Understanding gendered issues in health programs and services

This factsheet helps health service staff understand gendered issues in health services. It builds on the Commission’s GIA toolkit (Step 1: Define the issues and challenge assumptions), providing sector-specific examples.

This factsheet can be adapted and shared to help different teams understand issues they might explore in a GIA. Staff can use this to start conversations about how gender shapes consumers' experiences with health programs or services.

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

What we know

Gender is a major factor in health outcomes. Gender inequality can shape health through:

• harmful gendered stereotypes
• bias and discrimination
• unequal representation in health research and policy
• lack of knowledge and training.

Health services must understand how gender affects access to health services, types of services used, and quality of care. This helps organisations design programs and services that are fair, inclusive and responsive.

Taking an intersectional approach ensures health service staff understand how gender inequality intersects with other factors, such as:

• ableism
• ageism
• racism
• homophobia or biphobia
• transphobia
• socioeconomic disadvantage.

Note: this tipsheet is a starting point. It doesn’t cover every experience or barrier. Do research based on your program or service’s context and consumers.

How can gender shape consumers’ experience of health programs and services?

Women and girls

Practitioner bias:

• Outdated gender stereotypes can negatively impact the care women receive.
• This can lead to delayed diagnosis, incorrect diagnosis, poor pain management and insufficient medical treatment.
• Providers may dismiss women’s medical concerns, due to common stereotypes that women are overly ‘emotional’ or that they ‘overreact’ to pain.

Key research: Department of Health and Aged Care 2024; Department of Health 2023; Moretti et al. 2023; Samulowitz et al. 2018.

Lack of gender-specific research:

• Medical research has traditionally focused on men.
• It leads to gaps in understanding women’s health and their experience in health services.
• Women’s health needs are often overlooked and under-researched because of this gap.

Key research: Australian Women’s Health Alliance, 2024; Merone et al. 2022.

Sexual and reproductive health services:

• Women face barriers when trying to access contraception, abortion, or fertility care.
• These barriers are due to limited service availability, restrictions and societal stigma.

Key research: Mazza 2020; Sarder et al. 2024; Women’s Health Victoria 2022.

Personal safety:

• Gender-based violence, including family violence, affects women disproportionately.
• Fear of judgment, shame, stigma and past trauma can prevent them from seeking medical help, particularly if health service staff are not trained to understand these experiences.

Key research: Lynch et al. 2022; Hollingdrake et al. 2023

Mental health:

• Societal expectations, trauma and gendered experiences shape women’s mental health.
• Many women have limited access to gender-sensitive mental health services.
• This leads to unmet mental health needs and poorer overall health outcomes.

Key research: Barr et al. 2024

Underrepresentation in health leadership:

• Women and gender-diverse people are often missing from key decision-making roles in health services.
• Without their voices, programs and services can overlook gender-specific and other inequalities, leading to their needs not being met.

Key research: James et al. 2024; Lux et al. 2024; Adesina et al. 2024.

Financial barriers:

• Because of gender wage gaps and economic inequalities, many women struggle to afford or take time off to access health services.

Key research: Department of Health 2023.

Men and boys

Stigma and masculine norms:

• Traditional expectations pressure men to be strong and self-reliant.
• This can stop them from seeking help.

Key research: Macdonald et al. 2022; Rice et al. 2021; Seidler et al 2021; VicHealth 2020; Ragonese et al. 2019.

Health-seeking behaviour:

• Men typically access preventive health check-ups or screenings less than women.
• This reluctance can stem from the belief that men should only see a doctor when they are seriously ill.

Key research: Macdonald et al. 2022.

Gender norms in services:

• Men may feel excluded from services seen as ‘for women’, like parenting or reproductive health programs.

Key research: Wynter et al. 2023.

Lack of gender-specific services:

• Gaps in men’s health education and training lead to missed opportunities for early intervention.
• This is especially true for mental health, where there is a lack of communication tailored for men.

Key research: Seidler et al. 2024a; Seidler et al. 2024b; Macdonald et al. 2022.

Awareness and education:

• Expectations about being tough or handling problems alone can make men less likely to look for health information or seek help when they notice symptoms.
• This can make it harder for them to get the care they need.
• The health system can be hard to navigate, with unclear information about where to go, how to use services, or what to expect at an appointment.

1. Key research: Macdonald et al. 2022.

Gender diverse-people

Discrimination and stigma:

• Gender-diverse people often face prejudice or discrimination from health workers.
• These experiences can make them hesitant to seek medical care.
• Discrimination from the broader community also affects their overall well-being.

Key research: Hill et al. 2023; Haire et al. 2021; Clark et al. 2023; Bretherton et al. 2021.

Personal safety:

• Gender-diverse people may experience discrimination and harassment in health services.
• Unsafe or unwelcoming environments can lead them to avoid or delay seeking the care they need.
• This can stop them from participating in community health programs.

Key research: Kerr et al. 2019.

