28 , 34 ]. Gender as a broad term can also refer to the expressions and identities of girls, women, boys, men, and gender diverse people [ 39 , 40 ]. For this reason, definitions of sex and gender are evolving as science changes, and it remains challenging to easily separate the biological from the social. Sex and gender are often interrelated, interactive and potentially inseparable [ 6 , 11 ]. Given the epistemology of knowledge, and the social nature of implementation and behavior change, the effect of gender and other identity factors, either alone or in combination, can serve as barriers or enablers to the outcome or impact of IRP interventions.
Measuring and understanding sex and gender
Collecting and analyzing data on sex in IRP is relatively simple if using typical male and female categories. Sex can be self-reported, designated by an examination of external genitalia, or genetically determined based on an XX, XY or intersex genotype [ 11 ]. Data on sex-related factors can include measuring sex hormones, body and organ size, metabolism, or fat tissue distribution [ 41 ]. Gender is more complex, and can be operationalized along four different constructs: gender roles, gender identity, gender relations and institutionalized gender [ 6 , 28 , 31 , 32 ]. Table 1 defines these four constructs, gives examples of key questions that can be asked of each in IRP, and lists measures and methods for use in IRP research [ 6 , 28 , 31 , 32 , 42 – 44 ].
Relevance of four gender constructs to implementation research and practice
Gender construct | Definition | Examples of potential questions for implementation research | Examples of potential questions for implementation practice | Examples of measures |
---|---|---|---|---|
Gender roles [ , ] | Represent the behavioral norms applied to men and women in society, which influence individuals’ everyday actions, expectations, and experiences. Gender roles often categorize and define individuals within the family, the labour force, or the educational system. May form the basis for stereotypes. | How can considering gender roles help us understand and anticipate barriers and opportunities facing health-care professionals in the uptake of new interventions? | How can considering gender roles help inform dissemination strategies that are successful in reaching different audiences where they are? | The Gender Role Conflict Index [ ] |
Other variables such as occupation [ ], primary breadwinner status, time doing household chores and caregiving responsibilities can also be used to capture gender roles in data collection and analysis [ ]. | ||||
Gender identity [ , , , , , ] | Describes how we see ourselves, and are seen by others, as female or male, or across a feminine-masculine continuum. Individuals may also self-identify dynamically along the continuum of gender-queer and/or transgender. Gender identity affects our feelings and behaviors. | Do a range of gender identities need to be considered when asking the question, “for whom does this implementation strategy work and under which circumstances?” | Will the reach of the implementation intervention extend to male, female and transgender individuals? | The BEM sex role inventory [ ] |
The Personal Attributes Questionnaire [ ] | ||||
Should the content of the implementation intervention consider gender identity or sexual orientation? | The Conformity to Masculine Norms Inventory [ ], | |||
A two-step approach to measuring gender identity first asks individuals to indicate their sex assigned at birth (male/female), and then asks the same individuals how they currently self-identify (male, female, trans male/trans man, trans female/trans woman, gender queer/gender non-conforming) [ , ]. | ||||
Gender relations [ , , ] | Refers to how we interact with or are treated by people in the world around us, based on our ascribed or experienced gender. | How might the outcomes of implementation interventions differ by sex and gender according to whether the degree to which the geographic setting is culturally homogeneous, diverse or gender equitable? | What are the implications of an implementation intervention being communicated or delivered to women only, men only, men and women separately or together? How is this mediated by cultural context? | The Self-Perceived and Self-Reported Gender Equality scale [ ]. |
Institutionalized gender [ , , ] | Reflects the distribution of power between men and women in the political, educational, and social institutions in society. The institutionalized aspect of gender also shapes social norms that define, reproduce, and often justify different expectations and opportunities for men and women. | If particular decision-maker groups value, use, or require, different kinds of knowledge, have you considered how institutionalized gender might play a role? How might this change over time? | How can dissemination messages be crafted in a way that responds to sex and gender–related factors without reproducing or exploiting any negative stereotypes embedded in institutionalized gender? | The use of qualitative methods (e.g. case studies, ethnography, narrative and descriptive qualitative approaches etc.) can be used to explore concepts of institutionalized gender, and to gain a more in-depth understanding of gender as a barrier or enabler. |
Traditionally, individuals are asked to categorize their sex as male or female and many assumptions, often based in gender and not biology, are made on the basis of their responses. Researchers are now rethinking this approach to be more inclusive of gender identity and expression [ 39 ]. A two-step approach to measuring sex and gender identity could first ask individuals to indicate their sex assigned at birth (male/female), and then ask the same individuals how they currently self-identify, which could include male, female, trans male/trans man, trans female/trans woman, gender queer/gender non-conforming; and provide space to self identify as another option not provided [ 40 ]. Similarly, participants could also be given the option to disclose sexual orientation and whether they consider themselves part of the lesbian, gay, bisexual or transgender (LGBT) community.
The scales in Table 1 list measures that can be used to quantify different dimensions of gender. Researchers can also create gender scales using gender-related variables of relevance to their particular research topic [ 45 , 46 ]. Pelletier et al. created a composite gender score using 7 characteristics: 1) status on primary earner; 2) personal income; 3) number of hours per week spent doing housework; 4) status of primary person responsible for doing housework; 5) level of stress at home; 6) masculine traits; and 7) feminine traits. They were able to demonstrate that gender, independent of sex, predicts poor outcome after acute coronary syndrome, pointing to new areas of intervention [ 44 ].
Qualitative methods are also useful for the collection of data on specific dimensions of gender. Case studies, ethnography, narrative and descriptive qualitative approaches can provide evidence and contextualized insight across a range of participants’ personal characteristics, including those of sex and gender. Qualitative methods can also be used to explore concepts of institutionalized gender, and to gain a more in-depth understanding of gender as a barrier or enabler to the use of implementation interventions, the uptake of the evidence-informed clinical interventions or program and the outcomes of implementation efforts. A number of texts, casebooks, examples and online courses are available that provide guidance on how to conduct sex and gender science using commonly employed quantitative and qualitative methods [ 6 , 32 , 42 , 43 ].
The case for considering sex and gender in implementation research methods
Emerging evidence suggests that sex and gender are important in decision-making, stakeholder engagement, communication and preferences for the uptake of interventions. Furthermore, when gender norms, identities and relations are ignored, unintended consequences may occur. The following five scenarios give examples of when and why sex and gender should be measured and considered in implementation research:
- When the implementation of an intervention requires decision-making on the part of individuals or organizations . Decision-making is a critical component of behavior change interventions, and plays a key role in the uptake of new organizational practices and programs [ 47 ]. Research from the fields of business and management offer insights for IRP on important sex and gender factors related to decision-making [ 48 – 50 ]. Qualitative research conducted by Deloitte Consulting with 18 large business organizations suggests that female executives have a tendency to be more attuned to micro-level signaling during meetings, and may favour discovery options and iterative thinking during decision-making processes [ 48 ]. Male executives tend to end a conversation once they connect with a good idea or solution. Their female counterparts are inclined to be more inquisitive, wanting to hear everyone’s thoughts before deciding, and taking more time to find the ideal solution. Different leadership traits among male and female leaders can therefore influence the outcome of decision-making processes [ 49 , 50 ].
- When sex and gender dynamics may play a role in stakeholder engagement and conflict resolution . A survey queried reasoning methods among 624 corporate board directors, of whom 75 % were male and 25 % female [ 51 ]. Female directors scored significantly higher scores on the complex moral reasoning dimension, which implies attending more to relationships and to the challenge of balancing multiple stakeholders’ interests. Females may also engage in more collaboration and consensus building, not only to make sound decisions but also to elicit common support for a course of action [ 49 , 50 ]. The outcome of an implementation intervention may therefore depend on the sex and gender dynamics in each particular context.
- When communication strategies are being tested, as sex and gender may be differentially responsive to the choice of language used, the strength of persuasion of the communication strategy, and the way promotional information is processed . This is why sex and gender form the basis for market segmentation in the fields of marketing and consumer behaviour, where subtle changes in language and emotional appeal can have a differential effect on men and women’s attitudes towards the brand advertised and purchase intentions [ 52 ]. The way messages and interventions are primed or packaged to reflect gender norms or stereotypes may also influence the outcomes of health promotion interventions. For instance, priming individuals to the perception that women eat healthier foods than men leads both male and female study participants to prefer healthy foods, whereas priming masculinity results in unhealthy food preferences [ 53 ]. When the packaging and healthiness of the food are gender congruent (i.e., feminine packaging for a healthy food, masculine packaging for an unhealthy food) both male and female participants rate the product as more attractive, report that they would be more likely to purchase it, and even rate it as tasting better compared to when the product is stereotype incongruent.
- When negative or harmful gender stereotypes may impede the uptake and outcomes of an IRP initiative [ 54 ]. A realist review of the implementation of school-based interventions to prevent domestic abuse for children and young people reported that lesbian, gay, bisexual and transgender youth felt excluded from the programmes, as the content did not address gender identity or sexual orientation in high-risk populations [ 55 ]. Similarly, data suggest that masculine norms around emotional control and self-reliance are associated with recurrent non-suicidal self-injury [ 56 ]. Stigma related to healthcare seeking for male depression and suicide [ 57 , 58 ], may explain why women are more likely to benefit from psychosocial treatment for the prevention of suicide and suicidal ideation compared to men [ 59 ]. Some studies purport that gender bias in prescription patterns among health care providers results in more women receiving treatment with antidepressants for mental health [ 60 ] and pain symptoms, but only among female clinicians [ 61 ]. Men, on the other hand, may be preferentially managed with orthopaedic surgery to manage knee arthritis [ 62 ].
- When gendered power relations may inadvertently skew the uptake of information focused on women’s health needs, such as maternal and child health, sexual and reproductive health, or family planning [ 63 ]. This occurs in cultures and settings where male partners and head of households play a large role in female’s health-seeking behaviour due to their authority and decision-making role. For example, the introduction of health programs enhanced by mobile phone technologies overall fosters women’s empowerment in low-income countries [ 64 ]. However, in some cases these programs exacerbated gender relations and gender inequalities, such as when women were pressured to give the phones provided by the program to their husband if he did not already own a phone, or when conflicts about phone use led to cases of spousal abuse.
The World Health Organization outlines a spectrum of gender-responsive programs, illustrating the progression from the exploitative use of gender stereotypes in IRP messaging, through to accommodation and ultimate transformation to gender equity (Fig. 1 ) [ 65 , 66 ]. Making active choices reflecting content, messaging and decision-making processes during the implementation of an intervention can have a critical impact on gender equity for women and men. Gender transformative approaches are preferred as they anticipate unintended barriers and consequences and address the causes of gender-based health inequities where they exist [ 67 ]. For example, during implementation of a tobacco control program, investigators can decide to use motivational recruitment techniques that appeal to a person’s health and self-respect, as opposed to messaging that invokes and reinforces stereotypical gendered norms of sexual attractiveness, beauty claims or images based on masculinity or femininity [ 63 ]. Recent guidance based on qualitative research suggests de-linking messages for men and for women when promoting tobacco reduction during pregnancy and post partum, since the uptake of the intervention can be hindered by negative couple dynamics if the partners have different smoking behaviours or attitudes about smoking during this period [ 68 – 70 ]. Another transformative approach to encourage uptake of smoking cessation interventions would be to focus on a wider range of non-stereotypical gendered roles that include fathering for men and work for women as potential motivators.
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A continuum of approaches for integrating sex and gender. Reproduced with permission from: Lorraine Greaves, Ann Pederson, Nancy Poole (Eds). Making It Better: Gender Transformative Health Promotion. Canadian Scholar’s Press/Women’s Press. 2014. Available at http://promotinghealthinwomen.ca/wordpress/wp-content/uploads/2015/02/Continuum-of-Approaches_colour.pdf Accessed March 20, 2016
Sex and gender can be therefore be pivotal at multiple points along the IRP process, from the content and messaging surrounding the intervention, to decision making around the uptake and unintended consequences of an intervention. Asking sex and gender questions can also elucidate enablers and barriers to the adoption of complex behavioral interventions. For example, examining the outcome of implementing a multidisciplinary cardiac rehabilitation program merits asking whether women or men have less time to devote to recovery and prevention activities due to gender-based expectations regarding their responsibilities at home. The potential advantages of including sex and gender in the study of other complex behavioral interventions (e.g., hand hygiene, reducing clinician's opioid prescribing, reducing falls in hospital, increasing vaccination rates, and obesity prevention) require further investigation. Measuring the way sex and gender influences these interventions may help elucidate potential mechanisms and contexts behind the success or failure of various IRP efforts, as shown in the examples above on tobacco cessation, healthy eating, depression and suicide, pain, heart disease and domestic violence.
