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Gender identities, water insecurity, and risk: Re‐theorizing the connections for a gender‐inclusive toolkit for water insecurity research
Abstract
Informed by decades of literature, water interventions increasingly deploy “gender‐sensitive” or even “gender transformative” approaches that seek to redress the disproportionate harms women face from water insecurity. These efforts recognize the role of gendered social norms and unequal power relations but often focus narrowly on the differences and dynamics between cisgender (cis) men and women. This approach renders less visible the ways that living with water insecurity can differentially affect all individuals through the dynamics of gender, sexuality, and linked intersecting identities. Here, we first share a conceptual toolkit that explains gender as fluid, negotiated, and diverse beyond the cis‐binary. Using this as a starting point, we then review what is known and can be theorized from current literature, identifying limited observations from water‐insecure communities to identify examples of contexts where gendered mechanisms (such as social norms) differentiate experiences of water insecurity, such as elevating risks of social stigma, physical harm, or psychological distress. We then apply this approach to consider expanded ways to include transgender, non‐binary, and gender and sexual diversity to deepen, nuance and expand key thematics and approaches for water insecurity research. Reconceptualizing gender in these ways widens theoretical possibilities, changes how we collect data, and imagines new possibilities for effective and just water interventions.
This article is categorized under: Human Water > Value of Water
Engineering Water > Water, Health, and Sanitation
Human Water > Water as Imagined and Represented
Human Water > Methods
... Importantly, this knowledge gap regarding LGBTQ persons' experiences of water insecurity extends across global contexts (Benjamin and Hueso, 2017;Brewis et al., 2023;Wutich, 2020). The discussion of gender in the water, sanitation and hygiene (WASH) sector focuses on cisgender (non-transgender) persons and the gender binary (women, men) (Benjamin and Hueso, 2017;Brewis et al., 2023;Wutich, 2020). ...
... Importantly, this knowledge gap regarding LGBTQ persons' experiences of water insecurity extends across global contexts (Benjamin and Hueso, 2017;Brewis et al., 2023;Wutich, 2020). The discussion of gender in the water, sanitation and hygiene (WASH) sector focuses on cisgender (non-transgender) persons and the gender binary (women, men) (Benjamin and Hueso, 2017;Brewis et al., 2023;Wutich, 2020). Yet LGBTQ persons' gender roles, norms, practices and family configurations expand beyond and often conflict with cisgender, heterosexual gender dynamics (Tannenbaum et al., 2016). ...
... Yet LGBTQ persons' gender roles, norms, practices and family configurations expand beyond and often conflict with cisgender, heterosexual gender dynamics (Tannenbaum et al., 2016). Thus, a better understanding water insecurity experiences among LGBTQ populations is urgently needed (Brewis et al., 2023). For instance, a Nigerian study with LGBTQ persons found water insecurity was associated with living with a man, transactional sex and food insecurity (Hamill et al., 2023), and Brewis et al. describe how this study "highlights the intersectional nature of gender and sexual identities in creating risks for water insecurity" (p. 6) (Brewis et al., 2023). ...
Background
Water insecurity disproportionally affects socially marginalized populations and may harm mental health. Lesbian, gay, bisexual, transgender and queer (LGBTQ) persons are at the nexus of social marginalization and mental health disparities; however, they are understudied in water insecurity research. Yet LGBTQ persons likely have distinct water needs. We explored associations between water insecurity and mental health outcomes among LGBTQ adults in Mumbai, India and Bangkok, Thailand.
Methods
This cross-sectional survey with a sample of LGBTQ adults in Mumbai and Bangkok assessed associations between water insecurity and mental health outcomes, including anxiety symptoms, depression symptoms, loneliness, alcohol misuse, COVID-19 stress and resilience. We conducted multivariable logistic and linear regression analyses to examine associations between water insecurity and mental health outcomes.
Results
Water insecurity prevalence was 28.9% in Mumbai and 18.6% in Bangkok samples. In adjusted analyses, in both sites, water insecurity was associated with higher likelihood of depression symptoms, anxiety symptoms, COVID-19 stress, alcohol misuse and loneliness. In Mumbai, water insecurity was also associated with reduced resilience.
Conclusion
Water insecurity was common among LGBTQ participants in Bangkok and Mumbai and associated with poorer well-being. Findings signal the importance of assessing water security as a stressor harmful to LGBTQ mental health.
... Indeed, assumptions about cisgendered and heteronormative experiences are rife in many mainstream explorations of gender and water. While the need to think about trans and queer bodies and experiences has been signaled for some time (see Hawkins et al., 2011), only very recently have we seen work that explicitly considers trans, nonbinary, and gender-diverse peoples and experiences (Brewis et al., 2024;Mukherjee et al., 2021;Hazard, 2022). ...
... Adding to these contributions, several recent works offer empirical insights regarding the situation of water insecurity for trans, queer, and non-gender conforming communities (Mukherjee et al., 2021;Boyce et al., 2018). Even with such examples, there remains an overriding tendency in the gender and water literature to reinforce the gender binary, or to focus exclusively on women (Brewis et al., 2024;Davies et al., 2023). ...
Common paradigms of water insecurity focus on material aspects and outcomes, for instance, piped infrastructure or bodily health. Definitions of water insecurity often engage with uses of water for domestic, productive, and industrial purposes. Considerable research foregrounds the ways that water insecurity is differentiated in terms of gender, age, socio-economic status, caste, or other axes of inequity, with varied outcomes for well-being and health. This chapter builds on recent work to propose an approach to gendered aspects of water insecurities that highlights non-material dimensions, enabling the consideration of gender and water insecurities otherwise. This perspective builds on an extended gender approach, as well as a relational understanding of water inspired by feminist, post-structural, post-humanist, and Indigenous theories and ontologies. Including these diverse understandings enables a consideration of gender and water insights more fully beyond the material. This chapter develops these ideas by moving through three interconnected currents/themes – 1) gendered notions of the self as linked with broader understandings of water, 2) water relations as fostering connections to place, landscape, and more-than-human beings and waterscapes, and 3) gendered and intersectional political engagements made possible through relationality with water.
