Activity scenarios: Starting conversations

GIAs in the health sector: Factsheet series

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This factsheet helps health service staff start conversations about gender in health services. It provides 8 scenarios to help small groups discuss how gender stereotypes and bias affect consumers’ experiences.

These scenarios can be used in training or workshops to spark reflection and discussion. Staff can use one or more scenarios to identify biases, identify skills and actions to strengthen GIA implementation.

You can download a copy of these scenarios at the bottom of this page.

Making the most of this activity

Open conversations about gender help build awareness, confidence, and skills to create more equitable health services.

Each scenario shows common challenges in addressing gender equality within health programs and services.

Allow 30 minutes per activity.

Steps:

  1. Form pairs or small groups and choose a scenario.
  2. Discuss what’s happening and why.
  3. Suggest two possible ways to respond, then share your ideas with the larger group.

Each scenario includes discussion prompts and example responses for guidance.

Scenario 1: Gender bias and pain in healthcare

Scenario:

Mila is a 24-year-old woman who has been experiencing chronic pelvic pain. She visits a new health service for help. Her provider asks her if she has been ‘stressed or overwhelmed’. Adding that ‘many women your age deal with anxiety’. The clinician suggests lifestyle changes to help with her discomfort. They tell her, ‘sometimes it’s just all about mindset’”.

Instructions:

  • Unpack the scenario (10 minutes): In pairs or small groups, discuss the situation and what might be happening.
  • Report back (10 minutes): As a group, share a summary of your scenario and the individual or organisational responses you explored together.

Prompts for unpacking the scenario:

  • The clinician links Mila's pain to emotions, which can downplay the physical symptoms.
  • Comments like ‘many women your age deal with anxiety’ make her feel dismissed and she may lose trust in her healthcare provider.
  • Research shows women’s pain is under-treated or misdiagnosed because of sexism and stereotypes. This results in women getting lower-quality care compared to men with similar symptoms.
  • Women are often less likely to receive pain management because of stereotypes that they ‘overreact’ to pain.

Prompts for responding:

  • Clinicians should challenge their assumptions and assess women’s pain seriously.
  • Acknowledge that medical research has historically overlooked women’s experiences. Understanding women’s health issues is crucial to avoiding misdiagnosis and inadequate care.
  • Women are less likely than men to receive pain medication or surgery, even with similar symptoms. Health services need training and support to recognise and address these biases.
  • The link between pain and mental health is complex. This can be especially true for women with chronic pain. Providers should avoid blaming pain on stress or anxiety without a thorough assessment. This helps ensure fair and effective care.

Resources to share:

Scenario 2: Using gender-neutral language in healthcare

Scenario:

Sarah, a non-binary person who uses they/them pronouns, moved to a new town and goes to a new healthcare service. During intake process Sarah is asked, ‘Are you a Mr. or a Ms.?’ In the appointment, the clinician uses ‘ladies’ when discussing reproductive health. When Sarah mentions they have a supportive partner, the provider refers to the partner as ‘he’ through the conversation.

Instructions:

  1. Unpack the scenario (10 minutes): In pairs or small groups, discuss what’s happening and why.
  2. Report back (10 minutes): As a group, share your scenario and the individual or organisational responses you explored together.

Prompts for unpacking the scenario:

  • Asking 'Are you a Mr. or a Ms.?' ignores non-binary identities. This can make someone feel excluded from the start.
  • Gendered language can cause alienation and anxiety. This makes it harder to build trust between patient and clinician. Trust is essential for effective healthcare delivery.
  • Assuming a consumer's relationships or family structures reinforces stereotypes and feelings of exclusion.
  • Misunderstanding gender and identity can lead to oversights in the consumer’s medical history and poor treatment decisions.
  • Even with new guidelines for collecting sex at birth and gender data, some staff may not know how to ask questions respectfully and in a gender-affirming way.

Prompts for responding:

Use inclusive intake questions, such as:

  • What was your sex recorded at birth?
  • How do you describe your gender?
  • What pronouns do you use?
  • How would you like us to address you?”