Some research questions to drive the selection of methods
Researchers can start by asking a series of questions about how sex and gender can have an impact on their implementation initiative in order to determine the best way to measure and analyze the effect of sex and gender. First, how might sex or gender affect decision-making and stakeholder engagement, or facilitate or impede the uptake of evidence-informed practice, programs, policies? Second, how might sex based characteristics or prevailing gender norms or gender roles serve as barriers or enablers to the uptake of evidence-informed practices, programs, policies? Third, when and how should the communication strategy, wording or messaging be tailored across sex, gender or other identity characteristics? Fourth, when using participatory/collaborative or integrated knowledge translation research approaches, could the sex and gender of the researchers and knowledge users matter, and if so, how? Similarly, how might gender relations as a function of dyads or interpersonal dynamics within an organization, community, workplace or institution influence the outcome of the intervention? And finally, should the research protocol consider examining whether there are unintended impacts of implementation that exacerbate or diminish sex, gender or other diversity-related inequities? Table 2 lists a series of questions for researchers to consider when designing their IRP research. Additional opportunities for integrating sex and gender in IRP as relates to models of health systems research have been reviewed in detail elsewhere [ 33 ].
Some sex and gender research questions for researchers studying implementation
• Are theories of behaviour change (i.e. processes of reasoning or reflection) equally applicable across sexes, genders and other intersecting variables? |
• How does consideration of sex, gender and diversity affect the assessing of barriers and supports to uptake of evidence-informed practice, programs, policies? |
• How do prevailing gender norms or gender roles serve as barriers or enablers to the uptake of evidence-informed practices, programs, policies? |
• When and how should implementation interventions be tailored to the sex, gender and diversity of the target audience? |
• Do cognitive and emotional learning strategies differ across sexes or genders, and if so how? |
• When and how should the wording or messaging included in the implementation intervention be tailored differently across sex, gender and other identity characteristics? |
• How does the implementation intervention increase or decrease gender inequities in socio-economic status, cultural or ethnic groups, and political contexts? |
• Does the implementation intervention work differently for sub-groups of men, women and gender-diverse people, and if so, how? |
• When using participatory/collaborative or integrated knowledge translation research approaches, does the sex and gender of the researchers and knowledge users matter, and if so, how? |
• How do gender relations as a function of dyads or interpersonal dynamics within an organization, community, workplace or institution influence the outcome of the intervention? |
• Are there unintended impacts of implementation that exacerbate or diminish sex, gender or other diversity-related inequities? |
Another way to study issues of sex and gender in IRP resides in the realist approach which attempts to answer the question, “What works, for whom, in what circumstances, and why?” [ 47 ] This is accomplished through the identification and examination of underlying generative mechanisms or program theories associated with the implementation intervention or program, the conditions or contexts under which the mechanisms operate, and the pattern of outcomes produced. Realist evaluators may wish to examine sex and gender through the lens of this Context-Mechanism-Outcomes configuration for the evaluation of new initiatives, programs and scale-up [ 71 , 72 ].
Through this lens, context can be defined as the particular sub-groups for whom the outcomes were successful, the gender relations between the stakeholders, the sex and/or gender of the individuals who implemented the intervention, and the institutional, socio-economic, cultural and political conditions. Mechanism refers to the explanation of how a particular program’s resources work to change the reasoning and responses of participants to bring about the adoption of the clinical intervention or program that results in both intended and unintended outcomes. Outcomes are the impacts of the intervention. Some questions of how sex and gender considerations can align with the Context-Mechanism-Outcomes configuration are: How do gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why? Or, how do program theories operate/work within and across sexes, genders and other diversity characteristics, in what circumstances and why? Finally, research results should be disaggregated and reported by sex or gender groups [ 11 ]. It is important to report whether there are similar effects or differences.
When critically appraising the publications of implementation research, reviewers should increasingly ask whether the reports consider sex and gender during a study’s life cycle, and if so, how? Table 3 provides a beginning list of questions that can be asked of implementation research to help the reader assess whether sex and gender have been adequately considered, and the extent to which this may have influenced the study findings and conclusions.
Questions to ask when appraising an implementation research or practice initiative for inclusion of sex and gender considerations
• Has the systematic review of the effectiveness of implementation interventions considered evidence related to sex and gender? |
• Has the literature review and analysis of the know-do-gap considered gender roles, gender identity, gender relations, institutionalized gender? |
• Does the monitoring and evaluation plan for the intervention collect data on sex, gender and diverse factors, and include a strategy for assessing and mitigating inequitable outcomes? |
• Has the assessment of barriers and facilitators of the use of evidence-informed practices, programs, policies considered gender roles, gender identity, gender relations, institutionalized gender? |
• Has the process by which local or targeted adaptation of the evidence-informed practices, programs, policies considered cultural contexts of gender roles, gender identity, gender relations, institutionalized gender? |
• Has the implementation intervention been tailored to address sex, gender or other identity or diversity-related characteristics identified in the barriers assessment? |
• Has knowledge use (uptake of the practice, program, policy) been reported by sex, gender, and other population characteristics such as age, socioeconomic status etc? |
• Have health outcomes (impact of adopting the practice, program, policy) been reported by sex, gender, and other population characteristics? |
• Has the impact of unintended consequences of implementation been reported by sex, gender, and other population characteristics? |
This paper argues that sex and gender should always be considered in implementation research. Considering sex and gender should be an essential component of IRP. Failing to integrate sex and gender may neglect an important determinant of knowledge use, reducing the effectiveness of implementation interventions, inadvertently reinforcing sex neutral claims and negative gender stereotypes, and possibly creating or increasing gender and health inequities in care and health outcomes. Only by consistently investigating sex and gender in a critical and reflective manner that addresses underlying gender inequities, will the field of IRP reach its full potential for meeting the requirements of scientific rigour, excellence and maximal impact.
Acknowledgments
We express gratitude to Jo Rycroft-Malone, Professor of Implementation & Health Services Research, Bangor University, United Kingdom, for providing direction to get out of the “realist swamp.” We also thank Krystle van Hoof, Assistant Director of the CIHR Institute of Gender and Health for her thoughtful comments, and Justin Presseau, Scientist at the Ottawa Hospital Research Institute for insightful discussions about sex and gender in implementation research and the Theoretical Domains Framework. IDG is a recipient of Canadian Institutes of Health Research, Foundation Grant Scheme, Inaugural competition, FDN #143237.
Institute of Gender and Health, Canadian Institutes of Health Research.
Availability of data and materials
Authors’ contributions.
CT, LG and IDG conceived and drafted the article. All authors read and approved the final manuscript.
Competing interests
The authors declare that they have no competing interests.
Consent for publication
All authors consented.
Ethics approval and consent to participate
Not applicable.
Abbreviations
EPOC | Effective Practice and Organisation of Care |
IRP | Research and practice |
Additional file
Appendix 1. List of the top implementation science papers published in 2015. (DOCX 19 kb)
Contributor Information
Cara Tannenbaum, Email: [email protected] .
Lorraine Greaves, Email: ac.cb.wc@sevaergl .
Ian D. Graham, Email: ac.irho@mahargi .
QUALITATIVE DATA COLLECTION METHODS
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QUALITATIVE DATA USES
Qualitative research methods are useful for assessing community needs, designing prevention campaigns, planning and evaluating interventions, and engaging community actors via participatory research. They are also useful in designing and field-testing questionnaires, and in interpreting quantitative research findings. Qualitative methods can provide deeper insight into meaning, motivations and dynamics around women and girls’ empowerment. The table below provides an illustrative list of commonly methods for qualitative data collection.
Method | When to use it | Key considerations when using this method to measure empowerment |
---|---|---|
FOCUS GROUP DISCUSSIONS | Focus group discussions (FGDs) are useful for capturing information on attitudes or opinions and why they are held, unpacking the progress and achievements of a program, and when different perspectives and points of views of stakeholders need to be explored. They are useful for collecting data on the empowerment dimensions of decision-making, critical consciousness, and norms. | |
IN-DEPTH INTERVIEWS | In-depth interviews are well suited to collecting data on social norms, attitudes and behaviors, as well processes of change, and nuances around decision-making. Interviews are also useful for collecting data on individual as opposed to collective opinions. The data captured is often valuable for triangulating or confirming data captured by other methods. | |
EMBEDDED ETHNOGRAPHY | Embedded ethnography is used to understand an ongoing process or situation. It is useful for understanding empowerment in a holistic way to see how different elements interact in a situation. Embedded ethnography also provides direct information about behavior of individuals and groups, rather than relying on what people said they did, and is helpful in identifying unanticipated outcomes. | |
BODY MAPPING | Body mapping is an interactive tool to obtain visual representation of women and girls ability to assert choice and articulate voice over resources (including bodily integrity). It is most valuable at the formative stage to understand the link between resources and expressions of agency. Body mapping can be used at the project and community level. |
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How to write qualitative research questions.
11 min read Here’s how to write effective qualitative research questions for your projects, and why getting it right matters so much.
What is qualitative research?
Qualitative research is a blanket term covering a wide range of research methods and theoretical framing approaches. The unifying factor in all these types of qualitative study is that they deal with data that cannot be counted. Typically this means things like people’s stories, feelings, opinions and emotions , and the meanings they ascribe to their experiences.
Qualitative study is one of two main categories of research, the other being quantitative research. Quantitative research deals with numerical data – that which can be counted and quantified, and which is mostly concerned with trends and patterns in large-scale datasets.
What are research questions?
Research questions are questions you are trying to answer with your research. To put it another way, your research question is the reason for your study, and the beginning point for your research design. There is normally only one research question per study, although if your project is very complex, you may have multiple research questions that are closely linked to one central question.
A good qualitative research question sums up your research objective. It’s a way of expressing the central question of your research, identifying your particular topic and the central issue you are examining.
Research questions are quite different from survey questions, questions used in focus groups or interview questions. A long list of questions is used in these types of study, as opposed to one central question. Additionally, interview or survey questions are asked of participants, whereas research questions are only for the researcher to maintain a clear understanding of the research design.
Research questions are used in both qualitative and quantitative research , although what makes a good research question might vary between the two.
In fact, the type of research questions you are asking can help you decide whether you need to take a quantitative or qualitative approach to your research project.
Discover the fundamentals of qualitative research
Quantitative vs. qualitative research questions
Writing research questions is very important in both qualitative and quantitative research, but the research questions that perform best in the two types of studies are quite different.
Quantitative research questions
Quantitative research questions usually relate to quantities, similarities and differences.
It might reflect the researchers’ interest in determining whether relationships between variables exist, and if so whether they are statistically significant. Or it may focus on establishing differences between things through comparison, and using statistical analysis to determine whether those differences are meaningful or due to chance.
- How much? This kind of research question is one of the simplest. It focuses on quantifying something. For example:
How many Yoruba speakers are there in the state of Maine?
- What is the connection?
This type of quantitative research question examines how one variable affects another.
For example:
How does a low level of sunlight affect the mood scores (1-10) of Antarctic explorers during winter?
- What is the difference? Quantitative research questions in this category identify two categories and measure the difference between them using numerical data.
Do white cats stay cooler than tabby cats in hot weather?
If your research question fits into one of the above categories, you’re probably going to be doing a quantitative study.
Qualitative research questions
Qualitative research questions focus on exploring phenomena, meanings and experiences.
Unlike quantitative research, qualitative research isn’t about finding causal relationships between variables. So although qualitative research questions might touch on topics that involve one variable influencing another, or looking at the difference between things, finding and quantifying those relationships isn’t the primary objective.
In fact, you as a qualitative researcher might end up studying a very similar topic to your colleague who is doing a quantitative study, but your areas of focus will be quite different. Your research methods will also be different – they might include focus groups, ethnography studies, and other kinds of qualitative study.
A few example qualitative research questions:
- What is it like being an Antarctic explorer during winter?
- What are the experiences of Yoruba speakers in the USA?
- How do white cat owners describe their pets?
Qualitative research question types
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Marshall and Rossman (1989) identified 4 qualitative research question types, each with its own typical research strategy and methods.
- Exploratory questions
Exploratory questions are used when relatively little is known about the research topic. The process researchers follow when pursuing exploratory questions might involve interviewing participants, holding focus groups, or diving deep with a case study.
- Explanatory questions
With explanatory questions, the research topic is approached with a view to understanding the causes that lie behind phenomena. However, unlike a quantitative project, the focus of explanatory questions is on qualitative analysis of multiple interconnected factors that have influenced a particular group or area, rather than a provable causal link between dependent and independent variables.
- Descriptive questions
As the name suggests, descriptive questions aim to document and record what is happening. In answering descriptive questions , researchers might interact directly with participants with surveys or interviews, as well as using observational studies and ethnography studies that collect data on how participants interact with their wider environment.
- Predictive questions
Predictive questions start from the phenomena of interest and investigate what ramifications it might have in the future. Answering predictive questions may involve looking back as well as forward, with content analysis, questionnaires and studies of non-verbal communication (kinesics).
Why are good qualitative research questions important?
We know research questions are very important. But what makes them so essential? (And is that question a qualitative or quantitative one?)
Getting your qualitative research questions right has a number of benefits.
- It defines your qualitative research project Qualitative research questions definitively nail down the research population, the thing you’re examining, and what the nature of your answer will be.This means you can explain your research project to other people both inside and outside your business or organization. That could be critical when it comes to securing funding for your project, recruiting participants and members of your research team, and ultimately for publishing your results. It can also help you assess right the ethical considerations for your population of study.