... Inequitable barriers in access to income supports likely remain even under CERB-or CRB-or CCB-like schemes, and these barriers should be identified, monitored, and addressed (Burke, 2023). Some of these barriers may be cultural safety barriers largely unique to 2SLGBTQ + people, which may affect not only capacity to navigate through the administrative burden associated with accessing income supports but also capacity to navigate and access other kinds of food security resources (e.g., Brewis et al., 2023;Conron et al., 2022;Leslie et al., 2022). As our data show that discrimination is associated with significantly increased odds of experiencing HFI, efforts should be made to ensure that food banks and similar resources are culturally safe and welcoming for 2SLGBTQ + individuals. ...
Introduction: Household food insecurity (HFI), stress, isolation, and discrimination are major determinants of health that disproportionately affect 2SLGBTQ+ people. The COVID-19 pandemic potentially exacerbated these inequities. This study investigates HFI rates among 2SLGBTQ+ adults living in diverse household conditions during the pandemic and explores the idea that heteronormative conceptions of the “household” may affect measurement of HFI.
Methods: Cross-sectional survey responses were collected from 437 self-identified 2SLGBTQ+ people from Toronto, Canada between March and July 2021. The survey measured HFI, sexual/gender identities, socio-demographic factors, household composition, and psycho-social stress/distress. Multinomial logistic regression was used to assess variation in odds of marginal, moderate, and severe HFI in relation to sexual/gender identities, household composition, psycho-social distress, and socio-demographic covariates.
Results: Forty-two percent of respondents reported some level of HFI, with severe HFI higher among respondents who were bisexual, transgender/gender diverse, and/or assigned-female-at-birth. Living alone was associated with decreased odds of reporting marginal HFI but increased odds of moderate or severe HFI compared to living with a partner, family, or roommates; living with children was associated with decreased odds of both marginal and severe HFI. One indicator of psycho-social distress (perceived discrimination) was associated with higher odds of all levels of HFI, while the other (isolation) was associated with decreased odds of marginal HFI.
Conclusion: These findings highlight the high prevalence of HFI linked with discrimination among 2SLGBTQ+ individuals during the pandemic. The complicated results regarding household composition and social isolation may suggest a need to revise definitions of the household when measuring, monitoring, and seeking to mitigate HFI in 2SLGBTQ+ communities.
Purpose of review
Discuss the recent evidence on climate change and related extreme weather events (EWE) and linkages with HIV prevention and care outcomes.
Recent findings
We identified 22 studies exploring HIV prevention and care in the context of EWE. HIV prevention studies examined sexual practices that increase HIV exposure (e.g., condomless sex, transactional sex), HIV testing, and HIV recent infections and prevalence. HIV care-related outcomes among people with HIV included clinical outcomes (e.g., viral load), antiretroviral therapy adherence and access, HIV care engagement and retention, and mental and physical wellbeing. Pathways from EWE to HIV prevention and care included: structural impacts (e.g., health infrastructure damage); resource insecurities (e.g., food insecurity-related ART adherence barriers); migration and displacement (e.g., reduced access to HIV services); and intrapersonal and interpersonal impacts (e.g., mental health challenges, reduced social support).
Summary
Studies recommended multilevel strategies for HIV care in the context of EWE, including at the structural-level (e.g. food security programs), health institution-level (e.g., long-lasting ART), community-level (e.g. collective water management), and individual-level (e.g., coping skills). Climate-informed HIV prevention research is needed. Integration of EWE emergency and disaster preparedness and HIV services offers new opportunities for optimizing HIV prevention and care.
Introduction
Household water fetching elevates physical and emotional harms, and these are generally assumed to accrue to women due to gendered labor assignments. But even in cases like India where fetching remains a highly feminized task, there are households where the primary responsibility is assumed by men.
Methods
We test the proposition that men's responsibility for water fetching is predicted by greater gender equity, reflected in measures of wives' empowerment. We used an extremely large, nationally representative Demographic and Health Survey dataset from India (2019–2020), narrowed to only households in which spouses co‐reside with off‐plot water sources ( N = 10 616), and applying a multinomial regression approach.
Results
In >20% of households, men are the primary fetchers. They are more likely to have primary responsibility when water is more distant, privately purchased, or transported by vehicle. Contrary to predictions, men assume greater responsibility for household water fetching as their wives' empowerment measures decrease and when they want to control their movement.
Conclusion
Married men in India sometimes assume responsibility for water fetching, but this is not explained by greater household gender equity. The findings also suggest that when men are responsible for fetching they have heightened risk of some forms of physical trauma but less relative psychological harm. Detailing why men fetch water matters for identifying and mitigating the physical and emotion harms of bearing responsibility for water labor, with implications for how gender should be conceptualized in water interventions intending to improve health and well‐being.
