08 SES 06 B, Gender, Sexuality and Health Inequalities
Textbooks include gender bias (Blumberg, 2007, 2015) as a quite persistent and invisible obstacle to gender equality in education (Blumberg, 2007). In most of textbooks male individuals are much more presented (Blumberg, 2007, 2015; Elgar, 2004; Moser, Hannover, 2014; Parker et al., 2017; Sovič, & Husa, 2015) and show more active roles than females, who present quiet and socially approved roles (Sovič, & Husa, 2015). Gender stereotypes are still expressed in textbooks representations regarding the type of physical activity (Martinez-Bello, & Molina-Garcia, 2016), the expression of emotions (Parker et al., 2017), occupational functions (Moser, Hannover, 2014; Parker et al., 2017; Wu, & Liu, 2003), domestic functions (Blumberg, 2007; Wu, & Liu, 2003), health representations (Parker et al., 2017), and language (Moser, Hannover, 2014; Wu, & Liu, 2003). The research has been shown that women continue to be portrayed as weaker than men, with men more likely than women to be depicted as healthy, and less likely to be shown as injured or unhealthy (Parker et al., 2017). Gender bias also manifests itself visually through the intersection of dominant gender stereotypes with unequal social representation groups. However, gender stereotypes have been removed from some textbooks (Menescardi Royuela, Estevan Torres, Ros Ros, & Moya-Mota, 2017). The occurrence of stereotypes has also been emerged linked to ethnicity (Martinez-Bello, & Molina-Garcia, 2016; Menescardi Royuela et al., 2017; Parker et al., 2017), body type (Martinez-Bello, & Molina-Garcia, 2016; Menescardi Royuela et al., 2017; Parker et al., 2017), age (Martinez-Bello, & Molina-Garcia, 2016; Menescardi Royuela et al., 2017;Parker, & Cockburn, 2017), and being a person with a disability (Martinez-Bello, & Molina-Garcia, 2016; Parker et al., 2017).
Currently, in Portugal, where this study was carried out, the National Curriculum establishes that in order to promote health in the school setting, health education should be a mandatory part of the school curriculum, as a cross-curricular component included in a more comprehensive area of citizenship education (Portugal, Decreto-Lei n.º 91/2013 de 10 de julho). Therefore, the Portuguese legislation regarding the criteria for assessing, selecting and adopting school textbooks states that, among other things, school textbooks should: "Promote education for citizenship, in particular by not discriminating on a cultural, ethnic, racial, religious and sexual basis and respecting the principle of gender equality" (Portugal, Circular nº. S-DGE/2015/1571, p. 4). The national curricular goals for the 9th grade of the Natural Sciences subject establish that its field of education is "Living Better on Earth", that should integrate three subdomains: "Individual and community health", "Human organism in equilibrium" Transmission of life "(Bonito et al., 2014). These subdomains are divided into fifteen general objectives (e.g. understanding the importance of individual and community health in the quality of life of the population; synthesizing health promotion strategies; understanding the importance of healthy eating in the balance of the human organism; analysing the influence of environment and lifestyles on the respiratory system; applying basic life support measures; understanding the functioning of the human reproductive system). The holistic concept of health and health education approach within the paradigm of health-promoting schools (e.g. Clift & Jensen, 2005; McNamara & Simovska, 2015), were used as the theoretical framework in all 9th grade Science Education textbooks.
Against this background, this study aims to analyze the occurrence of possible stereotypes linked to gender and health representations (body type, facial expression, health behaviors) and, their interception with differences in age, ethnicity, individuals with disability and type of physical activity.
Science textbooks of the 9th grade used in the current academic year in Portugal were examined for health and gender representations. The sample of books analysed included the five books most chosen by Portuguese schools (78.2%) among the nine books certified by the Directorate General of Education. All images of these textbooks in which the sex or gender of the individual was identified based on the physical indicators of sex (e.g., genitalia, breasts) or cultural indicators of gender (e.g., dress or hair), were included in the analysis. Repeated images were only coded once. The author coded all images and an additional coder coded a random sample of images. The analysis included all pages of textbooks. A content analysis coding schema was developed for the analysis related to how health and gender were represented in all images to ensure that data collection was consistent across each textbook. The coding categories included: book location, image size, illustration method, the type of illustration (i.e. conceptual or narrative); whether the image was sex-specific; sex/gender; morpho physiological description (e.g., full body, body part), age (e.g., child, teenager), ethnicity, body type (mesomorph, endomorph, ectomorph), hair colour, hair length, hair in the body. For the images that were identified as narrative, in which an active story was shown to be unfolding (Parker et al., 2017), the following additional categories were identified: health behaviours (healthy versus unhealthy individual behaviours), sex of the individual - group (e.g., woman, group of women), individuals with disability (e.g., Intellectual/ physical disability), type of clothing (e.g., naked, underwear, sportswear), props, individual or group physical activity, type of physical activity (Martinez-Bello, & Molina-Garcia, 2016), type of sport, character's look, facial expression, occupational functions, domestic functions. In the analysis of the written text, it was selected as a unit of signification to encode the section of the book, because it usually corresponds to the (re) construction of a concept (e.g., what is health? What is health promotion?). The categorization system that emerged in this analysis included the categories used in the narrative images, the type of language to communicate (binary/ non binary) and the health education approach (biomedical/ health promotion). Relative frequencies of each category of analysis were used to evaluate the relationships between gender and other variables (e.g. health behaviors, occupational functions). After a descriptive statistic, the Chi-square test (χ²) test was used to determine whether these relationships were statistically significantly different.