Availability of specialised services:

• Trans and gender-diverse people are often left out in health research and data collection.
• This can lead to a shortage of programs and services that meet their needs.
• Few health services are designed to be inclusive and affirming for trans and Gender-diverse consumers.
• Health information is often not inclusive or adequate, leaving people unaware of services or specific health risks.

Key research: Kerr et al. 2019; Rosenberg et al. 2023.

Knowledge and training:

• Many health services staff haven’t been trained in how to meet the needs of gender-diverse people.
• This includes:
  • delivering gender-affirming and inclusive care
  • talking about gender identity respectfully
  • understanding the concerns of gender-diverse consumers
  • offering the right screenings and care for trans-specific health needs.

Key research: Holland et al. 2024; Strauss, 2020.

Administrative processes:

• Gender-diverse people often face difficulties when their legal names or health records don’t match their gender identity.
• Confusion and lack of respect for the difference between sex at birth and gender identity create distress and discomfort.
• These issues can result in mistakes or inappropriate care.

Key research: Ho et al., 2024; Tan et al., 2022.

What additional needs do health consumers have?

Consumer needs and experiences are influenced not only by gender but also by factors such as age, disability, cultural background, and socioeconomic status.

The following sections outline additional themes to consider. These can help teams to take an intersectional approach in their GIA.

When considering any of the groups below, always ask: “How does this issue affect women, men or gender-diverse people differently?”

LGBTIQA+ communities

LGBTQIA+ people may experience:

Barriers to disclosing sexual orientation:

• LGBTIQA+ people may hesitate to share their sexual orientation or gender identity with Health services.
• They can be afraid of judgment or discrimination.
• This can prevent them from getting the right care, especially for sexual health.

Key research: Brookes et al. 2018; Cronin et al. 2021; Sanchez et al. 2023.

Lack of respectful, inclusive care:

• Health services staff may not have been trained in how to engage with LGBTIQA+ consumers respectfully.
• This can lead to misunderstandings, discrimination or poor experiences.
• This can make LGBTIQA+ people less likely to access health services.

Key research: Brookes et al, 2018; Cronin et al, 2021;Sanchez et al. 2023.

People with disabilities

People with disabilities, especially women, face poorer health outcomes and barriers, including:

Discrimination and stigma:

• Staff in health services may hold negative attitudes or make wrong assumptions about people’s abilities.
• Women and gender-diverse people may face even more discrimination due to ableist and sexist views.

Key research: Australian Institute of Health and Welfare 2024c; Matin et al. 2021; Women with Disabilities Victoria 2021.

Resources and information:

• Health information is often not accessible in accessible formats like:
  • Auslan
  • Braille
  • large print
  • audio messaging
  • plain language
  • easy English
  • non-digital formats.

Key research: State Government of Victoria 2025.

Knowledge and training:

• Health services may not have trained staff on how to support consumers with disabilities.
• This can lead to inadequate care.
• Women with disabilities often miss out on sexual and reproductive healthcare.

Key research: Women with Disabilities Victoria 2021; Women’s Health East 2023.

Access to transport:

• Limited or inaccessible public transport can make it hard to reach appointments or services.

Key research: Badji et al. 2021.

Navigating the National Disability Insurance Scheme (NDIS):

• The NDIS is complex and doesn’t link well with health systems.
• This can make it difficult for people with disabilities to get the services they need.
• The lack of coordination can cause long delays in accessing support.

Key research: Women with Disabilities Australia 2023.

Personal safety:

• Women with disabilities are two to three times more likely than women without disabilities to experience violence.
• Trauma from violence makes it harder to seek and receive care.
• Fear of judgment or blame from services can mean people are more hesitant to access health services.

Key research: People with Disability Australia 2021; Women with Disabilities Victoria 2026.

First Nations communities

First Nations people face barriers to accessing health services, including:

Systemic racism:

• Many First Nations people experience racism in health service settings.
• This includes negative attitudes, racial stereotypes and a lack of care and respect for their culture.
• This can cause isolation and make people less likely to seek care from mainstream health services.

Key research: Gatwiri et al. 2021; Parter et al. 2021.

Mistrust and trauma:

• The history of colonisation, displacement and ongoing racism has created deep mistrust of government-funded health services.
• This trauma continues to affect individuals today.
• This makes it harder for First Nations peoples to engage with services and contributes to complex health conditions.

Key research: Nolan-Isles et al. 2021.

Connection to Country:

• Connection to Country is central to identity, culture and wellbeing.
• A strong connection is linked to better mental and physical health.
• Separation from Country can increase stress, anxiety, and isolation.

Key research: Australian Institute of Health and Welfare 2024b; Ganesharajah 2009; Weir et al. 2011.

Personal safety:

• First Nations women experience higher rates of family violence than non-Indigenous women.
• This is driven by the ongoing impacts of colonisation and gender inequality.

Key research: Our Watch 2018.