Compounding systems of marginalization differentiate and shape water-related risks. Yet, quantitative water security scholarship rarely assesses such risks through intersectionality, a paradigm that conceptualizes and examines racial, gendered, class, and other oppressions as interdependent. Using an intersectionality approach, we analyze the relationships between household head gender and self-reported socio-economic status, and water affordability (proportion of monthly income spent on water) and water insecurity (a composite measure of 11 self-reported experiences) for over 4000 households across 18 low- and middle-income countries in Central and South America, Africa, and Asia. Interaction terms and composite categorical variables were included in regression models, adjusting for putative confounders. Among households with a high socio-economic status, the proportion of monthly income spent on water differed by household head gender. In contrast, greater household water insecurity was associated with lower socio-economic status and did not meaningfully vary by the gender of the household head. We contextualize and interpret these experiences through larger systems of power and privilege. Overall, our results provide evidence of broad intersectional patterns from diverse sites, while indicating that their nature and magnitude depend on local contexts. Through a critical reflection on the study’s value and limitations, including the operationalization of social contexts across different sites, we propose methodological approaches to advance multi-sited and quantitative intersectional research on water affordability and water insecurity. These approaches include developing scale-appropriate models, analyzing complementarities and differences between site-specific and multi-sited data, collecting data on gendered power relations, and measuring the impacts of household water insecurity.
Introduction Poor access to water, sanitation and
hygiene (WASH) services threatens population health and contributes to gender and social inequalities, especially
in low-resource settings. Despite awareness in the WASH sector of the importance of promoting gender equality
and social inclusion (GESI) to address these inequalities, evaluations of interventions focus largely on health outcomes, while gender equality and other social outcomes are rarely included. This review aimed to collate and describe available research evidence of GESI outcomes evaluated in WASH intervention studies.
Methods We applied a systematic mapping methodology and searched for both academic and grey literature published between 2010 and 2020 in 16 bibliographic databases and 53 specialist websites. Eligibility screening (with consistency checking) was conducted according to predetermined criteria, followed by metadata coding and narrative synthesis.
Results Our evidence base comprises 463 intervention studies. Only 42% of studies measured transformative GESI outcomes of WASH interventions, referring to those that seek to transform gender relations and power imbalances to promote equality. A majority of studies disaggregated outcome data by sex, but other forms of data disaggregation were limited. Most included studies (78%) lacked a specific GESI mainstreaming component
in their intervention design. Of the interventions with
GESI mainstreaming, the majority targeted women and girls, with very few focused on other social groups or intersectional considerations.
Conclusion The review points to various areas for future primary and secondary research. Given the potential contribution of WASH to GESI, GESI considerations should be incorporated into the evaluation of WASH interventions. Regular collection of data and monitoring of GESI outcomes is needed as well as developing new and testing existing methods for monitoring and evaluation of such data.
Research on armed conflict's gender dynamics has expanded significantly in the past decade. However, research in this field pays little attention to sexual orientation and gender identity. Moreover, where scholarship focused on violence against sexual and gender minority (SGM) individuals during war exists, it is largely divorced from work on gender-based violence (GBV) in conflict-related environments and from sexuality studies. In this article, we integrate these bodies of work and argue for the theoretical expansion of GBV as a conceptual, empirical, and analytic category to study and explain targeted attacks against lesbian, gay, bisexual, transgender, and otherwise queer individuals. We suggest two theoretical interventions to better equip existing GBV frameworks to explain violence perpetrated against SGM people. We argue, first, that violence targeting SGM communities is GBV, as sexuality and gender identity are integral components of gender, and second, that analyzing gender dynamics adds to our understanding of when, how, and why targeting SGM individuals composes part of an organization's regulatory “repertoire of violence.” We examine violence in Colombia's civil war as an illustrative application of our approach and we identify future, fruitful research avenues with important policy implications for studying and responding to GBV during war.
We reviewed the existing literature documenting the association between water insecurity and gender‐based violence to (1) describe the characteristics and contexts of available studies, and (2) identify and classify documented gender‐based violence across domains of water insecurity (access, affordability, adequacy, reliability, and safety). 18 peer‐reviewed articles mentioned associations between water insecurity and gender‐based violence. All studies were conducted in sub‐Saharan Africa and South Asia and were published in English. The most common manifestation of the relationship between water insecurity and gender‐based violence was an increased risk of sexual and physical violence for women who walked long distances to access water. This was followed by intimate partner violence sparked by the inability to meet domestic obligations due to household water inadequacy. Despite these trends, the domains of water insecurity, and the types of violence experienced by women, were often intertwined. We conclude that there is a dearth of information assessing gender‐based violence and water insecurity, especially in Latin America, North America, and Southeast Asia, and involving locally‐based scholars. We suggest that the spectrum of what is considered “violence” in relation to water insecurity be expanded and that scholars and practitioners adopt the term “gender‐based water violence” to describe water‐related stressors that are so extreme as to threaten human health and well‐being, particularly that of women and girls. Finally, we encourage the development of cross‐culturally validated measures of gender‐based violence, which can be deployed in conjunction with standardized measures of water insecurity, to evaluate interventions that target these linked threats to global health.
This article is categorized under: Engineering Water > Water, Health, and Sanitation
Human Water > Rights to Water
Water insecurity is a critical public-health challenge in Africa's urban informal settlements, where most of the population often lacks access to household taps. In these settings, water fetching is disproportionately performed by women. While water fetching is physically laborious and exposes women to multiple risks, the water-insecurity literature has predominantly focused on household experiences, ignoring women's water-collection journeys. This paper uses the water journey as a window into embodied dimensions of water insecurity. Combining theoretical insights from embodiment, embodied political ecology of health, and time geographies, we use video-recorded walking interviews to analyze women's everyday water journeys in Ntopwa, an urban informal settlement in Blantyre, Malawi, from initial decision making through exposure to water-fetching risks and household practices regarding use and storage. We identify three principal sources of environmental risk— terrain, built environment, and human behavior—that present challenges for water collectors. Using the walking interview as a heuristic, we show how the seemingly simple practice of water fetching is compounded by complex decision making, constant spatiotemporal trade-offs, and exposure to diverse risks, all of which have embodied health consequences. Based on our findings, we conclude that interventions seeking to improve household water insecurity must consider the embodied effects of water-fetching journeys. This study also provides methodological insights into using walking interviews and videos for water and health research.