Results indicate that the majority of the textbooks analyzed have a similar visual representation of men and women, contrary to the results found in the majority of previous researches (e.g., Blumberg, 2007, 2015). White bodies are normative with a limited representation of people with other ethnicity or a physical disability as shown in other studies (e.g., Martinez-Bello, & Molina-Garcia, 2016; Parker et al., 2017), thus promoting unequal power relations and possibilities of inclusion in the school community. There is a prevalence of muscular bodies for men and slim bodies for women showing particular unrealistic standards for both male and female health, contributing also to the marginalization of fat bodies as was found in previous researches (Parker et al., 2017). All textbooks visually show both the man and woman in active roles, with sports being the most frequent activity, showing a positive innovation compared to previous studies. However, all books show almost exclusively male scientists. The passive roles are most often represented in old age, devaluing the importance of active aging. All textbooks analysed used a gender-neutral language to communicate in a way that did not demarcate the gender of the people, however this way of writing was not consistent. In addition, none of them used to first put the woman's name and then the man's name when they are mentioned at the same time or to put the man's name first and then the woman's name. The findings highlight the need to minimize differences in function of age, ethnicity and individuals with disability, as well as in the representations of male and female bodies. Teachers should be made aware of the imbalance of images according to these categories in order to think critically on under-represented individuals engaged in health education in multiple settings represented in these textbooks.
Blumberg, R. L. (2007). Gender bias in textbooks: A hidden obstacle on the road to gender equality in education. Paper commissioned for the EFA Global Monitoring Report 2008, Education for All by 2015: will we make it. Paris: UNESCO. Electronic version, http://unesdoc.unesco.org/images/0015/001555/155509e.pdf | Blumberg, R. L. (2015). Eliminating gender bias in textbooks: Pushing for policy reforms that promote gender equity in education. Paper commissioned for the EFA Global Monitoring Report 2015, Education for All 2000 - 2015: achievements and challenges. Paris: UNESCO. Electronic version, http://www.rosadoc.be/digidocs/dd-000659_2015_Eliminating_gender_bias_in_textbooks_policy_reform.pdf | Clift, S., & Bruun Jensen, B. (2005). The health promoting school: International advances in theory, evaluation and practice. Copenhagen: Danish University of Education Press. | Elgar, A. (2004). Science textbooks for lower secondary schools in Brunei: issues of gender equity. Int. J. Sci. Educ., 26(7), 875-894. | Martinez-Bello, & Molina-García, J. (2016). Representation of physical activity domains and sedentary behaviours in physical education textbooks: an image analysis. South African Journal for Research in Sport, Physical Education and Recreation, 38(2), 139-152. | McNamara, P. M., & Simovska, V. (2015). Schools for health and sustainability: Insights from the past, present and for the future. In V. Simovska & P. M. McNamara (Eds.), Schools for health and sustainability – Theory, research and practice (pp. 3–17). Dordrecht: Springer. | Menescardi Royuela, C., Estevan Torres, I., Ros, Ros, C., Moya-Mota, I. (2017). Bodily stereotypes in English textbooks’ images. Educatio Siglo XXI, 35(1), 55-76. | Moser, Franziska, & Hannover, B. (2014). How gender fair are German schoolbooks in the twenty-first century? An analysis of language and illustrations in schoolbooks for mathematics and German. Eur J Psychol Educ, 29, 387-407. | Parker, Rhiannon; Larkin, Theresa; & Cockburn, Jon (2017). A visual analysis of gender bias in contemporary anatomy textbooks. Social Science & Medicine, 180, 106e113. | Sovič, A., & Husa, V. (2015). Gender Stereotype Analysis of The Textbooks for Young Learners Procedia. Social and Behavioral Sciences, 186, 495 – 501. | Wu, H., & Liu, W. L. (2003). Gender Representation in Primary English Textbooks in Mainland China 1978 to 2003. International Journal of Humanities and Social Science, 5(6), 116-129).
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