Access to care:

• Many First Nations communities live in rural or remote areas with limited access to health care.
• Long distances and travel costs make it harder for people to get to health services.

Key research: Australian Institute of Health and Welfare 2024a.

Faith-based and culturally and racially marginalised communities

Faith-based and culturally and racially marginalised communities may experience barriers when accessing health services, including:

Language and communication:

• Health services often fail to provide communication options for people with limited English..
• Some health services do not fully understand the role of interpreters or use them effectively.
• This can cause misunderstandings about health conditions, treatment and informed consent.

Key research: Khatri et al. 2022; Gender Equity Victoria 2022; Raymundo et al. 2020; Cho 2022.

Beliefs and practices:

• Some health service staff lack understanding of cultural and religious beliefs and practices.
• This can lead to culturally unsafe experiences around dietary restrictions, dress or mourning rituals.

Key research: Gender Equity Victoria 2022.

Gendered cultural practices:

• Health services do not always provide access to a provider of a specific gender, even when this is important for sensitive health issues.
• The lack of private spaces for consultation can also prevent people, especially women, from seeking care or sharing health concerns.

Key research: Gender Equity Victoria 2022.

Financial constraints:

• Economic hardship makes it harder to access and travel to health services.
• This is even harder for people who cannot access Medicare due to temporary visas or immigration status.

Key research: Gender Equity Victoria 2022.

Service stigma:

• Cultural and religious beliefs may create stigma around some types of health services, like mental health.
• This can influence how people seek help.

Key research: Commonwealth of Australia Department of the Prime Minister and Cabinet 2022; Kara et al. 2024; Luu et al. 2023; Tran et al. 2023; Radhamony et al. 2023.

Older people

People of older age are not one single group. Their health, income, mobility, culture and support networks vary widely and shape how they use health services.

Ageism and discrimination:

• Older people may feel dismissed or spoken down to by health workers.
• Their concerns are often ignored or seen as part of ’old age’.
• Older women may face both age and gender bias. This can influence assumptions about being too fragile for certain treatments.

Key research: Hand et al. 2023; Chrisler et al. 2016.

Mobility and transportation:

• Some older people have health conditions and mobility issues. This can make it harder to travel to health services.
• These issues may overlap with disability, though not all older people identify as having a disability.

Key research: van Gaans et al. 2018.

Social isolation:

• Some older people live alone or are socially isolated, particularly women.
• Women tend to live longer than men and are more likely to be widowed.
• Digital access and skills vary, and some people find online health services hard to use. This can make it difficult to access health information or assistance online.

Key research: Stevens et al. 2024.

Financial strain:

• Financial situations vary across older age groups.
• Some older people, especially women, have limited income due to lifelong economic disadvantage.
• Health costs, including aids and medications, can put pressure on people living on pensions or fixed incomes.

Key research: National Seniors Australia 2023; van Gaans et al. 2018.

Young people

Young people face many of the same issues as adults, along with some that are unique to their age group. These include:

Mental health stigma:

• The rate of psychological distress among young people, especially young women, is rising faster than in other age groups.
• Many hesitate to seek help due to fear, embarrassment, or the belief that they can handle it alone.
• Stigma and fear of judgment from family and friends can further discourage them from reaching out for help.

Key research: Australian Institute of Health and Welfare 2021; Brennan et al. 2021

Health information and systems:

• Health services do not always have effective ways to reach young people with information about available services.
• Targeted information may be needed to effectively communicate with young people from marginalised communities (i.e. First Nations, LGTBIQ+, culturally and racially marginalised communities, and people with disabilities).

Key research: Australian Institute of Health and Welfare 2021.

Economic resources:

• Many young people are studying and working casually or part-time and many work in low-paid jobs.
• Limited income and rising cost of living can make it hard to afford healthcare or take time off for appointments.

Key research: McHale et al. 2024.

Regional and rural populations

People in rural and regional areas often have worse health outcomes than people in cities. This is mainly due to systemic barriers. These barriers can have a greater impact on some groups, including First Nations people, LGBTIQA+ communities, people with disabilities, and culturally and racially diverse communities.

Specific additional challenges include:

Limited services:

• Many regional and rural areas don’t have enough health services.
• Particularly, specialist and mental health programs.
• People often travel long distances to get care.
• This can delay or stop them from getting help.

Key research: Australian Institute of Health and Welfare 2024d; National Rural Health Alliance 2025.

Stigma and privacy:

• In small communities, people may worry about confidentiality or being judged.
• Especially when seeking help for mental or reproductive health.
• This can stop them from reaching out.

Key research: Kavanagh et al. 2023; Wood et al. 2024; Youth Affairs Council Victoria 2019.

Workforce shortages:

• There are fewer health professionals in regional and rural areas.
• This can lead to longer wait times, fewer choices and less access to quality care.
• Fewer health services have expertise in the specific health needs of women, men or gender-diverse consumers.

Key research: Bradow et al. 2021; National Rural Health Alliance 2025.

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