Accounting for the influences of sex- and gender-related factors on health is one of the most interesting and important challenges in contemporary health research. In biomedical research, models, experimental designs, and statistical analyses create particular challenges in attempting to incorporate the complex, dynamic, and context-dependent constructs of sex and gender. Here, we offer conceptual elaborations of the constructs of sex and gender and discuss their application in biomedical research, including a more mechanism-oriented and context-driven approach to experimental design integrating sex and gender. We highlight how practices of data visualization, statistical analysis, and rhetoric can be valuable tools in expanding the operationalization of sex and gender biomedical science and reducing reliance on a male–female binary approach.
Few studies assess the relationship between food and water access, despite global concerns about people's inability to maintain access to both food and water. We conducted a mixed-methods comparative case study in northern Nicaragua, with smallholders from two neighboring communities that differed in water availability and institutional strength, using a feminist political ecology framework and food and water security definitions that focus on access, availability, use, and stability. We adopted a participatory approach that included: a sex-disaggregated survey in 2016; interviews, participant observation, and community-based water quality testing from 2014 to 2019; and analysis of a severe drought that occurred from 2014 to 2017. Our results suggest that uneven power relations, biophysical conditions, gender, and institutions shape food and water access, and indicate that households across both communities average 2 months of drinking water insecurity during the dry season followed by an average of 2.5 months of food insecurity early in the growing season. The average duration of lean food months was similar across communities and sex, but water insecurity lasted longer in the community that had weaker local institutions and less surface water availability. Ethnographic research helped to document uneven and gendered experiences of water access and to illustrate how they were also shaped by conflicts over water for irrigation vs. domestic uses and cross-scalar limitations in water and land governance. Although we found that gender and institutions were not strong predictors of several food and water insecurity indicators on their own, both factors influenced the terms of access, conflict, and cooperative governance needed to secure resources and well-being. Our study highlights the need for theory, methods, and field research that integrate the analysis of food and water security, and it contributes to developing a feminist political ecology approach that unifies this analysis with a focus on gender.
Drawing from deep longitudinal and ethnographic work, this article interrogates a set of key relationships between bodies, gender and infrastructure in the context of understanding cities such as Bharatpur and Dhangadhi in Nepal as well as Delhi, India. This article seeks to make two contributions. First, utilizing feminist political geography approaches, we examine bodies as infrastructure, referring to how the social and material work of the body helps to build, develop and maintain cities through gendered infrastructures in the everyday. We show conceptualizing bodies as infrastructure reveals important and intimate dimensions of the everyday politics and social and material forms that enable critical resources to flow and integral networks be built in cities. Second, we demonstrate from our comparative case studies the ways that gendered “slow infrastructural violence” accrues through patterns of infrastructural invisibility. Particular bodies act as urban infrastructure in everyday and unremarkable ways, shaping the uneven social and political consequences of embodied infrastructural configurations. We specifically examine slow violence and informal financial infrastructure in Bharatpur and the provisioning of health in Dhangadhi followed by the exploration of slow violence and fragmented water in Delhi. This article thus raises a simultaneous call for theoretical engagement with the socio-materiality of infrastructure and the body, an increased regard for the multiplicity of urban infrastructures, and an interrogation of gender and infrastructural politics in cities where more people will be living in the future and where politics and infrastructure are being actively created.
Puerto Rico’s residents were left without water services for up to nine months in the wake of hurricanes Irma and María (2017). Further, it was clear that there were no viable plans for addressing water provision gaps in anticipation of future hazards. In response, Puerto Ricans initiated autogestión, a strategy to secure survival through self-provisioning. Utilizing mixed methods, we reveal two different emergent forms of autogestión water self-provision in three differently serviced Puerto Rican communities. These provide an informed reflection on the trade-offs and pitfalls of reliance on autogestión for water security in the wake of disaster.
Droughts are associated with several societal ills, especially in developing economies that rely on rainfed agriculture. Recently, researchers have begun to examine the effect of droughts on the risk of Intimate-Partner Violence (IPV), but so far this work has led to inconclusive results. For example, two large recent studies analyzed comparable data from multiple sub-Saharan African countries and drew opposite conclusions. We attempt to resolve this apparent paradox by replicating previous analyses with the largest data set yet assembled to study drought and IPV. Integrating the methods of previous studies and taking particular care to control for spatial autocorrelation, we find little association between drought and most forms of IPV, although we do find evidence of associations between drought and women’s partners exhibiting controlling behaviors. Moreover, we do not find significant heterogeneous effects based on wealth, employment, household drinking water sources, or urban-rural locality.
Access to water and sanitation as a basic human right is still limited within resource-poor rural settings of Africa, including Kitui, Kenya. This is exacerbated by prevailing gender inequalities which can be mediated when communities leverage on social capital. Qualitative methods were used to examine how values embedded in social capital enable women and vulnerable groups to cope with household water insecurity. How communities exploit the bonding and bridging dimensions of social capital to cope with water insecurities has gendered implications. Understanding the role of social capital is important in advancing public policy to reduce gender inequalities in water access.
Indigenous peoples experience water insecurity disproportionately. There are many parallels between the injustices experienced by racialized and marginalized populations and Indigenous peoples. However, the water insecurity experienced by Indigenous peoples is distinctly shaped by settler colonialism. This article draws on examples from Canada and the United States to illustrate how jurisdictional and regulatory injustices along with the broader political and economic asymmetries advanced by settler colonial States (re-)produce water insecurity for Indigenous peoples. We conclude by engaging with how Indigenous peoples are pushing back against these arrangements using State and non-State strategies by revitalizing Indigenous knowledge and governance systems.
