The double X factor

There is little to no denial that the coronavirus has created increased rates of gender-based violence of all kinds. As I wrote a month ago, the United Nations Secretary General has spoken about the “horrifying surge in domestic violence” around the world. Calls to crisis lines and sexual assault centres have increased significantly; many shelters for abused women are operating at or beyond capacity. According to Statistics Canada, one in 10 women in this country are “very or extremely concerned about violence in the home” during the pandemic.

We understand why: trapped at home with an abusive partner or other family member, with no access to the usual escapes or supports creates more opportunities for abuse to happen and fewer ways for the victim to escape. Increased stresses associated with the pandemic contribute to increased abuse. With no privacy, it is hard for a woman to get legal information or advice or other supports.

There are different risks and challenges for women who have left an abusive relationship. Those of us working with women at this time are seeing the proof of this every day. Their ex-partner may take advantage of the public health crisis to manipulate parenting arrangements. Because supervised access centres are closed, the abuser may insist that the woman exchange the children directly and privately with him, placing her at risk of harm. They may fail to meet their financial obligations as set out in a support order or they may empty joint bank accounts or lines of credit. The courts, which are limited to dealing with only the most urgent matters, are strongly encouraging parents to work out their issues on their own; again, placing women with abusive partners and their children at increased risk of harm.

None of this should be news: a 2015 paper entitled “Unseen, unheard: Gender-based violence in disasters,” produced by the International Federation of Red Cross and Red Crescent Societies noted that:

“Overall, it seems that disasters tend to increase the risk of GBV and that new forms of GBV can emerge in their aftermath.”

And yet, there was no apparent nod to the need for a gender-based analysis when all levels of government in this country and elsewhere were implementing pandemic protocols.

Gender plays other roles, too

I am grateful every day that my children are grown, so that I can focus on my work and my own anxieties and frustrations without also monitoring a child’s schoolwork, screen time, fears, moods and desire to see friends. I don’t know how my colleagues who are juggling all of this manage; but it seems to me that, as always, women are carrying the heavier load.

Women with paid work are also taking a disproportional hit. While, in March, 61% of jobs lost in Canada were those held by women, the in-person jobs that remain are dominated by women: the ones that involve constant exposure to the public and, potentially, the virus: health care workers, cleaners, grocery store cashiers, fast-food restaurant staff.

One size does not fit all

Even as we are quick to praise, hold up signs and bang pots and pans on our front yards to show our support for health care workers, gender is being ignored.

The majority of those frontline health care workers are women, yet the personal protective equipment (PPE) they must wear to minimize their exposure to the virus, is designed for men. As one worker put it:

“PPE is designed for a 6 foot 3 inch bloke built like a rugby player.”

Dr. Helen Fidler, with the British Medical Association said:

“Women’s lives are definitely being put at risk because of ill-fitting PPE. We know that properly fitted PPE works, but masks are designed for a male template with the irony being that 75% of workers in the NHS [National Health Service] are female.”

Even where the worker is safe from infection, wearing gear designed for a larger, heavier body can leave injuries. My sister sent me a stark photo of her daughter, a nurse practitioner in a large American hospital, at the end of her shift, and the bruises and scrapes from her face mask were shocking.

X chromosomes may save the day

It appears that, while women and men have more or less equal rates of infection, men are more likely to die from it. Some of this may be due to social factors: more men smoke and men are more resistant to frequent hand washing and, when they do, less likely to use soap, for example.

But, it also seems that women have stronger immune systems, perhaps due to the two X chromosomes we have compared to men’s one. Women produce more estrogen which, based on the small amount of gender-disaggregated research that has been done on viruses, appears to offer some protection from dying.

Caroline Criado-Perez, author of “Invisible Women: Exposing Data Bias in a World Designed for Men” says that researchers have found sex differences in every tissue and organ system in the human body, including the immune system, when they have taken the time to look at women’s and men’s bodies as distinct. Unfortunately, as she also notes:

“It’s been assumed that there wasn’t anything fundamentally different between male and female bodies other than size and reproductive function.”

It’s time to make a serious commitment to gendered medical research: women’s bodies may contain, if not the magic solution to all disease, important information both to prevent and treat future global viruses.

The leadership of women

Some of the calmest and best informed public health and political voices throughout the pandemic to date have been women’s. Despite the racist attack on her by Ontario Conservative MP Derek Sloan, Canada’s Chief Public Health Officer Dr. Theresa Tam, has maintained her cool, continuing to provide strong leadership to government and a comforting face to Canadians.

British Columbia’s Chief Public Health Officer, Dr. Bonnie Henry, has led the province’s response to the virus with intelligence and grace.

New Zealand’s Prime Minister, Jacinda Ardern, has not had an easy first term in office. The Christchurch massacre was followed within several months by the deadly volcano.  However, New Zealand seems to have made its way through COVID-19 with remarkably few cases (just over 1,000) and deaths (20). Certainly, being isolated by virtue of its island status made it easier to seal borders, but Ardern’s contributions should not be dismissed. As she said in mid-March, her government made the decision to go hard and to go early in terms of closing borders and implementing social distancing. According to commentators, she was able to combine that hard approach with a clearly explained reliance on and trust in science as well as with empathy.

Ardern avoided the aggressive language of many government leaders, who have talked about waging war on the virus, the battle ahead of us, and the like, preferring to talk about the country being united as a “team of five million.”

In addition to her official appearances, she is visible on Facebook almost every day, dressed casually, to check in with New Zealanders, while also sharing snippets of personal and family stories. She ends her public appearances by encouraging her fellow countrypeople to “Be strong. Be kind.”

And, she and her Cabinet as well as senior public servants have taken a 20% pay cut for at least six months to show solidarity with New Zealanders who have lost their jobs or are otherwise suffering financially. Leading by example: what better way to encourage people to put up with inconvenience and difficulty?

Looks like we could learn a lot about how to manage pandemics from paying more attention to women’s bodies and women’s voices.

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