- It maintains focus Good qualitative research questions help researchers to stick to the area of focus as they carry out their research. Keeping the research question in mind will help them steer away from tangents during their research or while they are carrying out qualitative research interviews. This holds true whatever the qualitative methods are, whether it’s a focus group, survey, thematic analysis or other type of inquiry.That doesn’t mean the research project can’t morph and change during its execution – sometimes this is acceptable and even welcome – but having a research question helps demarcate the starting point for the research. It can be referred back to if the scope and focus of the project does change.
- It helps make sure your outcomes are achievable
Because qualitative research questions help determine the kind of results you’re going to get, it helps make sure those results are achievable. By formulating good qualitative research questions in advance, you can make sure the things you want to know and the way you’re going to investigate them are grounded in practical reality. Otherwise, you may be at risk of taking on a research project that can’t be satisfactorily completed.
Developing good qualitative research questions
All researchers use research questions to define their parameters, keep their study on track and maintain focus on the research topic. This is especially important with qualitative questions, where there may be exploratory or inductive methods in use that introduce researchers to new and interesting areas of inquiry. Here are some tips for writing good qualitative research questions.
1. Keep it specific
Broader research questions are difficult to act on. They may also be open to interpretation, or leave some parameters undefined.
Strong example: How do Baby Boomers in the USA feel about their gender identity?
Weak example: Do people feel different about gender now?
2. Be original
Look for research questions that haven’t been widely addressed by others already.
Strong example: What are the effects of video calling on women’s experiences of work?
Weak example: Are women given less respect than men at work?
3. Make it research-worthy
Don’t ask a question that can be answered with a ‘yes’ or ‘no’, or with a quick Google search.
Strong example: What do people like and dislike about living in a highly multi-lingual country?
Weak example: What languages are spoken in India?
4. Focus your question
Don’t roll multiple topics or questions into one. Qualitative data may involve multiple topics, but your qualitative questions should be focused.
Strong example: What is the experience of disabled children and their families when using social services?
Weak example: How can we improve social services for children affected by poverty and disability?
4. Focus on your own discipline, not someone else’s
Avoid asking questions that are for the politicians, police or others to address.
Strong example: What does it feel like to be the victim of a hate crime?
Weak example: How can hate crimes be prevented?
5. Ask something researchable
Big questions, questions about hypothetical events or questions that would require vastly more resources than you have access to are not useful starting points for qualitative studies. Qualitative words or subjective ideas that lack definition are also not helpful.
Strong example: How do perceptions of physical beauty vary between today’s youth and their parents’ generation?
Weak example: Which country has the most beautiful people in it?
Related resources
Qualitative research design 12 min read, primary vs secondary research 14 min read, business research methods 12 min read, qualitative research interviews 11 min read, market intelligence 10 min read, marketing insights 11 min read, ethnographic research 11 min read, request demo.
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Qualitative research on gender identity: phase 1 summary report
Our 2021 Census topic consultation identified a need for information on gender identity. As part of our work to help determine whether, and how best, to meet user needs for information on this topic, the ONS Data Collection Methodology branch was commissioned to undertake qualitative research. This report details Phase 1 of the research. It covers: the purpose of the research, the methodology used, as well as findings, conclusions and recommendations.
In this section
- Executive Summary
- Introduction
- Objectives and methodology
- Findings, conclusions and recommendations
- Acceptability, purpose and trust and census administration
- Within-household privacy, proxy response, prefer not to say and private response
1. Executive Summary
We have conducted qualitative research to help inform whether and how best to meet user needs for information on gender identity – the main one being a reliable estimate of the population identifying as “trans” (an umbrella term covering people who self-identify as an identity different to the sex assigned to them at birth).
We explored relevant issues, including responses to sex and gender questions and potential barriers to answering, terminology, privacy, burden and acceptability. The Office for National Statistics (ONS) Data Collection Methodology branch undertook 4 focus groups and 18 one-to-one in-depth interviews with members of the public, including those with a trans identity and those who are cisgender (people whose self-identity conforms to the sex or gender assigned at birth). These were conducted in March and April 2017.
Three question designs were explored:
- the 2011 Census “Sex” question
- a hybrid design with the addition of “Other” to the sex question
- a two-step design with separate sex and gender identity questions
None of the question designs, as they were presented, would meet the requirement for a reliable estimate of the trans population. Furthermore, none of the question designs would fully meet respondent needs for questions that are easily understood and answered. It is therefore recommended that none of these designs be used in the 2021 Census.
2. Introduction
Our 2021 Census topic consultation identified a need for information on gender identity. As part of our work to help determine whether, and how best, to meet user needs for information on this topic, the ONS Data Collection Methodology branch was commissioned to undertake qualitative research. This work is in addition to other strands of research and testing we have committed to in our Gender identity research and testing plan . This report details Phase 1 of the qualitative research. It covers: the purpose of the research, the methodology used, as well as findings, conclusions and recommendations. We will be undertaking Phase 2 of the qualitative research in due course.
3. Objectives and methodology
The objectives were to provide findings and recommendations with regard to: how the trans population tackle the 2011 Census “Sex” question, including potential barriers to answering the question and completing the census; how both the trans population and cisgender population (people whose self-identity conforms to the sex or gender assigned at birth) interpret concepts around gender identity and sex; how both populations might answer questions on sex and gender identity; what terminology respondents understand and enables them to answer the question(s) appropriately; and potential privacy, security, burden and acceptability concerns.
A purposive sample design was employed. The primary sampling criterion was sex or gender. Four focus groups were conducted with the cisgender population (total 29 participants) and 18 one-to-one in-depth interviews were conducted with the trans population, including trans men, trans women, non-binary and intersex identities, and the parents of trans children. Secondary criteria included age, educational attainment, ethnic group and household type (see Appendix A: Achieved sample). Note that it is not appropriate or possible to draw statistical inferences from the findings when purposive sampling methods are used.
A topic guide covered the areas to be probed, with some tailoring for the cisgender group, the trans group and the parents of trans children. Participants were shown three different question designs (detailed in this section). For each design they were asked for their initial views; their understanding of the questions, the measurement concepts and related terms; whether and how they might answer them; their reaction to each design potentially being used in the census; and suggestions for changes. Probing was also conducted about aspects of the census, such as questions being mandatory or voluntary, data security and confidentiality, privacy within the household, answering by proxy, and the purpose of such questions.
The three question designs explored with all participants:
The 2011 Census question: ‘What is your sex?’ 1. Male, 2. Female
A “hybrid” question, still asking ‘What is your sex?’ but which added a third response category, “Other” potentially allowing varied interpretation of sex or gender
A two-question design:
Question 1: ‘What is your sex?’ 1. Male, 2. Female
Question 2: ‘Which of the following options best describes how you think of your gender identity?’ 1. Male, 2. Female, 3. In another way
4. Findings, conclusions and recommendations
The three question designs meeting data requirements.
None of the question designs, as they were presented, would meet the main data requirement of a reliable estimate of the trans population:
- the 2011 Census question provides no means of distinguishing trans and cisgender people
- the hybrid question enables respondents to answer “Other” but a proportion of trans people would answer “Male” or “Female”, so it would undercount the trans population
- the two step question design would not necessarily result in answers that would identify a trans person; so again, there would be an undercount of the trans population
Question validity
None of the questions are completely valid, that is conceptually clear and consistently understood and answered by respondents. This would result in some measurement error. From qualitative research we cannot know the extent of error; at the whole population level it is probably very marginal, but might be more significant with regard to the population of interest.
Cisgender participants could answer the 2011 “Sex” question and the hybrid question without error. However, interpretations and therefore answers that would be given varied among the trans population.
Trans participants expressed confusion about the subject of the “Sex” question; either thinking the “Sex” question referred to biological sex, or that it was indirectly asking about gender identity. Either way, they expressed negativity about the question and confusion about how to answer.
For the hybrid question, the retention of the word “sex” in the stem paired with “Other” in the options caused trans participants to be unsure whether they were being asked about their biological sex (when “Other” would be intersex) or their gender (when “Other” would be open to them). This led to inconsistencies in responses.
The two step design was something of an improvement but again was met with varied interpretations and answer strategies. The distinction between the concepts of sex and gender was broadly recognised but the need for two questions and the distinction between them was not always clear. Thus there arose some confusion, uncertainty in answering and indications that Question 2 might sometimes be skipped, including among cisgender people.
Meeting respondent needs
Furthermore, none of the question designs would fully meet respondent needs for questions that are easily understood and answered, inclusive of all population groups and acceptable.
The 2011 “Sex” question was considered to be irrelevant, unacceptable and intrusive, particularly to trans participants, due to asking about sex rather than gender. The lack of response options for intersex and non-binary people could make it difficult to answer and cause feeling of having to make a forced choice, leading to potential item non-response or invalid response, non-response to the census as a whole and could cause complaints to ONS.
The hybrid design was thought an improvement. However, asking about sex was again thought irrelevant and intrusive. The addition of “Other” caused respondent uncertainty as to whether the question was actually about gender. The “Other” category was thought to homogenise trans people and differentiate them from the rest of society. A “specify” field would mitigate the negative views to some extent.
The two step design was considered even more of an improvement, because Question 2 introduced gender to the equation and the category “In another way” allowed expression of non-binary gender and other trans identities. However, the same feelings arose for Question 1 as did with the 2011 question. The wording of Question 2 met with some differences of opinion as to the use of the word “identity”. There were cisgender and trans participants who did not understand why there were two questions, leading to uncertainty in answering and potentially measurement error or item non-response to Question 2.
Trans participants had mixed feelings that their two answers, in combination, might or might not result in their trans identity being visible in the census data. Some were positive that they could be represented in statistics about trans people, which they felt was important. However, others expressed negativity, either because if they gave the same answers to the two questions their trans identity would not be visible in data (at the aggregate level) when they wanted it to be; or, conversely, if their answers differed they would be visible in the trans statistics, when they did not want to be visible. They did not feel the questions were clear enough, in meaning and purpose, to enable an informed decision as to how to answer.
Conclusions and recommendations
We recommend that none of the three designs be used in the 2021 Census. Even if it is not possible to meet data requirements, change should be made to better meet the needs of trans respondents (for example, removing “sex” and adding one or more additional categories for non-binary and intersex people, recognising that those are distinct).
It is not possible to firmly recommend specific changes to question(s) because data requirements should first be clarified (including for the 2011 “Sex” question). Which is or are the appropriate measurement concept(s) – for example, sex assigned at birth, transitioned sex, reclaimed sex, acquired gender, gender or gender identity – is a matter for consideration by ONS and data users. Stakeholders should be informed of these findings and the implications for what data can be collected.
Any changes need to consider legislative and ethical issues. For example, to meet the data requirement questions on sex at birth and current sex or gender would be needed but might be precluded by the Gender Recognition Act and the discomfort felt among trans people for such questions, with implications for the mandatory status of one or other question.
Changes to questions might have further implications both in the census context (editing and imputation procedures; linking with administrative data) and more widely (the National Statistics Harmonised Standard and social survey data collection – for example, the processing of derived variables and suitability of questions for interviewer modes).
Consideration could be given to approaches used in other countries, such as Australia, where only male and female response options are provided but another means of expressing a trans identity is available.
Consideration should be given to provision of explanation as to why a particular design has been chosen, the meaning of question(s) and guidance on answering, within the census. However, we caution against over-reliance on guidance, given the typically low rates of referral by respondents.
Various specific recommendations are made relating to the different designs presented to participants and to potential redesigns, relating to the question stems, existing or additional response categories and the presentation of questions on paper and online. They are too many and detailed, and too contingent on other factors outlined previously, to be summarised concisely here.
Any changes made should be thoroughly tested using qualitative and quantitative methods, to ensure designs would better meet data requirements and respondent needs without unforeseen negative consequences, such as impact on either trans or cisgender people’s comprehension, ability to answer and the acceptability of questions.
5. Acceptability, purpose and trust and census administration
General acceptability of the topics of sex and gender.
There is sufficient positive evidence from the Phase 1 research to recommend that work continues to consider inclusion of questioning about gender or trans identity for the 2021 Census or social surveys. Broadly speaking, inclusion of the topic of gender was acceptable across cisgender and trans groups. However, there were objections too. The detail of the questions asked was central to views about the acceptability of inclusion in the census or social surveys. As well as the question designs themselves, other aspects of the census influenced participants’ views of the acceptability of inclusion and the likely accuracy of the responses that would be provided.
Scope – of whom should questions be asked?
No subgroups should be excluded from being asked about sex and/or gender due to considerations of either relevance or acceptability. However, consideration should be given to what the appropriate age to start asking about the gender (identity) of children is.
Mandatory versus voluntary questions
Decisions as to which question or questions might be mandatory and which voluntary must take into account several factors: acceptability to respondents, the potential impact forced response might have on data quality and Census unit response and legal considerations.
We would tentatively recommend that an unchanged 2011 Census question should not be mandatory, for the benefit of, particularly, intersex and non-binary people who cannot choose male or female as a reflection of their current sex or gender. We would also recommend that a question specifically about sex at birth, or one that forces an answer indicating a trans identity, should not be mandatory given the needs of trans people living with disclosure concerns. Perhaps as long as one or other question has a substantive answer, that would be acceptable. However, “Other” or “In another way” type categories could potentially be answered without a valid sex or gender, which would result in unusable data.