To improve the outcomes of research and medicine, government-based international research funding agencies have implemented various types of policies and mechanisms with respect to sex as a biological variable and gender as a sociocultural factor. After the 1990s, the US National Institutes of Health (NIH), the Canadian Institute for Health Research (CIHR), and the European Commission (EC) began 1) requesting that applicants address sex and gender considerations in grant proposals and 2) offering resources to help the scientific community integrate sex and gender into biomedical research. Although, it is too early to analyze data on the success of all of the policies and mechanisms implemented, here we review the use of both carrots (incentives) and sticks (requirements) developed to motivate researchers and the entire scientific research enterprise to consider sex and gender influences on health and in science. The NIH focused on sex as a biological variable (SABV) aligned with an initiative to enhance reproducibility through rigor and transparency; CIHR instituted a sex- and gender-based analysis (SGBA) policy; and the EC required the integration of the “gender dimension”, which incorporates sex, gender, and intersectional analysis into research and innovation. Other global efforts are briefly summarized. Although we are still learning what works, we share lessons learned to improve the integration of sex and gender considerations into research. In conjunction with refining and expanding the policies of funding agencies and mechanisms, private funders/philanthropic groups, editors of peer-reviewed journals, academic institutions, professional organizations, ethics boards, healthcare systems, and industry also need to make concerted efforts to integrate sex and gender into research, and we all must bridge across silos to promote system-wide solutions throughout the biomedical enterprise. For example, policies that encourage researchers to disaggregate data by sex and gender, the development of tools to better measure gender effects, or policies similar to SABV and/or SGBA adopted by private funders would accelerate progress. Uptake, accountability for, and a critical appraisal of sex and gender throughout the biomedical enterprise will be crucial to achieving the goal of relevant, reproducible, replicable, and responsible science that will lead to better evidence-based personalized care for all, but especially for women.
Background
We are witnessing renewed debates regarding definitions and boundaries of human gender/sex, where lines of genetics, gonadal hormones, and secondary sex characteristics are drawn to defend strict binary categorizations, with attendant implications for the acceptability and limits of gender identity and diversity.
Aims
Many argue for the need to recognize the entanglement of gender/sex in humans and the myriad ways that gender experience becomes biology; translating this theory into practice in human biology research is essential. Biological anthropology is well poised to contribute to these societal conversations and debates. To do this effectively, a reconsideration of our own conceptions of gender/sex, gender identity, and sexuality is necessary.
Methods
In this article, we discuss biological variation associated with gender/sex and propose ways forward to ensure we are engaging with gender/sex diversity. We base our analysis in the concept of “biological normalcy,” which allows consideration of the relationships between statistical distributions and normative views. We address the problematic reliance on binary categories, the utilization of group means to represent typical biologies, and document ways in which binary norms reinforce stigma and inequality regarding gender/sex, gender identity, and sexuality.
Discussion and Conclusions
We conclude with guidelines and methodological suggestions for how to engage gender/sex and gender identity in research. Our goal is to contribute a framework that all human biologists can use, not just those who work with gender or sexually diverse populations. We hope that in bringing this perspective to bear in human biology, which novel ideas and applications will emerge from within our own discipline.
Psychological science has been slow to incorporate intersectionality as a concept and as a framework for conducting research. This limits not only the potential for intersectionality theory, but also limits the potential impact of the research claiming to use it. Mennies and colleagues conducted a study of psychopathology and treatment utilization using a large racially diverse sample of youth and frame their work as intersectional because they compare across three social categories (race, sex, and social class) and consider social issues that may impact the groups studied. We argue that while this represents a preliminary step, it does not represent intersectionality theory and praxis. In this article we review intersectional theory and praxis, examine psychological science and its resistance to fully incorporating intersectionality, and highlight how research must shift to be truly intersectional. Finally, we issue a call to the field to integrate intersectionality theory and praxis and to resist the tendency to dilute and depoliticize intersectionality theory and disconnect from its social justice frame.
Background: The highest quality of appropriate care is required to achieve the UN’s Sustainable Development Goals and improve the health of the LGBT population in the global south. This study assessed the training, knowledge, beliefs, attitudes and practice of Nigerian healthcare students and faculty living, working and learning within the constraints of religious, legal and cultural barriers for LGBT people.
Methods: This study was carried out among all the tutors in the faculty of clinical sciences, year five medical and nursing students in the College of Medicine, University of Lagos. The sequential mixed methods study design was guided by the socio-ecological model of health. Quantitative data were collected with an adapted questionnaire. The results were used to generate prompts for the qualitative component consisting of In-depth interviews with 21 of the respondents. Transcripts were analysed using thematic analysis. The quantitative and qualitative data were subsequently integrated and, using the socio-ecological model, synthesized.
Results: The response rate was 88.2% (medical students), 66.2% (nursing students) and 60.7% (tutors). Themes uncovered were: knowledge of LGBT terminologies; teaching and learning about LGBT health topics; ethics, professionalism and personal beliefs. A fifth of tutors reported teaching related topics or using LGBT examples in class. Students were more knowledgeable of LGBT terminologies than tutors. Facilitators and barriers to LGBT inclusion in healthcare education settings were identified within the following socio-ecological domains: globalization, policy, community, institution, intrapersonal and individual.
Conclusion: Ongoing advocacy with policy makers and educational leaders on the right to health for all citizens was recommended. A multilevel intervention by non LGBT and LGBT individuals is required for inclusion of LGBT health in educational curriculum of healthcare students and professionals.