Provide clear explanations:

  • ‘You don’t have to answer these questions if you prefer not to. We respect your choices regarding your personal information.’
  • ‘We need to collect this information on sex and gender to meet government guidelines and improve care for everyone.’

Use open and gender-neutral language to make all patients feel welcome:

  • Say ‘partner’ instead of ‘wife’, ‘husband’, ‘spouse’
  • Use ‘they/them’ when unsure of someone’s gender.
  • If you are unsure, ask privately and respectfully, ‘Can I ask what pronouns you use?’

Resources to share:

Scenario 3: Culturally responsive healthcare

Scenario:

Fatima is a 29-year-old Muslim woman who has recently arrived in Victoria. At her first medical appointment, she requests to see a female clinician. The health service receptionist says, ‘We don’t have any available today, but it will only be a quick check.’ In the appointment the clinician asks about Fatima’s diet. Fatima mentions fasting during Ramadan. The doctor says ‘That can’t be healthy, no wonder you feel tired. You really need to eat more often’.

Instructions:

  • Unpack the scenario (10 minutes): Discuss what is happening and why. Come up with two possible responses.
  • Report back (10 minutes): share a summary and the responses with the group.

Prompts for unpacking the scenario:

  • Dismissing Fatima’s request for a female clinician shows a lack of understanding of cultural or religious needs. This can make her feel uncomfortable and disrespected.
  • Criticising her fasting during Ramadan disrespects her faith. This can cause distrust in the healthcare system.
  • Research shows that when health services don’t meet the needs of culturally and racially marginalised women, it can lower satisfaction and decrease engagement in healthcare. This can affect both physical and mental health.
  • The clinician’s lack of cultural sensitivity may create a sense of isolation and stop Fatima from seeking help in the future.

Prompts for responding:

  • Clinicians should show cultural awareness and respect patients from all backgrounds.
  • Health services should have protocols to meet requests for providers of a specific gender.
  • Clinicians should listen and validate consumers’ dietary practices and cultural beliefs without making assumptions about their health. A better response might be to acknowledge Fatima’s fasting and discuss how to support her health during Ramadan.
  • Shared decision-making helps patients like Fatima to voice their health concerns and needs. This enhances their overall care experience.

Resources to share:

Scenario 4: Breaking down gender stereotypes

Scenario:

Jake is a 19-year-old man who has been struggling with an eating disorder for several years. After researching options, he decides to seek help at a local eating disorder service. When he arrives, the staff seem surprised to see a male seeking treatment. The service’s brochures and environment are heavily tailored towards women. Images and resources primarily depict female patients. During his initial assessment, the clinician questions Jake's symptoms but often refers to examples involving women with eating disorders.

Instructions:

  • Unpack the scenario (10 minutes): Discuss what’s happening and why. Come up with two possible responses.
  • Report back (10 minutes): Share a summary and suggested responses with the group.

Prompts for unpacking scenario:

  • Assuming eating disorders only affect women reinforces gender stereotypes. This can prevent men like Jake from seeking help.
  • Materials and environments that focus mainly on women and girls can reinforce that eating disorders are ’women’s issues’. This can make men and gender-diverse people feel unwelcome or invisible.
  • Referring only to women’s experiences can lead clinicians to overlook the unique challenges men face. This can lead to misdiagnosis or inadequate treatment.
  • Social stigma around men’s mental health can also make it harder for them to seek treatment. Especially when healthcare settings lack inclusivity.

Prompts for responding:

  • Update service material to use gender-neutral language and highlight that eating disorders can affect people of all genders. Use stories from male and gender-diverse people who have experienced eating disorders.
  • Review images and graphics in brochures, websites and social media to make sure they show people of all genders.
  • Run awareness campaigns for men and boys, addressing myths about eating disorders and promoting seeking help as a sign of strength.
  • Provide staff training to build understanding of how gender stereotypes affect access to care and to support more inclusive and empathetic practice.
  • Services need to collect feedback from consumers and their families about their experiences with the program or service. This can guide improvements in how diversity is represented and considered in healthcare settings.