Purpose and trust
The views of participants about the purpose of the question(s), trust in the data users or uses and in data security and confidentiality, lead us to recommend consideration of: whether general census guidance is adequate to meet the need for information and reassurance participants said they required, in conjunction with the provision of question-specific guidance; requirements relating to census publicity and to the Census helpline in preparing the ground; and concerns about personal data going into the public domain after 100 years.
Government social surveys
The following points should be considered in assessing whether to take forward collection through government social surveys rather than (or as well as) the census. The issues regarding the validity and unacceptability of the 2011 “Sex” question suggest its continued use as a harmonised standard should be reviewed. Other implications of change would need to be managed: for example, relevance of questions to the specific survey topic; the complexity of survey systems that refer to the “Sex” variable; the current practices of interviewers in asking or recording a respondent’s sex; and methods that maintain a respondent’s privacy. Further development and testing would be required to introduce revised questioning on social surveys.
6. Within-household privacy, proxy response, prefer not to say and private response
The varied approaches to completing the individual sections of the census questionnaire taken within households – individually, collectively, personally and by proxy – have implications for the accuracy of data about sex and gender.
Within-household privacy
Cisgender participants had no concerns about their responses to questions being known to other household members, when each individual’s questions were answered in a single online or paper questionnaire. Trans participants varied as to whether they shared this view. Some indicated that they would be uncomfortable and may give answers they deemed to be socially desirable instead. This would result in an undercount of the trans population; of what extent we cannot say.
Proxy data collection
Views about proxy response were varied. There were participants in both the cisgender and trans groups who would be happy to answer sex and/or gender questions on behalf of others in their households, or to have their questions answered by others. However, there were also views against, on the basis of it being a person’s right to answer personal questions for themselves and because the answer might not be accurate.
Although there is potential for complaints to be made if respondents are unhappy that their questions have been answered by proxy without their consent, pragmatically the census can’t disallow proxy response without increasing item non-response to levels that would severely compromise data utility. The likelihood of thus undercounting the trans population should be explained to stakeholders.
”Prefer not to say” or similar response options
It is recommended that “prefer not to say” (or any other such category) not be included at questions unless there is strong justification from other evidence or opinion. Such categories would be likely to increase missing data, reducing data utility. Instead, responders can skip a question if they wish, or be forced to answer a mandatory question with a substantive category when that is critical to census processing and outputs. Decisions need to be made in light of question designs and the voluntary or mandatory status of questions. It should be acknowledged, however, that categories such as “Other” and “In another way” might be used by respondents instead and this would need to be dealt with in processing.
Private response (individual internet access codes or paper forms)
There were mixed views about the need for private response, its potential administration and likely effectiveness as a means of reducing socially desirable responses by trans people living in stealth, reducing the proportion of proxy response and lessening the need for “prefer not to say”.
Views in favour related to:
trans people with disclosure concerns thus being more able to answer accurately
it being more appropriate to today’s society that individuals respond for themselves (to all individual questions, not just sex and gender) especially in shared households
There were also views against the method of administration which would involve, including:
the burden of requesting a private response
the ability to request a private response being limited to the person completing the household section, which was deemed inappropriate
the arousal of suspicion this may cause
Serious consideration should be given to improving the method of administration of private response – not limiting the power to request it to one household member – to increase awareness of it within households and empower individuals, without drawing undue attention to themselves. Whether private response by default (for example, providing several individual codes or forms per address at first contact) is pragmatic or feasible might be questionable and could be constrained by technical considerations, costs and the need for one member of a household to be responsible for ensuring all members respond and to respond by proxy when they are unable or are unwilling personally.
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Article contents
Implications of queer theory for qualitative research.
- Boni Wozolek Boni Wozolek Penn State University, Abington College
- https://doi.org/10.1093/acrefore/9780190264093.013.735
- Published online: 26 April 2019
Queer theory is a tool that can be used to reconsider sociopolitical, historical, and cultural norms and values. Similarly, in qualitative research, queer theory tends to analyze the narratives of LGBTQ+ people and groups in ways that seek to queer everyday experiences. Both the theoretical framework and the narratives collected and analyzed in qualitative research are significant to unpacking business-as-usual in and across sociocultural contexts. This is especially true for systems of schooling, whereby LGBTQ+ people and groups are marginalized through schooling and schools, a process of exclusion that is detrimental to queer youth who are learning in spaces and places specifically designed against their ways of being and knowing. The significance of qualitative research as it meets the framework of queer theory is that it offers a practically and institutionally queered set of voices, perspectives, and understandings with which to think about the everyday in schools. This becomes increasingly important as schooling has historically been a place in which LGBTQ+ students and groups have resided at an intersection, where the sociopolitical and cultural marginalization that keeps the status quo in place crosses with contemporary values that both interrupt and reify such histories.
- Queer theory
- qualitative research
- educational histories
- and pedagogy
Introduction
In 1993 , Eve Kosofsky Sedgwick asked a genre-defining question: “What’s queer?” (p. 8). The complexity behind this inquiry has historical and contemporary implications, particularly as they intersect with educational contexts. Defining “queer” is a task wrought with sociocultural, political, and historical challenges, as Sedgwick and other queer theorists (e.g., Butler, 1990 ; Cohen, 1997 ; Lorde, 1984 ; Halberstam, 1998 ) have argued. For example, even among an open set of possibilities and perspectives that is central to wrestling with definitions, queer theory, and the research that is engendered by and through queerness are not immune to questions of colonization and of co-opting narratives in the name of political agendas that call for equity but narrow the terms under which access is available (Cohen, 1997 ).
The multiplicity of dimensions, differences, and similarities that constitute queerness, its forever-fluid identities and forms, and numerous scholarly lenses answer Sedgwick’s question as a productive knot of possibilities. Within this knot there is a sense of temporality imbued with potential (Muñoz, 2009 ) that reaches through fictional discourses (Butler, 1988 ) and is grounded in everyday challenges. Queer literature is often characterized by theories that press for more fluid “both/and” perspectives, attention to everyday practices and policies that impact queer and questioning peoples, and modes of qualitative research that focus on the methodological opportunities afforded by various constructions of “queering” research practices and possibilities.
Queer theory and its relationship to qualitative research is significant to higher education, sociocultural understandings, and experiences for marginalized populations in schools for at least the following three reasons. First, there is a question about what queerness means, a question that is often unpacked through sociohistorical, contemporary, and self-reflexive lenses. Queerness is therefore one possible way to think about scholarly fields and offer a particular kind of critique of academic understandings. Second, as cis-normative and heteronormative perspectives remain the status quo for norms and values in everyday school culture, queer theory put into practice through qualitative research can serve as a powerful tool with which to shift historical and contemporary understandings in schools and communities. This is an intentional move away from deficit models of queer youth. A moment when research can redefine the image of the wounded queer child and focus on questions of agency within the challenges queer youth face in schools (e.g., Brockenbrough, 2012 ; Carlson & Linville, 2016 ; Wozolek, 2018 ). Finally, because the consequences for such scholarship strongly inform the ways of being and knowing of marginalized youth in schools, implications for this work are similarly significant. In sum, queer theory is therefore not only important to the productive movement of qualitative research and education, but also to questions of equity and access for some of the most vulnerable youth living and learning in schools today.
This article begins by giving a brief historical outline of queer theory. This is important because, as is discussed in the section “ The Contours of Qual, Queer Theory, and Education ,” educational places and spaces are significant to the historical contexts that have informed the field. Next, the article briefly defines the contours of queer theory in qualitative research and education. Then there is an exploration into the implications of queer theory and qualitative research as it is resonant with education. This examination is carried out by specifically looking at three facets: the implications of queer theory for academic understandings, the impact of the field on schools and schooling, and the influence that such theories and ideas have on the everyday lives of students. Finally, the article discusses potential next steps for the field as it continues to act as a bloom space (Stewart, 2010 ) for affective ideas, ideals, and possibilities.
Queered Histories
Queer theory has a rich, longstanding history of voices and perspectives that consistently and continually seek to define, redefine, and trouble the boundaries and borders of its theoretical frameworks and the multiple fields they touch (e.g., Abelove, Barale, & Halperin, 1993 ; Butler, 1990 ; de Lauretis, 1991 ; Halberstam, 1998 , 2011 ; Hall, Jagose, Bebell, & Potter, 2013 ; Johnson, 2016 ; Johnson & Henderson, 2005 ; Sedgwick, 1993 ). In other words, queer theory was not ahistorical prior to 1991 , when Teresa de Lauretis coined the term and thus named the field. In fact, it can be argued that those scholars and scholarship that are widely regarded as foundational were retroactively brought under the umbrella of the burgeoning field now known as queer theory. In short, it was not queer theory but work about queer ways of being and knowing that underscored the field prior to its early nomenclature.
Part of the difficulty in defining queer theory as it relates to qualitative research is that there have always been queer voices in qualitative work. Regardless of what is formally discussed in terms of queer ways of being and knowing (e.g., Gilbert, 2014 ; Sedgwick, 1993 ), whether it is hidden cultures that exist with an undercurrent of queer voices (e.g., Kumashiro, 2002 ; Pinar, 1998 ), or that which is explicitly and implicitly silenced from heteronormative spaces (e.g., Brockenbrough, 2012 ; Lorde, 1984 ; Miller & Rodriguez, 2016 ), queer perspectives and voices have always been, and continue to be, present. Whether they do this, for example, through broad social behaviors in science (e.g., LeVay, 1996 ; Stein & Plummer, 1994 ), or the arts (e.g., Halberstam, 2005 ), queer ideas permeate scholarly fields. In short, a complex web of queer theory has always existed in the form of narratives across qualitative research.
Although these stories are central to the metanarratives of the field, they ultimately belong to people and groups that compose a counterculture that is steeped in sociopolitical challenges and successes. These histories exist across layers of scale, from individual voices to polyvocal cultural understandings (Bakhtin, 1981 ; Gershon, 2018 ). For example, within the United States, queer theory resonates, from Two-Spirit identities (Driskill, Finley, Gilley, & Morgensen, 2011 ) and Walt Whitman’s Leaves of Grass , to Emily Dickinson’s love poems and Audre Lorde’s essays (Bronski, 2012 ). It has roots that reach from the Mattachine Society, extend to the Stonewall Riots, and are enmeshed with the AIDS epidemic. It is a culture that lives in rock and roll, the glam of the 1970s, and the glitter of Studio 54. Although not always identified as “gay” at the time, these spaces opened the epistemological closet (Sedgwick, 1990 ) of queer ways of being into the places of heteronormative culture. While figures like David Bowie and nvironments like the discotheque were not always discussed in terms of queerness, it took a particular kind of heteronormative privilege not to see particular icons and places as having an eye toward the LGBTQ+ community.
Historically the policing of gender identity and expression and of sexual orientation has been a tool for privileging and maintaining cisgender, heterosexual, masculine norms and values (Bronski, 2012 ; Mogul, Ritchie, & Whitlock, 2011 ). Further, the controlling of queer people and places is rooted in white supremacy movements that continue to be, for example, colonial iterations used against indigenous groups (Driskill, Finley, Gilley, & Morgensen, 2011 ). Such cis-hetero hegemony also has historical recursions against Black bodies in the transatlantic slave trade (Tinsley, 2008 ) and iterations within the atrocities committed against LGBTQ+ people in the Holocaust (Plant, 1986 ). Finally, there are recurrences of racial and political stratification of queerness in urban spaces (Holmes, 2016 ). The normalized idea of queerness-as-illness has been used as a mechanism of control that was impacting people and groups well before the Diagnostic and Statistical Manual (DSM) characterized “homosexuality” under “paraphilia,” or transgender and gender-variant individuals as having a “disorder” (Boehmer, 2002 ; Shapiro & Powell, 2017 ). Attending to this marginalization is significant because, as scholars like Cohen ( 1997 ) have argued, without an attention to “shared experiences of oppression and resistance . . . to shape consciousness” (p. 459), queer politics can unintentionally reify the very ideals they are designed to interrupt.
As queer spaces and places disrupted the cis-hetero patriarchy, these events proliferated across scholarly dialogues. The destabilization of normalized ideas about sex, gender, and power existed across theoretical conversations (Butler, 1990 ; Foucault, 1978 ; Rubin, 1984 ), and resonated with qualitative inquiry that was rooted in sociocultural implications (Bersani, 1987 ; Lather & Smithies, 1997 ). In other words, as scholars read across contexts and understood everyday activism as having as much significance as theoretical understandings, qualitative frameworks were deeply impacted.
As Allen ( 2016 ) argues, “queer theorists arrived on our bookshelves only after we had already imbibed the political and poetic nectars of intellectual activism and intersectional politics offered by Black lesbian and gay poets, essayists, and scholars” (p. 35). One only needs to see the work of scholars like Laud Humphreys ( 1970 ), Patti Lather and Chris Smithies ( 1997 ), Tomás Almaguer ( 1991 ), and Ellen Lewin ( 1995 ) to understand how qualitative work was touched by multiple contexts and perspectives, and is driven by voices across sociocultural, political, and historical spaces. From Kushner’s Angels in America to Sylvia Wynter’s work on gender and diaspora, qualitative work has been strongly influenced by queer voices, from places of art to theoretical spaces.
