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Policies of the Emilia-Romagna Region in the field of gender medicine

Interview with Roberta Mori

In recent years there has been considerable ferment about a topical issue: gender medicine. Do you believe that gender is a determinant of health?

I believe that an advanced social and healthcare system, centred on the needs of individuals, the appropriateness of healthcare, the effectiveness of treatment and the adequacy of care, cannot neglect the complex factors that affect our health and have an impact on our well-being. In fact, we know that gender as a determinant of health is the result of the biological differences between women and men, as well as of different lifestyles and of the different socio-cultural and environmental contexts of reference. All this leads us to consider the opportunity, as well as the need to ensure the development and dissemination of gender medicine to make it become a practice and methodology applied for better prevention and treatment of diseases in men and women alike.

This because gender medicine is not “women’s medicine,” but a medicine that goes beyond any scientific bias of neutrality and leverages gender specificity as a means of equity and objective advancement of knowledge in the field.

The cultural buzz around this innovative form of multidisciplinary approach has not yet been translated into widespread awareness and there are still many stereotypes that orient the collective imagination and the individual behaviour of professionals and citizens alike. The time is ripe to make a quantum leap.

To what degree is gender medicine involved and what meaning does it have in the broader scenario of the relationship between inequality and health?

Clearly, the principle of equality enshrined in article 3 of the Italian Constitution sees its highest embodiment in the right to health and in the removal of all the obstacles that hinder full enforceability.

The fact that the subjectivity of women has been underestimated in all areas of society is a matter of fact and powerful evidence of this marginalization still exists.

The Gender Gap is an element of analysis of the condition of women around the world and spans from wage differentials to lesser female representation in the decision-making positions and positions of power, and from lower levels of education to socio-cultural segregation. It is an urgent dimension that bears on the competitiveness of Countries and on the respect for human rights. Italy is still caught in these contradictions that become full-fledged gender gaps and substantial inequalities.

Health is not free from a discriminatory approach that for centuries has considered experimentation, research, and remedies to be neutral. The only aspect of attention and differentiation has always been the reproductive and genital system of women in the logic of a so-called “bikini” approach. Indeed, the first pharmacological trial targeted at women dates back to 2002, when Columbia University in New York opened the first course of gender medicine.

Gender medicine, therefore, also constitutes a form of cultural and compensatory emancipation from centuries of delay in respect of the female gender that is no longer acceptable in a modern civilization with advanced rights and fair policies.

In your opinion, how should health disparities be addressed in health planning? The Emilia Romagna Region seems to have taken the right road: tell us what will happen in terms of tangible gender-oriented actions?

In order to counteract the inequalities that inappropriate organization and healthcare can cause, it is essential to implement mandatory instruments to redress the status quo in social and healthcare planning at both national and regional level, in its fields of competence. All this is being done in a logic of subsidiarity which does not exempt the central government from providing for organic national legislation that promotes and upholds gender medicine. The Emilia-Romagna Region has made a structural choice in terms of equity, gender and fairness policies. The Commission for Equality between Women and Men, a permanent body no longer with mere advisory functions only, but also with legislative powers, composed of elected councillors, both men and women, was established in 2011. To date, it is the only experience of its kind in Italy’s regions. This has made it possible to carry out thorough political and institutional work, a broad and credible debate with social players and, finally, the presentation of a draft law that for the first time has addressed all areas of competence from the point of view of mainstreaming with structural gender policies.

We wanted to use the “framework law” instrument to cover all sectors precisely because it was the only appropriate one for pervasive and lasting equality policies, hinging them on an institutional effort geared toward the development and prevention of violence that continues to dramatically affect women up to this very day.

The inclusion of gender medicine in the Regional Law for Equality and against Gender Discrimination (art. 10 of Regional Law No. 6/2014), based on the principle of personalised and appropriate care, has therefore assigned the healthcare “machine” the task of providing for an equity and gender-oriented update.

Continuing vocational training of social and healthcare staff, communication campaigns and correct information to citizens, promotion of scientific research and new prevention and equal opportunities pathways according to gender specificity are all objectives and tangible actions provided for by the Law for Equality and to which the Emilia-Romagna Region needs to adapt its social and health organisation and their policy documents. Specifically, the new Regional Social and Healthcare Plan that is being developed through a pathway that sees the active participation by all the system’s protagonists in public meetings and hearings, will expressly comprise, for the very first time, gender medicine as an approach no longer left to chance.

The horizon of continuous improvement of the quality of the healthcare system of the future and its sustainability in economic terms, as well as in terms of the increased and tangible well-being of women, men and children of all ages depend on the complete implementation of this law being drafted by the Committee that I chair. We really believe that gender medicine is an essential piece of that cultural and social change that we are implementing in Emilia-Romagna and that we are proposing throughout the country.

Interview by
Mariapaola Salmi