Transgender and gender diverse (TGD) people are increasingly visible in U.S. communities and in national media. With this increased visibility, access to gender affirming healthcare is also on the rise, particularly for urban youth. Political backlash and entrenchment in a gender binary, however, continue to marginalize TGD people, increasing risk for health disparities. The 2016 National Institute of Health recognition of sexual and gender minority people as a health disparities population increases available funding for much‐needed research. In this article, we speak to the need for a biocultural human biology of gender/sex diversity by delineating factors that influence physiological functioning, mental health, and physical health of TGD people. We propose that many of these factors can best be investigated with minimally invasively collected biomarker samples (MICBS) and discuss how to integrate MICBS into research inclusive of TGD people. Research use of MICBS among TGD people remains limited, and wider use could enable essential biological and health data to be collected from a population often excluded from research. We provide a broad overview of terminology and current literature, point to key research questions, and address potential challenges researchers might face when aiming to integrate MCIBS in research inclusive of transgender and gender diverse people. We argue that, when used effectively, MICBS can enhance human biologists' ability to empirically measure physiology and health‐related outcomes and enable more accurate identification of pathways linking human experience, embodiment, and health.
Manual scavenging is widely practiced in densely populated cities and not just villages in India. The country’s sanitation workers are dying in large numbers due to suffocation inside manholes while cleaning sewer waste. This article presents some of the concerns and conditions of manual scavengers in Mumbai, the most populated metropolitan city in India. While most studies and reports bring out statistics on the issue, the point of this study is to enter the worlds of manual scavengers and learn about their lived experiences and narratives. This is a qualitative exploration done among multiple communities of manual scavengers all over Mumbai. This article tells the story of how manual scavengers are exploited by their employers as the government and society look away, avoiding seeing, hearing, or coming in direct contact with manual scavengers while benefiting from their labor and exploitation. The lived experiences of manual scavengers in Mumbai illustrate the complementary play of caste and class in upholding the oppression and continuing the violence directed to manual scavengers.
Introduction Water fetching for household needs can cause injury, but documentation of the burden of harm globally has been limited. We described the frequency, characteristics and correlates of water-fetching injuries in 24 sites in 21 low-income and middle-income countries in Asia, Africa and Latin America and the Caribbean.
Methods In a survey of 6291 randomly selected households, respondents reported whether and how they had experienced water-fetching injuries. Responses were coded for injury type, mechanism, bodily location and physical context. We then identified correlates of injury using a multilevel, mixed-effects logistic regression model.
Results Thirteen per cent of respondents reported at least one water-fetching injury. Of 879 injuries, fractures and dislocations were the most commonly specified type (29.2%), and falls were the most commonly specified mechanism (76.4%). Where specified, 61.1% of injuries occurred to the lower limbs, and dangerous terrain (69.4%) was the most frequently reported context. Significant correlates included being female (aOR=1.50, 95% CI 1.15 to 1.96); rural (aOR=4.80, 95% CI 2.83 to 8.15) or periurban residence (aOR=2.75, 95% CI 1.64 to 4.60); higher household water insecurity scores (aOR=1.09, 95% CI 1.07 to 1.10) and reliance on surface water (aOR=1.97, 95% CI 1.21 to 3.22) or off-premise water sources that required queueing (aOR=1.72, 95% CI 1.19 to 2.49).
Conclusion These data suggest that water-fetching injuries are an underappreciated and largely unmeasured public health challenge. We offer guidelines for comprehensive data collection on injuries to better capture the true burden of inadequate water access. Such data can guide the design of interventions to reduce injury risk and promote equitable water access solutions.
Some epistemologies remain marginalized in political ecology. Here I demonstrate why it is important to learn from various relational margins to further advance the field. Insights and critiques from feminisms and decolonial theories have enriched and expanded political ecology in nuanced ways, yet they continue to remain relegated to the margins. I contend that it is vital to engage and advance different forms of intersectional, interdisciplinary, and international feminist inquiries to address ongoing socioecological crises at the current conjuncture. Different epistemological, methodological, pedagogical, and praxis insights showcase how and why representation matters if we are to pursue decolonial futures and solidarities.
Urban water security strategies commonly pivot around supply-side initiatives to mitigate scarcity, forecasted population growth, or anticipated climate change; yet, scholars have begun to expand urban water security scholarship by including alternative frameworks that incorporate equity into the analysis. Our study seeks to contribute to this equity turn by opening the investigative aperture on urban water security research in several aspects. We address the question of water security for whom, and turn our attention to the urban resident and household. We shift empirical focus to smaller urban centers in the Global South, and we develop a new assessment tool for water insecurity, the Household Water Insecurity Index (HWISI), to assess differences across the urban waterscape. We conducted this research in Forquilha (Ceará, Brazil), which represents an overlooked class of small urban centers common across Brazil’s semiarid region. We draw on qualitative and quantitative data to describe household water insecurity using the HWISI. The prevalence of household water insecurity is variable, with a quarter of the population experiencing moderate to severe household water insecurity. In addition, analysis of the factors within the HWISI demonstrated how specific water insecurity domains push households across water insecurity thresholds.
Processes of urbanisation create peri-urban spaces that are socially and institutionally fluid. In this article, we analyse how contestations and competition over declining water resources in peri-urban Kathmandu Valley in Nepal reshape water use, access and rights as well as user communities themselves, by creating and reproducing new and existing exclusions and solidarities. Traditional caste-based discriminatory practices, prohibiting Dalits from physically accessing water from sources used by higher castes, are said to be no longer practiced in Nepal. However, our findings show that, exclusion persists for Dalits even though the characteristics of exclusion have changed. In situations of competing water claims in the research location, Dalit households, unlike higher-caste groups, are unable to exercise prior-use water rights. Their water insecurity is compounded by their relative inability to mobilise political, social and economic resources to claim and access new water services and institutions. By juxtaposing the hydro-social and social exclusion analytical frameworks, we demonstrate how exclusions as well as interpretations and experiences of water (in)security are reified in post-Maoist, supposedly inclusive Nepal.