From the contours of the cartography of queer theory emerged two questions that have reverberated, as Gershon ( 2018 ) might argue, from historical ideals to contemporary concerns about the field. They are: “What can queer theory do?” and “How does queer theory exist?” As has been explored, queer theory exists across fields in part because of the epistemological and ontological closet that was constructed for the physical and emotional safety of LGBTQ+ people and groups. Additionally, the multiplicity of fields that are layered within queer theory occur because, as many scholars have argued (e.g., Allen, 2016 ; Almaguer, 1991 ; Lorde, 1984 ; Plant, 1986 ), “queer” is an idea that traverses the boundaries and borders of sociocultural precepts. It is important to note that while Cohen’s ( 1997 ) call for intersectional dialogue is now over 20 years old, it is often because of the multiple fields that queer theory touches that intersectional conversations tends to break into the camps of identity politics. For example, there are scholars who focus on black queer feminists (Carruthers, 2018 ; hooks, 1989 ), black queer masculinities (Alexander, 2006 ; Ferguson, 2004 ), queer LatinX studies (Hames-García & Martínez, 2011 ), Latinx studies (Cashman, 2018 ), and transgender studies (Stryker & Whittle, 2006 ), to name but a few. To be clear, exploring the multiple pieces of the assemblage that constitutes any person or group (Puar, 2007 ; Weheliye, 2014 ) is significant and vital to disrupting normalized understandings while honoring the intimate details that are central to one’s way of being. One only needs to think about the consistent and often deadly violence used against transwomen of color to realize just how vital these discussions are to disrupting the aggressions that land physically and affectively on particular, and in many cases intentionally targeted, bodies and minds. However, while there is significance in solidarity, it is equally important to attend to the ways that identity politics can further marginalize people and groups.
With regard to the question of “what can queer theory do?,” one possible answer can be found in the helping professions that have used this field as a tool to disrupt normalized understandings about sex, sexual orientation, and gender, as well as gender identities and expressions (Case & Lewis, 2012 ; Logie, Bridge, & Bridge, 2007 ; Rubin, 1984 ). As these helping professions tend to exist in parallel play with education, it is no surprise then that the development of queer theory in qualitative work would seep into educational spaces and places. Although these professions and contexts have deeply informed qualitative research, this article will now build on that history to show what queer theory can do as it intersects with qualitative research and schooling. Such work has deep implications for students as they live, learn, and “be” in schools. As academics think about the multiple spaces of possibility (Helfenbein, 2010 ) for these fields, there may be few concerns more pressing than the physical and emotional safety of students.
The Contours of Qual, Queer Theory, and Education
As cis-hetero violence against LGBTQ+ people and groups across contexts continues unabated, qualitative research has become one possible tool with which to disrupt the normalized aggressions suffered by queer communities. One of the central ways that queer theory interrupts or inverts status quo understandings is by normalizing that which was previously considered to be abnormal. Because qualitative research has a strong history of making the familiar strange and the strange familiar (Spindler & Spindler, 1982 ), its entanglements with queer theory imbue these fields with a reflexive eye (Lather, 1986 ) toward lived experiences in general and queer lives in specific. Queer theory as a theoretical framework in qualitative research engages scholarship in at least the following ways. First, in her discussion of ethnographic work and Spivak’s discussion ( 1988 ) of the subaltern, Ortner ( 2006 ) argues that “Spivak arrives at what any good ethnography provides: an understanding of both the meaning and the politics of the meaning of an event” (p. 60). This quality is not unique to ethnographic work and is central to strong qualitative scholarship (e.g., Brown, 2006 ; Connelly & Clandinin, 1990 ; Mehan, 2000 ). Given queer theory’s imbrication with sociohistorical politics, Halberstam ( 2011 ) writes that queer theory similarly engages in Spivak’s ( 1988 ) attention to the politics of refusal through queerness. This is an attention to the many ways that queerness resists norms and values, often as an engagement in the resistance of political ideas and ideals. In sum, queer theory functions within the lines of qualitative research as a means to disrupt normalized ideals through an attention both to the event and the underlying understandings that are central to that event as it occurs, and to the analysis of what has happened. This is especially important as qualitative research is historically marked by colonizing projects that could potentially reify normalized understandings (e.g., Boas, 1888 ; Hewitt, 1903 ; Mead, 1928 ). While contemporary qualitative work attends to these histories and seeks to disrupt them in current iterations (e.g., Behar & Gordon, 1995 ; Gershon, 2018 ; Parker & Lynn, 2002 ), early- 21st-century queer theory as it is imbricated with qualitative research can be a powerful tool for the interruption of White, cis-hetero patriarchal ideas and ideals.
Second, qualitative work inherently responds to the multiplicity of experiences and associated ways of being that are formed, destroyed, patched together, affirmed, and troubled by those experiences. Whether it is abductive, deductive, or inductive reasoning (Agar, 1996 ) that builds the analysis, qualitative research exists in the vulnerability of experiences (Behar, 1996 ). Queer theory used within qualitative scholarship opens what Sedgwick ( 1993 ) discusses as the “open mesh of possibilities, gaps, overlaps, dissonances and resonances, lapses and excesses of meaning . . . that are made, or can’t be made” (p. 8) in these experiences. To be clear, strong qualitative research tends to be fluid in its analysis of epistemological and ontological understandings. This engagement with fluid possibilities is only buttressed through a queer lens that has a longstanding history of being explicit in its fluid tendencies.
Finally, it should be noted that queer theory in qualitative research tends to be both a space of potential political action (Carlson, 1998 ) and a reflection on sociocultural norms and values. This is true across contexts, from the explicit autobiographical study of sexual encounters as an antiracist analysis of power (Reid-Pharr, 2013 , p. 213) to archival research that focuses on queerness and postcolonial studies as a point of analysis and of disruption to educational structures (Coloma, 2006 ). For example, Lather and Smithies’s ethnography ( 1997 ) ethnography in many ways humanized HIV/AIDS during a time when women’s stories were largely invisible in the epidemic and overshadowed by the cognitive divorce with these narratives often caused by the quantitative tracking of the disease at the time. Similarly, in schools, researchers like Love ( 2017 ), Dumas and Nelson ( 2016 ), and Meyer, Tilland-Stafford, and Airton ( 2016 ) have used qualitative methods and queer theory to disrupt normalized ideas and ideals of schooling and academic spaces.
The map of qualitative research in schooling is formed in the classrooms, corridors, and coffins (Wozolek, Wootton, & Demlow, 2016 ) that often constitute the context of education for LGBTQ+ youth. To read this map is to perform an analysis of sociocultural and historical norms as they intersect with the everyday experiences of schooling. This is because education is inherently impacted by broader social ideas and ideals. From Mary McLeod Bethune’s article ( 1938 ) arguing for the inclusion of marginalized voices in the curriculum to Jack Halberstam’s discussion ( 2011 ) that explicates ideals of success in terms of their negative impacts on children, a longstanding dialogue exists across intellectual traditions and fields that focuses on the multiple ways in which sociocultural norms and values affect marginalized student populations.
The history of queer theory is exceptionally significant to education because the historical marginalization and victimization of people and groups based on queerness is the same move that is often used to publicly and privately despoil the queer energies of LGBTQ+ youth in schools (Sedgwick, 1993 ). The erasure of queer perspectives from formal curricula is but one example of how queer counter-narratives are explicitly not taught in schools. This null curriculum, or what is left out of formal lessons (Eisner, 1985 ) impacts the hidden curriculum, or the broader school culture and the lessons students learn through simply being at school (Giroux & Penna, 1983 ), by teaching both queer and straight students that at best LGBTQ+ narratives are insignificant and, at worst, a problem. Just as the AIDS epidemic stigmatized queerness, and in particular black male queerness (Bailey, 2016 ; Brockenbrough, 2016 ), AIDS is often discussed inaccurately and with little reference to LGBTQ+ history as a part of the STD/STI health curriculum in schools (Casemore, 2010 ; Gilbert, 2010 ; Sandlos, 2010 ). Further, the accomplishments and cultural contributions of LGBTQ+ identifying people and groups is largely left out of the curriculum across courses, from literature to the sciences (Gilbert, 2014 ; Quinn & Meiners, 2009 ).
These absences not only affect straight, cisgender students but also have a notable impact on LGBTQ+ youth. As the rates of self-harm and suicide continue to rise among queer youth (Kosciw, Greytak, Bartkiewicz, Boesen, & Palmer, 2010 ), the role of curricular absences (Pascoe, 2007 ; Sears, 1992 ), along with the discipline policies that disproportionally impact LGBTQ+ students (Mayo, 2014 ; McCready, 2007 ), and the continued normalization of transphobic and homophobic values in schools (Pinar, 1998 ; Whitlock, 2013 ) have become central concerns in scholarly dialogues. Additionally, the challenges that LGBTQ+ students face in K–12 classrooms and corridors does not exist in a vacuum and, as scholars like Miller and Rodriguez ( 2016 ) have argued, universities and communities are similarly impacted by the cis-hetero patriarchy.
Queer theory as it relates to qualitative research has been central to the interruption of LGBTQ+ youth marginalization. This disruption is multifaceted across schools and systems of schooling. Broadly discussed, at the K–12 level there is attention to the successes of LGBTQ+ youth in schools (e.g., Renn & Bilodeau, 2005 ); schooling as a safe space (Griffin, Lee, Waugh, & Beyer, 2004 ; Weems, 2010 ); queer students’ responses to oppression (e.g., Grossman, Haney, Edwards, Alessi, Adron, & Howell, 2009 ); violence against LGBTQ+ students of color (e.g., Cruz, 2011 ; Blackburn & McCready, 2009 ); the challenges and successes of Genders and Sexualities Alliances (Tierney & Dilley, 1998 ; Watson, Varjas, Meyers, & Graybill, 2010 ; Wozolek, Varndell, & Speer, 2015 ); as well as scholarship focused on queer teacher’s experiences (e.g., Endo, Reece-Miller, & Santavicca, 2010 ; Kissen, 1996 ). Within the lens of teacher preparation, there are dialogues about anti-homophobic and anti-transphobic teacher training at both the K–12 and teacher-education levels (e.g., Gorski, Davis, & Reiter, 2013 ; O’Malley, Hoyt, & Slattery, 2009 ; Payne & Smith, 2011 ); the creation of anti-oppressive pedagogy (Kumashiro, 2002 ) that rethinks the normalization of classrooms as cis-straight-only spaces (e.g., Anyon, 2008 ; Letts & Sears, 1999 ; Sweet & Carlson, 2017 ); and the queering of normalized academic understandings (e.g., Britzman, 1995 ; Kumashiro, 2001 ). To be clear, these examples are broad categories that define the contours of queer qualitative work. As Pinar ( 1998 ) discusses, this kind of work is historically situated and continues to proliferate in ways that make it impossible to name all the studies or completely articulate the significance of each scholar’s contribution. What is important to remember is that as qualitative researchers continue to tell these stories, they can become both a collective and corrective counter-narrative against the cis-hetero patriarchy in schools.
Qualitative research as it relates to systems of schooling, schools, and queerness is, as discussed, multifaceted in its dialogues. Additionally, the underlying provocation of queerness positions scholars to use “new narrative forms to enfranchise new relational modes” (Gilbert, 2014 , p. xxi) in classrooms and corridors. This is important because schooling is designed to reify sociocultural norms and values concerning “intersecting dynamics of sexuality, gender, social class, race, bodies” (Pascoe, 2007 , p. 3) as well as other ontological and epistemological ideals that are socially constructed. Although it has been 20 years since Bill Pinar ( 1998 ) articulated the necessity of queer theory in educational spaces as a form of resistance in the “highly conservative and highly reactionary field” (p. 2) of education, schools continue to be places where the physical and emotional safety of queer children is at risk. A response to the oppressive systems of schooling that created a context of harm for LGBTQ+ youth has been narratives that tend toward reflexivity, in both the self and social senses. This reflexivity constructs what Miller ( 1998 ) discusses as stories that make up the body of a queer curriculum. Such curricular forms are essential as they question the establishment and reification of hetero-masculine ways of being and knowing in current curricular models.
As this research continues to question what is, and envision what might be for students in schools, it has the potential to impact local, and less local, policies and practices. This is critical, as normalized oppression within these policies continually affects LGBTQ+ youth. For example, a topic of debate in the early 21st century across the United States is centered on how trans and gender queer youth are directly targeted through anti-inclusive policies regarding their ability to use the bathroom that aligns with their individual identities, rather than with the gender they were assigned at birth. Research and scholarship that focuses on how these policies have impacted trans and gender-fluid students along with their cis-gendered peers has a potential to influence how these policies get enacted in schools.
Finally, it is important to discuss how qualitative scholars have used queer theory in educational research as a means to begin and continue vital intersectional dialogues that attend to the complex assemblages that are students’ ways of being and knowing. Whether it is queering ideals of black girlhood (Love, 2012 ), reimagining of black boyhood (Dumas & Nelson, 2016 ), or empirical analysis of LGBTQ+ urban youth (Blackburn & McCready, 2009 ), qualitative research focused on queer people of color is significant in its reconsidering of identities in schooling. Everyday moments of being and becoming what Hucks ( 2016 ) refers to as an “intersectional warrior” in educational spaces are as much about fighting aggressions focused on race as they are about hostilities concerning queerness. The scholarship that attends to this everyday oppression within the double bind of queerness and race is central to building a counter-narrative against whiteness as it is further privileged by cis-hetero normalization.