Additional resources to share:


Scenario 5: Improving access for women with disabilities

Scenario:

Emily is a 32-year-old woman who uses a wheelchair. She is pregnant and excited but anxious about how she’ll navigate the healthcare system. At her first prenatal appointment, she finds the waiting area has no wheelchair-accessible seating area, and the examination room is too small for her to move around easily. She shares her concerns about her pregnancy and potential complications related to her disability. But the clinician dismisses her, saying she is ‘overthinking it’.

Instructions:

  • Unpack the scenario (10 minutes): Discuss what is happening and why. Come up with two possible responses.
  • Report back (10 minutes): Share you summary and the suggested actions with the group.

Prompts for unpacking scenario:

  • The lack of accessible waiting areas and exam rooms makes it hard for Emily to get the care she needs. Physical barriers like this can stop women with disabilities from seeking timely medical help.
  • The clinician's dismissal shows a lack of understanding of how pregnancy and disability interact. This reflects a gap in knowledge and skills, leading to poor care and a negative experience.
  • Calling Emily's concerns "’overthinking’ shows a bias in both gender and disability. It invalidates her experiences and discourages open communication.
  • Failing to meet both the physical and emotional needs of women with disabilities can harm health and pregnancy outcomes.

Prompts for responding:

  • Design pregnancy care programs and spaces to be inclusive and accessible, beyond basic code compliance.
  • Train staff to understand and support the unique needs of women with disabilities during pregnancy.
  • Advocate for policy changes to improve accessibility and staff education across health services.
  • Adjust intake processes to ask helpful questions such as:
    • ‘Do you need any adjustments or support to make your visit more comfortable or accessible?’
    • ‘Was there anything that we could have done to make your visit easier today?’

Additional resources

Scenario 6: Understanding equitable and inclusive care practices

Scenario:

Dr. Sian works at a community health service in Victoria. During a routine check-up, he is required to ask consumers questions about their sex at birth and gender identity. These questions are part of the service's commitment to inclusive care. When Alex, a non-binary person, comes in for a check-up, Dr. Sian hesitates. Instead, he says to Alex, ‘I make sure to treat everyone with care and respect regardless of their gender, so these questions aren’t really necessary’.

Instructions:

  • Unpack the scenario (10 minutes): Discuss what is happening and why. Come up with two possible responses.
  • Report back (10 minutes): Share a summary and the responses with the group.

Prompts for unpacking scenario:

  • Treating everyone ‘the same’ ignores the unique needs of people of different genders. True inclusivity involves recognising and respecting each person’s identity.
  • Skipping questions about sex at birth and gender identity overlooks information that can affect care, comfort and treatment decisions.
  • Avoiding these questions can make consumers like Alex feel unseen or invalidated, reducing their trust in the service.
  • Dr. Sian’s hesitation may come from unconscious biases or discomfort. This can limit the quality of care for non-binary and gender diverse patients.

Prompts for responding:

  • Clinicians need to understand why gender identity and inclusivity matter in care. This includes how to ask these questions respectfully and show that they value every patient’s identity.
  • Avoiding compulsory questions about gender shows a lack of commitment to inclusive healthcare.
  • Example language for asking intake questions:
    • ‘What was your sex recorded at birth?’
    • ‘How do you describe your gender?’
    • ‘What pronouns do you use?’
    • ‘How would you like us to address you?’
  • Additional statements might include:
    • ‘You do not have to answer questions if you prefer not to. We respect your privacy.’
    • ‘We need to collect this information on sex and gender to make sure our services meet government guidelines.’
    • ‘This is a new requirement for hospitals. We are here to deliver the best care for everyone.’

Scenario 7: Implementing GIAs

Scenario

A team meets to complete a gender impact assessment (GIA) for a women’s mental health service. During the discussion, Dr. Smith, a senior clinician, states, ‘Do we really need to dive into all these details? Mental health issues are just part of being a woman. They just need someone to talk to or some stress management techniques. Not every woman’s story is complicated. Some just need to toughen up. Isn't that true for most of us?’

Instructions:

  • Unpack the scenario (10 minutes): Discuss what is happening and why. Come up with two possible responses.
  • Report back (10 minutes): Share a summary and the responses with the group.