Ageism is known as discrimination and stereotyping against aged person. Transgender person is considered as neither male or female or a combination of both male and female. Transgender population being marginalized community in Pakistan have to face multiple problems (i.e. economic, psychological and health) with the increase in age. In this vein, the current study was conducted to explore the socioeconomic and health conditions of aged transgender in the Rawalpindi district of Punjab province. Specifically, this study aimed to assess the extent of this population' access to basic human rights such as health, food, shelter, cloth and sanitation. Least research has been done in Pakistan in this regard. Therefore, Case studies method was used for data collection. A sample of 9 aged transgender with age above 50 years was selected through snowball sampling technique. The result indicates that usually aged transgenders were living extreme alarming situation. Finding indicates that most of the older transgender profession was beggary and 55.6% (n=5) of the transgender fall into the category of low income. Most of the transgender health status was unpleasant due to lack of devotion. Likewise, 89.9 % (n=8) transgender lived in rented house and paid double fair because people stigmatized them questionable profession like dancing and sex work. The study has also shown that all aged transgender have imbalance diet, poor condition of seasonal clothes and sanitation system because they lived in the side areas of the city due to gender non-conforming. The study suggests further work on aged transgender people and mainstreaming them in the sociological, anthropological and human rights context.
Water security is essential not only to ensure the availability and accessibility of water for drinking, producing food, washing, but also to maintain both human and environmental health. The 2011 Census of India reveals that 17.4% of urban households in India live in deprived areas in urban landscapes which are designated as slums in the Census dataset. The increasing number of people living in these areas poses serious challenges to the provision of basic urban water, sanitation and hygiene (WaSH) services. Perceived susceptibility of risks from contaminated water and lack of proper sanitation and hygiene will be addressed in the light of social exclusion factors. This study attempts to assess the present situation of water, sanitation and required hygiene provisions within the areas defined as slums by the Census of India 2011 in Kolkata, India. Based on the results obtained from the datasets from the census, and a household survey, we identified a lack of supplies associated with WaSH provisions in these areas of Kolkata. The WaSH provisions in the slum areas of Kolkata city are facing various issues related to regularity, quality and quantity of supplied water. Additionally, there is poor maintenance of existing WaSH services including latrine facilities and per capita allocation of a sustainable water security among the slum dwellers. By adding to our understanding of the importance of factors such as gender, religions, and knowledge of drinking water in deprived areas, the study analyses the links between both physical and social issues determining vulnerability and presence of deprivation associated with basic WaSH provisions as human rights of slum communities.
Scholars have demonstrated that citizenship is tied to water provision in megacities of the Global South where water crises are extensive and the urban poor often do not have access to public water supplies. Drawing from critical feminist scholarship, this article argues for the importance of analyzing the connections between embodied intersectionalities of sociospatial differences (in this instance, gender, class, and migrant status) and materialities (of water and water infrastructure) and their relational effects on urban citizenship. Empirical research from the largest informal settlement in Dhaka, Bangladesh, as well as surrounding affluent neighborhoods, demonstrates that differences in water insecurity and precarity not only reinforce heightened senses of exclusion among the urban poor but affect their lived citizenship practices, community mobilizations, and intersectional claims-making to urban citizenship, recognition, and belonging through water. Spatial and temporal dimensions of materialities of water and infrastructure intersect with embodiments of gender, class, and migrant status unevenly in the urban waterscape to create differentiated urban citizens in spaces of abjection and dispossession. The article argues that an everyday embodied perspective on intersectionalities of urban citizenship enriches the scholarship on the water–citizenship nexus.
Background:
Food and water insecurity are associated with poor health outcomes that may be exacerbated by social marginalization and barriers to healthcare experienced by sexual- and gender-minorities (SGM) in resource-limited settings. We explored factors associated with food and water insecurity in SGM with HIV.
Setting:
A longitudinal study of 357 men who have sex with men (MSM), transgender women (TGW), and other gender-identifying people in Lagos, Nigeria.
Methods:
Laboratory testing, interviews, food and water assessments, and anthropometry were performed quarterly. Robust Poisson regression with generalized estimating equations was used to evaluate factors potentially associated with food and water insecurity.
Results:
From 2014-2018, 357 SGM with HIV completed either the food or water assessments. At baseline, participants identified as cisgender MSM 265(74.2%), TGW 63(17.7%), or as non-binary/other gender 29(8.1%). Food insecurity and water insecurity were reported by 63/344(18.3%) and 113/357(31.7%), respectively at any visit. Food and water insecurity each decreased with ongoing study participation. Food insecurity was associated with non-partnered relationship status, CD4 count <500 cells/mm3, and lack of access to piped water. Water insecurity was associated with age ≥25 years, living with a man, transactional sex, and food insecurity.
Conclusion:
Food and water insecurity were common among SGM in Nigeria and decreased with continued study participation, suggesting amenability to intervention when SGM are successfully engaged in care. Targeted interventions to support food and water security may improve HIV-related outcomes, such as CD4 count.
In sub-Saharan Africa, water insecurity is intertwined with gender and sociocultural norms. While extensive scholarship exists on gender-water relations in the region, it predominantly focuses on women’s roles and responsibilities, seldom considering the role of masculinities. This paper examines masculinities, gender relations, and women’s embodied experiences of water insecurity. It situates women’s embodied experiences of water insecurity within household and community masculinities. The study was conducted in Lilongwe, Malawi, and data were drawn from interviews, focus groups, observations, and household surveys. The findings advance the gender-water literature in at least three significant ways. First, they demonstrate how gendered labour underpins women’s embodied experiences of water insecurity. Second, they show that women’s decisions and strategies for coping with water insecurity are themselves an embodied consequence of water insecurity. Finally, they illuminate how men’s perceptions and constructions of masculinity, expressed through marital expectations of femininity, shape women’s embodied experiences of water insecurity. Together, the findings reveal intricate intersections between masculinities, gender relations, and women’s everyday embodied experiences of water insecurity, validating the body as a significant site of geographic inquiry.