While the work of qualitative educational researchers who queer systems of schooling through their scholarship has been instrumental in questioning heteronormative, business-as-usual in schools, it should be noted that this body of work is not without critique. Talburt and Rasmussen ( 2010 ) argue that educational research and the “queer project . . . follows certain traditions that often tethers itself to limited . . . imaginings of a need for a ‘subject’ of queer research and particular ideas of educational and political progress” (p. 1). Scholars have similarly called for the interruption of queerness as “representational vocabulary that simultaneously stabilizes and destabilizes” (Talburt & Rasmussen, 2010 , p. 3) through a post-queer lens that seeks to challenge the categories that have pervaded LGBTQ+ research (Gilbert, 2014 ; Noble, 2006 ; Sears, 2009 ; Talburt & Rasmussen, 2010 ).
The post-queer turn is significant in that it seeks to move away from queerness-as-usual, a vision of queer in schools that often attends more to sexual orientation, gender identity, and expression than the queering of ideas, ideals, and norms (Noble, 2006 ; Sears, 2009 ). However, as Noble ( 2006 ) argues, like most post-movements, such turns toward the post often reify the very norms they are meant to interrupt while setting up a pre-post binary that, particularly in queer literature seeking to move away from binaries, limits queer imaginings.
It is also significant to note that qualitative research focused on schooling and queerness often talks about space and place, but with little reference to critical geography. Further, the imaginings of the queer body as a space and place of possibility also misses the inclusion of critical geography as it meets affective dialogues. Such geography includes images of mapping the body and sexuality. This is one potential future direction of the field because, as scholars like Tuan ( 1977 ) and Massey ( 2005 ) have argued, dialogues about space and place are necessarily about questions of identities, multiplicity, ontologies, epistemologies, and fluidity. These fields not only resonate with each other but can serve to further complicate the valuable conversations that take place in schools around bodies, genders, sexualities, policies, practices, and being.
Queer theory has a longstanding history that began well before the conception of the field. Its iterations have significantly troubled sociocultural norms and values in ways that have been instrumental in the reconsideration of normalized policies and practices. In academic work, this scholarship has been helpful in the dismantling of the cis-hetero patriarchy that has been normalized across academic spaces, from the buildings that represent the academy to the dialogues that embody scholarly thought. Queer theory has historically, politically, and interpersonally opened up a “mesh of possibilities” (p. 8), as Sedgwick ( 1993 ) argues, within academic spaces.
In schools, queer theory as a lens through which qualitative research is carried out and analyzed is a powerful tool against hegemonic influences that seek to continually marginalize LGBTQ+ youth. This is important because the everyday of schooling is designed to disenfranchise specific populations. This sociopolitically enacted exclusion crashes affectively on the bodies and beings of LGBTQ+ youth. As has been well documented, these affective encounters tend to emerge and materialize through acts of self-harm and suicide. Although theorists and concerned educators who deal with the untimely death of LGBTQ+ youth alike are often arrested by wondering when one more incident of exclusion will be one too many, scholars have queered this focus and re-centered the dialogue around the idea that one is always too many. One death, one cut, one time holding in urine, one gay-bashing, one curriculum absent of queer voices, one oppressive pedagogy. One is always too many. The implication for queer theory in qualitative research in education is not only a disruption of these “ones,” but a call for attention to the historical, contemporary, political, and sociocultural ideas and ideals that engendered and maintained them so that they are the everyday of schooling.
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Institutional violence perpetrated against transgender individuals in health services: a systematic review of qualitative studies.
![ORCID qualitative research questions about gender](https://pub.mdpi-res.com/img/design/orcid.png?0465bc3812adeb52?1724334283)
1. Introduction
2. materials and methods, 4. discussion, 4.1. refusal of care, 4.2. resistance to the use of social names and pronouns, 4.3. barriers to accessing health services, 4.4. discrimination and stigma, 4.5. insensitivity of healthcare workers, 4.6. lack of confidence in healthcare services, 4.7. technological limitations relating to the binary-focused system, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.
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Click here to enlarge figure
Acronym Application | Descriptors Found | |
---|---|---|
P | Transgender persons | “transgender persons”, “transgender person”, transgender, transvestisme, “sexual and gender minorities”, transvestism, “gender dysphoria”, transfeminine, “trans-Feminine”, transmasculine, “trans-Masculine”, transexual *, transsexual *, “trans people”, “trans person”, “transgender individuals”, trans |
I | Violence | violence, “gender violence”, “gender-based violence”, “interpersonal violence”, “interpersonal violences”, “physical attack” |
Co | Health services | “health services”, “health care services”, “healthcare services”, “health facilities”, “health care facilities”, “healthcare facilities”, “primary health care”, “primary Care”, “primary healthcare”, “secondary care”, “secondary cares”, “tertiary healthcare”, “tertiary care”, “care center”, “health services for transgender persons”, “health services accessibility”, “transgender care”, “transinclusive care”, “sexual health”, hospital * |
Base | Adapted Search Strategy |
---|---|
MEDLINE | (“transgender persons” [All Fields] OR “transgender person” [All Fields] OR (“transgender persons” [MeSH Terms] OR (“transgender” [All Fields] AND “persons” [All Fields]) OR “transgender persons” [All Fields] OR “transgender” [All Fields] OR “transgendered” [All Fields] OR “transgenders” [All Fields]) OR “transvestisme” [All Fields] OR “sexual and gender minorities” [All Fields] OR (“transvestic” [All Fields] OR “transvestism” [MeSH Terms] OR “transvestism” [All Fields]) OR “gender dysphoria” [All Fields] OR “transfeminine” [All Fields] OR “trans-Feminine” [All Fields] OR “transmasculine” [All Fields] OR “trans-Masculine” [All Fields] OR “transexual *” [All Fields] OR “transsexual *” [All Fields] OR “trans people” [All Fields] OR “trans person” [All Fields] OR “transgender individuals” [All Fields] OR “trans” [All Fields]) AND (“violence” [MeSH Terms] OR “violence” [All Fields] OR “violence s” [All Fields] OR “violences” [All Fields] OR “gender violence” [All Fields] OR “gender-based violence” [All Fields] OR “interpersonal violence” [All Fields] OR (“violence” [MeSH Terms] OR “violence” [All Fields] OR (“interpersonal” [All Fields] AND “violences” [All Fields])) OR “physical attack” [All Fields]) AND (“health services” [All Fields] OR “health care services” [All Fields] OR “healthcare services” [All Fields] OR “health facilities” [All Fields] OR “health care facilities” [All Fields] OR “healthcare facilities” [All Fields] OR “primary health care” [All Fields] OR “primary Care” [All Fields] OR “primary healthcare” [All Fields] OR “secondary care” [All Fields] OR “secondary cares” [All Fields] OR “tertiary healthcare” [All Fields] OR “tertiary care” [All Fields] OR “care center” [All Fields] OR “health services for transgender persons” [All Fields] OR “health services accessibility” [All Fields] OR “transgender care” [All Fields] OR “transinclusive care” [All Fields] OR “sexual health” [All Fields] OR “hospital*” [All Fields]) |
Scopus | TITLE-ABS-KEY (“transgender persons” OR “transgender person” OR transgender OR transvestisme OR “sexual and gender minorities” OR transvestism OR “gender dysphoria” OR transfeminine OR “trans-Feminine” OR transmasculine OR “trans-Masculine” OR transexual * OR transsexual * OR “trans people” OR “trans person” OR “transgender individuals” OR trans) AND TITLE-ABS-KEY (violence OR “gender violence” OR “gender-based violence” OR “interpersonal violence” OR “interpersonal violences” OR “physical attack”) AND TITLE-ABS-KEY (“health services” OR “health care services” OR “healthcare services” OR “health facilities” OR “health care facilities” OR “healthcare facilities” OR “primary health care” OR “primary Care” OR “primary healthcare” OR “secondary care” OR “secondary cares” OR “tertiary healthcare” OR “tertiary care” OR “care center” OR “health services for transgender persons” OR “health services accessibility” OR “transgender care” OR “transinclusive care” OR “sexual health” OR hospital *) |
EMBASE | #1 ‘transgender persons’/exp OR ‘transgender persons’ OR ‘transgender person’/exp OR ‘transgender person’ OR ‘transgender’/exp OR transgender OR transvestisme OR ‘sexual and gender minorities’/exp OR ‘sexual and gender minorities’ OR ‘transvestism’/exp OR transvestism OR ‘gender dysphoria’/exp OR ‘gender dysphoria’ OR transfeminine OR ‘trans-feminine’ OR transmasculine OR ‘trans-masculine’ OR transexual * OR transsexual * OR ‘trans people’/exp OR ‘trans people’ OR ‘trans person’/exp OR ‘trans person’ OR ‘transgender individuals’ OR trans #2 ‘violence’/exp OR violence OR ‘gender violence’/exp OR ‘gender violence’ OR ‘gender-based violence’/exp OR ‘gender-based violence’ OR ‘interpersonal violence’/exp OR ‘interpersonal violence’ OR ‘interpersonal violences’ OR ‘physical attack’ #3 ‘health services’/exp OR ‘health services’ OR ‘health care services’ OR ‘healthcare services’ OR ‘health facilities’/exp OR ‘health facilities’ OR ‘health care facilities’ OR ‘healthcare facilities’ OR ‘primary health care’/exp OR ‘primary health care’ OR ‘primary care’/exp OR ‘primary care’ OR ‘primary healthcare’/exp OR ‘primary healthcare’OR ‘secondary care’/exp OR ‘secondary care’ OR ‘secondary cares’ OR ‘tertiary healthcare’/exp OR ‘tertiary healthcare’ OR ‘tertiary care’/exp OR ‘tertiary care’ OR ‘care center’ OR ‘health services for transgender persons’/exp OR ‘health services for transgender persons’ OR ‘health services accessibility’/exp OR ‘health services accessibility’ OR ‘transgender care’ OR ‘transinclusive care’ OR ‘sexual health’/exp OR ‘sexual health’ OR hospital* #4 #1AND #2 AND #3 #5 #4AND [embase]/lim |
Web of Science | “transgender persons” OR “transgender person” OR transgender OR transvestisme OR “sexual and gender minorities” OR transvestism OR “gender dysphoria” OR transfeminine OR “trans-Feminine” OR transmasculine OR “trans-Masculine” OR transexual * OR transsexual* OR “trans people” OR “trans person” OR “transgender individuals” OR trans (Topic) and violence OR “gender violence” OR “gender-based violence” OR “interpersonal violence” OR “interpersonal violences” OR “physical attack” (Topic) and “health services” OR “health care services” OR “healthcare services” OR “health facilities” OR “health care facilities” OR “healthcare facilities” OR “primary health care” OR “primary Care” OR “primary healthcare” OR “secondary care” OR “secondary cares” OR “tertiary healthcare” OR “tertiary care” OR “care center” OR “health services for transgender persons” OR “health services accessibility” OR “transgender care” OR “transinclusive care” OR “sexual health” OR hospital* (Topic) |
CINAHL | (“transgender persons” OR “transgender person” OR transgender OR transvestisme OR “sexual and gender minorities” OR transvestism OR “gender dysphoria” OR transfeminine OR “trans-Feminine” OR transmasculine OR “trans-Masculine” OR transexual* OR transsexual* OR “trans people” OR “trans person” OR “transgender individuals” OR trans) AND (violence OR “gender violence” OR “gender-based violence” OR “interpersonal violence” OR “interpersonal violences” OR “physical attack”) AND (“health services” OR “health care services” OR “healthcare services” OR “health facilities” OR “health care facilities” OR “healthcare facilities” OR “primary health care” OR “primary Care” OR “primary healthcare” OR “secondary care” OR “secondary cares” OR “tertiary healthcare” OR “tertiary care” OR “care center” OR “health services for transgender persons” OR “health services accessibility” OR “transgender care” OR “transinclusive care” OR “sexual health” OR hospital*) |
LILACS | (“transgender persons” OR “transgender person” OR transgender OR transvestisme OR “sexual and gender minorities” OR transvestism OR “gender dysphoria” OR transfeminine OR “trans-Feminine” OR transmasculine OR “trans-Masculine” OR transexual* OR transsexual* OR “trans people” OR “trans person” OR “transgender individuals” OR trans OR “pessoas transgênero” OR “pessoa transgênero” OR transgênero OR travestismo OR “minorias sexuais e de gênero” OR “disforia de gênero” OR transfeminino OR “trans-Feminino” OR transmasculino OR “trans-Masculino” OR transexual* OR “pessoas trans” OR “pessoa trans” OR “indivíduos trans” OR “personas transgénero” OR “persona transgénero” OR transgénero OR travestismo OR “minorías sexuales y de género” OR “disforia de género” OR transfemenino OR “persona trans” OR “individuos transgénero”) AND (violence OR “gender violence” OR “gender-based violence” OR “interpersonal violence” OR “interpersonal violences” OR “physical attack” OR violência OR “violência de gênero” OR “violência interpessoal” OR “violências interpessoais” OR “ataque físico” OR violencia OR “violencia de género” OR “violencia interpersonal” OR “violencias interpersonales”) AND (“health services” OR “health care services” OR “healthcare services” OR “health facilities” OR “health care facilities” OR “healthcare facilities” OR “primary health care” OR “primary Care” OR “primary healthcare” OR “secondary care” OR “secondary cares” OR “tertiary healthcare” OR “tertiary care” OR “care center” OR “health services for transgender persons” OR “health services accessibility” OR “transgender care” OR “transinclusive care” OR “sexual health” OR hospital* OR “serviços de saúde” OR “estabelecimentos de saúde” OR “cuidados de saúde primários” OR “cuidados secundários”or “cuidados de saúde terciários” OR “cuidados terciários” OR “centro de cuidados” OR “serviços de saúde para pessoas trans” OR “acessibilidade aos serviços de saúde” OR “atendimento a transgêneros” OR “atendimento transinclusivo” OR “atendimento sexual saúde” OR “servicios de salud” OR “servicios de atención médica” OR “centros de salud” OR “centros de atención médica” OR “atención primaria de salud” OR “atención primaria” OR “ atención secundaria” OR “atención médica terciaria” OR “atención terciaria” OR “centro de atención” OR “servicios de salud para personas transgénero” OR “accesibilidad a servicios de salud” OR “atención a personas transgénero” OR “atención transinclusiva” OR “atención sexual salud”) AND (db:(“LILACS”)) |