Prompts for unpacking scenario

  • Dr Smith’s comments reflects stigma around women’s mental health. They minimise the complexity of women’s experiences and suggest these issues don’t need specific attention or expertise.
  • This attitude trivialises the real challenges women face. It can make it harder for them to seek help or be taken seriously. It also overlooks the impacts of factors like social pressures, discrimination and trauma.
  • This comment comes from a senior clinician. When someone in authority dismisses a topic, it can signal to others that raising concerns is unwelcome - even when those concerns are valid.
  • GIAs are not just a compliance task. They help health services partner with consumers and improve care by identifying gender-based risks and barriers.

Prompts for responding:

  • There are different ways to address resistance. Depending on your confidence, you could calmly challenge the comment, share facts or redirect the discussion.
  • Power dynamics affect how safe it feels to speak up. A junior staff member may not feel comfortable challenging a senior clinician directly - and that's reasonable.Aim to create an environment where team members feel comfortable to share opinions - even controversial ones. Acknowledge different viewpoints. Steering the conversation back to understanding and inclusion can break down resistance.
  • If speaking up feels difficult, you could ask a question, redirect the discussion back to the GIA, or raise the issue with a facilitator, manager or project lead after the meeting. All of these are valid.

Sample responses might include:

  • ‘You’re right that stress affects everyone. But women’s mental health experiences are shaped by social and gendered factors we can’t ignore.’
  • ‘While it might seem like we’re overcomplicating things, completing a GIA is a requirement by law. And there’s a lot of evidence showing it leads to better care.’
  • ‘Women’s experiences are diverse. Looking into the specifics helps us design care to meet the unique needs of each patient.’
  • ‘I'd like to make sure we capture all perspectives - can we keep going through the GIA questions so we don't miss anything?’

It can also help to share simple messaging on the GIA requirements, the process to undertake them. This could build understanding across the team.

Additional resources

Scenario 8: Consumer consultation in GIAs

Scenario:

A small team of clinicians is discussing completing a GIA on the review of a mental health service. Dr. Papadopoulos stresses the importance of including lived experience advisors. His colleague Dr. Jenkins expresses scepticism and says that clinical guidelines should be enough. She asks the group “Do we really need to involve them? We’re professionals. We know the kinds of poor choices these people make.”

Instructions:

  • Unpack the scenario (10 minutes): Discuss what is happening and why. Come up with two possible responses.
  • Report back (10 minutes): Share a summary and ideas with the group.

Prompts for unpacking scenario:

  • Dr. Papadopoulos' focus on lived-experience advisors highlights the value of patient perspectives. His insights show real challenges that clinical guidelines can miss.
  • Dr. Jenkins’ comments show a misunderstanding about the value of lived experience advisors and a gap between clinical views and patient realities. She seems to believe that professional expertise alone is enough, without needing to include patient voices.
  • Dr. Jenkins’ comment about ‘poor choices’ is stigmatising and dismissive. It undermines the importance of an empathic approach to mental health and reinforces harmful stereotypes.
  • Dr Jenkin believes that following clinical guidelines automatically ensures fairness and equity. But that’s not always true.
  • Resistance is common when established beliefs or practices are being challenged. Or when people believe their position or power is being threatened.
  • Resistance can also be a sign of limited experience. For example, a man may be less aware of the gendered impacts of health programs and services, if this hasn’t been his lived experience.
  • Resistance can show up as:
    • refusing to engage in a conversation or activity
    • eye rolling, smirking, crossing arms, exhaling loudly
    • agreeing but not following through
    • talking down to the person raising gender or diversity issues
    • dismissing equality work as ‘woke’
    • stating inclusion is ’not my job’
    • using individual stories as evidence that there is no need to consider gender.

Prompts for responding:

  • Calmly challenge stigmatising language. Remind the team that mental health is complex and influenced by numerous factors social and personal factors.
  • Explain that involving lived experience advisors can make services more compassionate, practical and effective.
  • Reinforce the organisation’s legal duty under the Gender Equality Act:
    • ‘As part of the GIA process, we consider how different groups of people may be affected by a policy, program or service. This helps support fairer, higher-quality care.’

Download a copy of this factsheet:

6 - Activity Scenarios - starting conversations - GIA health factsheet
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