ID | Author/Year of Publication/Journal/Country | Study Objective | Place of Study/Participants | Data Collection/Data Analysis | Main Findings |
---|---|---|---|---|---|
A1 [ ] | Xavier et al./2013/International Journal of Transgenderism/USA | Identify the factors associated with greater risk of HIV infection and the principal social determinants of health status among transgender people in Virginia. | Virginia, USA/32 trans women and 15 trans men participated of the study | Seven focus groups and one individual interview were conducted/Initial descriptive coding was performed separately on the transcriptions line by line using NVivo 2.0 software | Victimization associated with social stigmatization played a dominant role in participants’ lives, manifested by discrimination; violence; and health care provider insensitivity, hostility, and ignorance of transgender health. Access to transgender-related medical services that would allow for participants to pass in their chosen genders was their highest medical priority. Faced with barriers to access, hormonal self-medication was common, and silicone injections were reported by both MtF and FtM participants. Due to economic vulnerability, sex work was reported as a source of income by both MtFs and FtMs. MtFs expressed concern over confidentiality of HIV testing and additional discrimination if testing positive. FtMs expressed difficulty accessing gynecological care due to their masculine gender identities and expressions. |
A2 [ ] | Kosenko et al./2013/Medical Care/USA | To explore the negative experiences of transgender individuals in health care settings. | USA/152 self-identified transgender adults from 40 different states and 2 foreign countries participated. | Data collected in 2010 as part of an IRB-approved needs assessment of transgender adults. Questionnaire completed online and through mailings to LGBTQ organizations/Data were collected and analyzed according to Morse and Field’s conventional qualitative content analytic approach. | Participants reported mistreatment in health care contexts due to gender identity or presentation. Problematic provider behaviors included gender insensitivity, displays of discomfort, denial of services, substandard care, verbal abuse, and forced care. |
A3 [ ] | Lyons et al./2015/Substance Abuse Treatment, Prevention and Policy/Canada | Qualitatively investigate the treatment experiences of transgender individuals using illicit drugs in a residential dependency setting in a Canadian environment. | Vancouver, Canada/34 transgender people participated. | In-depth semi-structured interviews were conducted/The interviews were transcribed verbatim and imported into Atlas.ti software (version 8.3.0.)/Theoretical thematic analysis and a participatory analysis approach were applied | Three themes emerged from the data characterizing individuals’ experiences in treatment settings: (1) stigma enacted through social rejection and violence, (2) felt transphobia and stigma, and (3) “trans-friendly” and inclusive treatment. Participants who reported feeling and experiencing stigma, including violence, prematurely left the treatment after experiencing isolation and conflicts. In contrast, participants who felt included and respected in the treatment settings reported positive treatment experiences. |
A4 [ ] | Souza et al./2015/Cadernos de Saúde Pública/Brazil | The article discusses the violence experienced by transvestites (in the family, school, police precincts, and health services), specifically seeking to understand how such violence relates to their experiences with health services and how the latter respond. | Rio Grande do Sul, Brazil/49 transvestites participated | The authors conducted an ethnographic research with transgender persons in Santa Maria, Rio Grande do Sul State, Brazil, in 2012, using participant observation, semi-structured interviews, and following their everyday lives/The observations and narratives that emerged from the field were transcribed, coded, thematically categorized, and compared with theoretical concepts from gender studies, violence studies, and the field of public health. | The various forms of violence experienced by transgender women throughout their lives directly interfere with their health conditions. Besides distancing them from their nuclear families and kinship relations, thereby removing material support and emotional connections, it also pushes them away from schools and health services, which, as we have seen, replicate violence, contributing to their suffering. The physical and symbolic violence and the resulting suffering were constants that participants had to deal with in their daily practices and routines. |
A5 [ ] | Lyons et al./2016/LGBT Health/Canada | Investigate the experiences of trans women and Two-Spirit people in accessing women-specific services in the Downtown Eastside of Vancouver. | Vancouver, Canada/32 trans women and two-spirit individuals participated. | In-depth semi-structured interviews were conducted/The interview data were analyzed using a participatory and inductive analysis approach. | Participants generally managed to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., the requirement for a feminine gender expression), and lack of staff intervention in the harassment by other service users. |
A6 [ ] | Ritterbusch; Salazar; Correa/2018/Global Public Health/Colombia | Present the stigma-related barriers to healthcare experienced by trans women and their experiences of multi-level violence within the healthcare system. | Colombia/28 transgender women participated | Semi-structured interviews were conducted within a participatory action research framework/The interviews were coded using a grounded theory approach. | Trans women experience violence at various levels, from intimate bodily violence to the formulation of high-level public health policies. |
A7 [ ] | Samuels et al./2018/Annals of Emergency Medicine/USA | To understand the experiences of transgender adults with at least one emergency department visit in the past 5 years and identify barriers and suggestions for improving emergency care for this population. | Oregon, USA/32 transgender adults participated in 4 focus groups, with most participants being white, preferring male pronouns, and identifying as female to male, transgender, or male. | Focus group discussions facilitated by the study principal investigator and another research team member, lasting approximately 2 h and recorded digitally/Transcripts were professionally transcribed, identified, and analyzed using qualitative data management software (NVivo). | Experiences of harassment and assault were common among participants, with the majority experiencing verbal harassment, physical assault, and sexual assault. While most had a primary care provider and insurance, only a small percentage had insurance plans covering sex affirmation or reassignment health services. Nearly half reported avoiding the emergency department when in need of acute care. |
A8 [ ] | Monteiro; Brigeiro/2019/Cadernos de Saúde Pública/Brazil | Analyzing the access experience of trans/transvestite women to the healthcare service. | Baixada Fluminense, Rio de Janeiro, Brazil/9 trans/transvestite women participated. | Individual and semi-structured interviews were conducted with trans women/transvestites from lower-income backgrounds in Baixada Fluminense, Rio de Janeiro. | Comparing to past experiences of aggression, narratives from trans women/transvestites highlight social advancements. They report that professionals generally do not discriminate based on their condition, though there is resistance to using their preferred name. |
A9 [ ] | King et al./2019/Culture, Health & Sexuality/Uganda | Exploring HIV and gender-related contexts among transgender women. | Kampala, Uganda/45 trans/transvestite women participated | Computer-assisted self-interviews, in-person qualitative interviews, and HIV and CD4 blood tests were conducted. Recruitment occurred through snowball sampling/Quantitative interviews utilized Questionnaire Design Studio (QDS v2.5). Trained qualitative social scientists coded and analyzed transcripts using NVivo Version 11 for data management, employing content analysis. | Nearly all interviewees reported frequently engaging in sex work, primarily due to lack of employment. HIV-related themes included limited access to non-stigmatizing health services, inconsistent condom use, inaccurate perceptions of risk for themselves and their partners, alcohol use, receptive anal sex with men, multiple sexual partners, frequent self-stigma, and enacted violence. |
A10 [ ] | Goldenberg et al./2019/The Counseling Psychologist/USA | Understanding the mental health experiences and healthcare of participants, including factors related to gender misalignment and less affirmative treatment by providers. | USA/506 transgender undergraduate and graduate students participated in the study. | It is a mixed methods study involving an online questionnaire with both open-ended and closed-ended questions. Thematic analysis was employed in the qualitative phase. | The prominent characteristics of negative interactions included invalidation, avoidance, or excessive focus on participants’ non-binary identities. Non-binary students reported more gender misidentifications by therapists and healthcare professionals, and less trans-affirmative care from healthcare providers, compared to binary students. |
A11 [ ] | Dutta; Khan; Lorway/2019/Culture, Health & Sexuality/India | Describing the effects of overlapping forms of structural violence around education, livelihood, family life, and attempts to access social and healthcare services. | Karnataka, India/3 transgender people participated. | Ethnographic research was conducted using thematic interpretative analysis and inductive reasoning. | The findings indicate how social inequalities contribute to the development of transgender identities along the journey to becoming a “jogappa”. They emphasize the evolving needs of transgender individuals in India, which are rooted in moral narratives of religiosity, urging policymakers to take these diverse needs into account. |
A12 [ ] | Calderón-Jaramillo et al./2020/International Journal for Equality in Health/Colombia | Identifying the primary sexual and reproductive health needs of individuals living a trans life; generating new evidence to guide the adaptation of sexual and reproductive health services centered on the needs, identities, and circumstances of trans people. | Barranquilla, Bogota, Cali and Medellín, Colombia/13 transgender people participated. | Focus group discussions and in-depth interviews were conducted for a qualitative study from a constructivist perspective. NVivo software was utilized for data coding and analysis. | Among the main barriers encountered were healthcare costs, lack of insurance, stigma, discrimination, and abuse by healthcare professionals. Some of the most notable sexual and reproductive health needs included trans-specific services, such as sensitive assistance for the transition process, endocrinology consultations, and sexual affirmation surgeries. |
A13 [ ] | Silva et al./2020/Revista Brasileira de Enfermagem/Brazil | Analyzing the health vulnerability of young transgender women living with HIV/AIDS. | Recife, Pernambuco, Brazil/6 transgender women participated. | Semi-structured interviews were conducted for a qualitative, descriptive, and exploratory study grounded in the theoretical framework of Social Representation and vulnerability concept. Individual interviews were analyzed, recorded, and fully transcribed using IRaMuTeQ software (version 0.7) for Similarity Analysis. | Young transgender women living with HIV/AIDS experience health vulnerability associated with lack of knowledge and difficulties in practicing self-care. There were representations of social abjection and unpreparedness among primary healthcare teams in providing qualified assistance for effective and humane care. |
A14 [ ] | Lacombe-Duncan; Olawale/2020/Journal of Interpersonal Violence/Canada | Understanding the context, types, and consequences of violence experienced by transgender women living with HIV across their lives, from intersectional and social–ecological perspectives. | Canada/Eleven transgender women living with HIV participated in the study. | Semi-structured individual interviews were conducted. Structural analysis was used to identify key themes, patterns within themes across participants, and patterns across themes among participants. | The findings revealed that transgender women living with HIV experience specific contexts of violence shaped at the intersection of stigma based on gender identity, gender expression, HIV status, and other identities/experiences. Once living with HIV, transgender women were subjected to discursive violence from healthcare professionals. These multiple forms of violence have serious consequences for the social, mental, and physical well-being of transgender women living with HIV. |
A15 [ ] | Reisner et al./2021/PLoS ONE/Peru | The user aims to increase visibility, document, and understand the health needs and contexts shaping the health and well-being of transgender men in Lima, Peru, to inform responsive public health efforts. | Lima, Peru/46 transgender men participated | User conducted 4 focus groups and 10 individual interviews. Analysis was conducted using an immersion crystallization approach to identify themes. | Transgender men reported lack of awareness and information among medical providers, avoidance of healthcare due to discrimination and mistreatment, absence of public services for medical gender affirmation (hormones, surgeries), and unmet mental health needs. They described health as multidimensional and influenced by social, economic, and legal contexts, including family, school, employment, legal identity recognition, discrimination in public spaces, and peer support. Violence, stigma, and intersecting forms of oppression were described as limiting social and legal recognition of transgender identity, a central dimension of health. Peer support, often in online spaces, was described as important for resilience and well-being. |
A16 [ ] | Oliveira et al./2022/Revista Brasileira de Enfermagem/Brazil | Understanding the meanings of being a transgender woman or transvestite in the healthcare provided by professionals of the Unified Health System. | Minas Gerais, Brazil/10 transgender women or transvestites residents and users of the Unified Health System (Sistema Único de Saúde) participated. | Interviews were conducted/Heideggerian Phenomenology was used as the theoretical, methodological, and philosophical foundation | Transgender women and transvestites often conform to socially constructed and accepted feminine patterns, frequently seeking hormone therapy. They sometimes resort to self-medication when facing difficulties obtaining prescriptions. Acceptance and use of their chosen name by healthcare professionals promote their recognition. These individuals experience daily prejudice, not only from professionals but also from assumptions made by other service users. |
A17 [ ] | Santander-Morillas et al./2022/PLoS ONE/Spain | Describing the experiences of transgender individuals regarding the healthcare they received in primary and hospital services in Barcelona from 2017 to 2019. | Barcelona, Espanha/16 transgender people participated | Semi-structured interviews were conducted based on a descriptive phenomenological approach. Data were analyzed descriptively and thematically following the method proposed by Colaizzi, aided by Atlas.ti 8 software. | The experiences of transgender care were divided into three categories: overcoming obstacles, training consultations, and coping strategies. Participants identified negative experiences and challenges with the healthcare system due to the lack of competence among healthcare professionals. Discriminatory, authoritarian, and paternalistic behaviors continue to exist, hindering therapeutic relationships, care, and access to health services. |
A18 [ ] | Tun et al./2022/J Internacional AIDS Society/Nigeria | Evaluate how stigma influences HIV services for transgender individuals in Lagos, Nigeria. | Lagos, Nigeria/25 transgender women and 13 transgender men participated. | In-depth interviews and focus group discussions were conducted. Thematic content analysis was used to analyze the data, utilizing NVivo 12 software. | The disclosure of gender identity is challenging due to anticipated stigma experienced by transgender individuals and fear of legal repercussions. Fear of being reported to authorities was a major barrier to disclosing to providers in non-affiliated transgender-inclusive clinic facilities. Participants reported a lack of sensitivity among providers regarding gender identity, with instances of confusion between transgender men and lesbian women, and transgender women with gay men or men who have sex with men, the latter being more common. Transgender participants also expressed feeling disrespected when providers were not sensitive to their preferred pronouns. HIV services that are not transgender-inclusive and affirming can reinforce stigma. |
A19 [ ] | Ssekamatte et al./2022/International Journal for Equity in Health/Uganda | Exploring sources of gender-based violence support services and the challenges faced by transgender women in seeking help. | Kampala, Uganda/60 transgender women and 10 key informants participated. | Deep interviews and a focus group discussion guide were utilized. Recruitment was through snowball sampling. Data were transcribed verbatim and analyzed following a thematic structure informed by the socioecological model. | Lack of recognition of transgender identity; long distances to health facilities; discrimination by healthcare professionals and civil society organization staff; inadequate questioning of transgender identity by police and healthcare providers; and the lack of transgender-competent healthcare professionals and legal personnel hindered seeking help after exposure to gender-based violence. |
A20 [ ] | Sherman et al./2022/PLoS ONE/EUA | To explore the help-seeking process post-exposure to violence among Black transgender women and the association between polyvictimization, barriers to healthcare, and mental health outcomes. | Baltimore e Washington, United States of America/Nineteen transgender women participated in the qualitative stage of the study. | Semi-structured interviews were conducted. Analyses included thematic content analysis, bivariate analysis, joint display, and multivariate linear regression analysis examining mediation and moderation. | The study found that barriers to accessing and engaging in healthcare, polyvictimization, and mental health symptom severity were interconnected among Black transgender women. The research highlighted the importance of addressing these barriers to improve overall well-being in this population. |
A21 [ ] | Lobo et al./2023/Revista Brasileira de Enfermagem/Brazil | Analyzing the repercussions of transphobia on the health of transgender men and transmasculine individuals. | Bahia, Brazil/Thirty-eight individuals participated, including 35 transgender men and three transmasculine individuals. | In-depth interviews were conducted. The Collective Subject Discourse technique was employed, and interpretation was based on the theoretical concept of transphobia. | Transphobia has brought intra and interpersonal repercussions in the lives and health of transgender men and transmasculine individuals who access healthcare services. Experiences of violence in private spaces, strained family ties, discrimination in educational settings, limitations in professional opportunities/employment, barriers in self-care and access to healthcare services, development of strategies to protect transgender identity, and consequences of transphobia on psychosocial health were found. |
A22 [ ] | Jesus et al./2023/Interface (Botucatu)/Brazil | Understanding how transgender women have been treated in institutions of the Unified Health System (Sistema Único de Saúde). | Minas Gerais, Brazil/Four transgender women participated. | Focus group interviews were conducted, and thematic content analysis was performed. | The participants mentioned not having ties with Primary Care and seeking care at the outpatient clinic linked to the teaching hospital and emergency services. Instances of institutional violence, negligence, and prejudice permeate their experiences. |
A23 [ ] | Muyanga et al./2023/BMC Women’s Health/Uganda | Exploring how gender-based violence affects the uptake and utilization of HIV prevention, treatment, and care services among transgender women in the greater Kampala metropolitan area, Uganda. | Kampala, Uganda/60 transgender women participated. | Twenty in-depth interviews, six focus group discussions, and ten interviews with key informants were conducted. Data were analyzed using a thematic content analysis framework. Verbatim transcription of data was performed, and NVivo 12 was used for coding. | Physical and emotional violence at the community level has led to fear among transgender women traveling to healthcare facilities. Emotional violence experienced by transgender women in healthcare settings has resulted in limited use of pre-exposure prophylaxis and HIV testing services, denial of healthcare services, and delays in receiving appropriate care. Fear of emotional violence has also made it difficult for transgender women to approach healthcare professionals. Fear of physical violence, such as being assaulted while in healthcare settings, has caused transgender women to avoid healthcare facilities. |
A24 [ ] | Burchell et al./2023/Culture, Health & Sexuality/Canada | Understanding the barriers to healthcare among non-binary individuals living in a medium-sized urban/rural region of Canada. | Waterloo, Ontario, Canada/12 non-binary individuals participated. | Semi-structured interviews were conducted. The theoretical framework of this study was based on interpretative phenomenology. Transcribed interviews were thematically analyzed using NVivo. | Three overarching themes were developed: erasure, barriers to accessing healthcare, and assessing whether (or not) to seek care. Subthemes included institutional erasure, informational erasure, general health barriers, medical transition barriers to healthcare, anticipated discrimination, and safety assessment. |
A25 [ ] | Atuk/2024/Social Science & Medicine /Turkey | Examining the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of healthcare professionals. | Turkey/10 women participated | As part of a broader research initiative, this article integrates multiple data sources, including public archives, medical records, newspaper articles, official government reports, and 45 in-depth interviews with healthcare providers/When it came to the inclusion of the study, it focused on in-dept interviews carried out with trans woman/thematic analysis was applied using ethnographically informed interpretive frameworks. | Trans women are treated by healthcare professionals as if they were always infectious. Trans communities are slowly weakened by the denial of healthcare services. |
ID | Is There Congruence between the Stated Philosophical Perspective and the Research Methodology? | Is There Congruence between the Research Methodology and the Research Question or Objectives? | Is There Congruence between the Research Methodology and the Methods Used to Collect the Data? | Is There Congruence between the Research Methodology and the Representation and Analysis of Data? | Is There Congruence between the Research Methodology and the Interpretation of Results? | Is There a Statement Locating the Researcher Culturally or Theoretically? | Is the Researcher’s Influence on Research and Vice Versa Addressed? | Are Participants and Their Voices Adequately Represented? | Is the Research Ethical According to Current Criteria or, Recent Studies, for Is There Evidence of Ethical Approval by an Appropriate Body? | Do the Conclusions Drawn in the Research Report Stem from Data Analysis or Interpretation? |
---|---|---|---|---|---|---|---|---|---|---|
A1 [ ] | Y | Y | Y | Y | Y | Y | U | Y | Y | Y |
A2 [ ] | U | Y | Y | Y | Y | U | U | Y | Y | Y |
A3 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A4 [ ] | U | Y | Y | Y | Y | U | U | Y | Y | Y |
A5 [ ] | Y | Y | Y | Y | Y | N | U | Y | Y | Y |
A6 [ ] | Y | Y | Y | Y | Y | Y | U | Y | Y | Y |
A7 [ ] | Y | Y | Y | Y | Y | U | U | Y | Y | Y |
A8 [ ] | U | Y | Y | Y | Y | Y | U | Y | Y | Y |
A9 [ ] | U | Y | Y | Y | Y | Y | U | Y | Y | Y |
A10 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A11 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A12 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A13 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A14 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A15 [ ] | U | Y | Y | Y | Y | U | U | Y | Y | Y |
A16 [ ] | U | Y | Y | Y | Y | U | U | Y | Y | Y |
A17 [ ] | U | Y | Y | Y | Y | Y | U | Y | Y | Y |
A18 [ ] | Y | Y | Y | Y | Y | Y | U | Y | Y | Y |
A19 [ ] | Y | Y | Y | Y | Y | U | U | Y | Y | Y |
A20 [ ] | Y | Y | Y | Y | Y | Y | U | Y | Y | Y |
A21 [ ] | Y | Y | Y | Y | Y | Y | U | Y | Y | Y |
A22 [ ] | Y | Y | Y | Y | Y | U | U | Y | Y | Y |
A23 [ ] | U | Y | Y | Y | Y | U | U | Y | Y | Y |
A24 [ ] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
A25 [ ] | U | Y | Y | Y | Y | Y | Y | Y | U | Y |
The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
Share and Cite
Leal, G.d.C.; Júnior, J.N.d.B.S.; Ferreira, Q.R.; Ballestero, J.G.d.A.; Palha, P.F. Institutional Violence Perpetrated against Transgender Individuals in Health Services: A Systematic Review of Qualitative Studies. Int. J. Environ. Res. Public Health 2024 , 21 , 1106. https://doi.org/10.3390/ijerph21081106
Leal GdC, Júnior JNdBS, Ferreira QR, Ballestero JGdA, Palha PF. Institutional Violence Perpetrated against Transgender Individuals in Health Services: A Systematic Review of Qualitative Studies. International Journal of Environmental Research and Public Health . 2024; 21(8):1106. https://doi.org/10.3390/ijerph21081106
Leal, Gilberto da Cruz, José Nildo de Barros Silva Júnior, Quezia Rosa Ferreira, Jaqueline Garcia de Almeida Ballestero, and Pedro Fredemir Palha. 2024. "Institutional Violence Perpetrated against Transgender Individuals in Health Services: A Systematic Review of Qualitative Studies" International Journal of Environmental Research and Public Health 21, no. 8: 1106. https://doi.org/10.3390/ijerph21081106
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This qualitative study explored female leaders' experiences with gender norms, implicit. bias and microaggressions that they have experienced over the course of their careers. Research questions explored what gender norms exist, how they show up behaviorally in. the workplace, and how gender norms, implicit bias and microaggressions impact.
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Context: This question within gender studies explores the qualitative dimensions of transgender individuals' workplace experiences, emphasizing the nuanced aspects of inclusion and discrimination they may encounter. ... These additional detailed examples provide a broader perspective on qualitative research questions, covering diverse fields ...
Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. ... Qualitative research conducted by Deloitte Consulting with 18 large business organizations suggests that female executives have a tendency to be more attuned to micro-level signaling during ...
They are also useful in designing and field-testing questionnaires, and in interpreting quantitative research findings. Qualitative methods can provide deeper insight into meaning, motivations and dynamics around women and girls' empowerment. The table below provides an illustrative list of commonly methods for qualitative data collection.
In Nigeria, the disparity in the ratio of male to female academics remains very high. For instance, in the 2001/2002 session, the total number of Nigerian university teachers was 20,124, and out of this number, 3,174 (15.7%) were females, while 17,040 (84.3%) were male. A study at the University of Benin in Southern Nigeria also revealed a ...
5. Ask something researchable. Big questions, questions about hypothetical events or questions that would require vastly more resources than you have access to are not useful starting points for qualitative studies. Qualitative words or subjective ideas that lack definition are also not helpful.
While many books and articles guide various qualitative research methods and analyses, there is currently no concise resource that explains and differentiates among the most common qualitative approaches. We believe novice qualitative researchers, students planning the design of a qualitative study or taking an introductory qualitative research course, and faculty teaching such courses can ...
1. Executive Summary. We have conducted qualitative research to help inform whether and how best to meet user needs for information on gender identity - the main one being a reliable estimate of the population identifying as "trans" (an umbrella term covering people who self-identify as an identity different to the sex assigned to them at birth).
Summary. Queer theory is a tool that can be used to reconsider sociopolitical, historical, and cultural norms and values. Similarly, in qualitative research, queer theory tends to analyze the narratives of LGBTQ+ people and groups in ways that seek to queer everyday experiences. Both the theoretical framework and the narratives collected and ...
This review aims to analyze the evidence related to violence perpetrated against transgender individuals in health services based on their narratives. This is a systematic literature review of qualitative studies. A search was carried out in the Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature ...
Bias—commonly understood to be any influence that provides a distortion in the results of a study (Polit & Beck, 2014)—is a term drawn from the quantitative research paradigm.Most (though perhaps not all) of us would recognize the concept as being incompatible with the philosophical underpinnings of qualitative inquiry (Thorne, Stephens, & Truant, 2016).