Access to water, sanitation, and hygiene (WASH) has been a challenge to south Asia’s rapidly growing and climate change-sensitive region. Nepal, a water-abundant country, faces obstacles to fulfilling the highly prioritized WASH Sustainable Development Goal 6 (SDG 6). This review offers details about Nepal’s WASH status from 2000 to 2020 with regard to the challenges Nepal had in delivering reliable WASH services to the people, as well as opportunities for a sustainable way forward, and provides insights that can be applied to other developing countries. From analysis of national-level assessments, estimates point toward healthy progress in extending WASH access to the population. However, large inequalities persist at the subnational level between urban and rural residents, between poor and rich residents, and between genders. Many local constraints such as a lack of long-term infrastructural capacity to provide and maintain WASH services, financial issues, and institutional and policy incompatibilities are some of the key factors that technical considerations and private sector involvement could address. We also propose roles for Nepal’s central, provincial, and local governments for identification and adaptation to the undeniable risks of climate change. Furthermore, there is a need to capitalize on the potential opportunities for developing a much-needed robust and climate-resilient WASH sector in Nepal, safeguarding the rights of future generations to safe and clean water.
Gender-based violence resulting from water, sanitation and hygiene (WASH) insecurity is a major public health problem. WaSH gender-based (WaSH-GBV) is a spatio-temporal experience and has disproportionate health and wellbeing impacts on women and girls. However, the global community of WaSH practitioners and policymakers is yet to adequately address women's vulnerability to violence in relation to WaSH access. Informed by the feminist political ecology of health framework, we conducted in-depth interviews (n = 27, 16 women and 11 men) with Ghanaian immigrants to Canada to explore perceptions of WaSH experiences over lifecourse. Results revealed that participants' perceptions and experiences of GBV are both socially and context dependent, organized around four dimensions: structural, physical, psychological, and sexual. These muti-scalar dimensions of diasporans' WaSH experiences and perceptions in Ghana are discussed along with their implications for policy and practice, specifically in enhancing health equity and water security.
Lesbian, gay, bisexual, and transgender (LGBT) persons lack legal support and face stigmatization in Nigeria. However, little is known about their lived experiences and the specific psychosocial interventions they need while living in Nigeria. Drawing on the sexual minority stress model, the authors utilize a phenomenological lens to explore the lived experiences of seven LGBT persons (age range 24–41 years) in Nigeria. Data were collected using in-depth interviews and analyzed using thematic analysis. Findings reveal that participants face discrimination. Participants live in fear and denial, need recognition and social support, have difficulties in heterosexual relationships, and experience misconceptions from friends. These findings offer directions to practitioners aiming to provide nondiscriminatory psychosocial interventions for the LGBT population in Nigeria. To extend current knowledge, further research is needed to understand how the lived experiences of the LGBT population may determine their health outcomes in Nigeria and other high-stigma countries.
There is a wealth of scholarly knowledge that aims to disentangle the complex relationship between gender and water. This scholarship coupled with practitioners' collective experiences and insights have resulted in the emergence of certain narratives that describe how unequal gender relationships to water are manifested and how they can be addressed. In this paper, we critically examine four of these water and gender narratives, myths, or realities: Are women solely responsible for water collection? Are women excluded from the global water workforce? Is technology is sufficient enough to solve water‐related gender inequalities? Does participation in design and implementation of water services address gender inequalities? By reviewing existing evidence underlying these water and gender narratives that are prominent in much academic research and international programming, we show the nuances of water and gender relationships, and the discrepancies upon which these narratives are grounded. We draw on examples and research largely focusing on the Global South, but highlight a need for similar examination of these narratives in the Global North. Finally, we discuss remaining knowledge gaps and argue that these normative understandings overlook limited and potentially contradicting evidence on the intricacies of the relationship between gender and water.
This article is categorized under: Human Water > Water Governance
Human Water > Water as Imagined and Represented
Engineering Water > Water, Health, and Sanitation
The right to water and sanitation is recognized as fundamental to attaining all other rights. Despite the progress in access to water and sanitation in Low-and Middle-Income Countries (LMIC), women and girls are vulnerable to various forms of violence when meeting their water, sanitation and hygiene (WaSH) needs. The findings on WaSH related gender-based violence (GBV) in LMICs are fragmented, and thus may not be able to inform policies and interventions aimed at addressing vulnerabilities to WaSH related violence. This scoping review characterizes forms of WaSH related violence against women in LMICs. A review of 29 peer-reviewed papers emerging from a search in Scopus, Medline, Embase and Web of Science reveals four dimensions of WaSH-GBV: structural, physical, psychological and sexual. We observed that gender norms reproduce power relations that intersect with drivers of inequities, social exclusion and marginalization to shape patterns of violence. Based on these findings, we propose a conceptual framework showcasing how contextual factors produce and reinforce WaSH related gender-based violence. We reflect on the implications of these findings for policy and suggest the need for WaSH practitioners and researchers to evaluate and measure WaSH access beyond the Joint Monitoring Program (JMP) service ladder. Further research on WaSH-GBV is essential to facilitate global efforts on achieving the Sustainable Development Goals (SDGs) for gender equality (SDG 5); and ensuring access to water and sanitation for all (SDG 6).
Indigenous households are 90 times more likely to be without running water than non-Indigenous households in Canada. Current primary indicators of water quality and security for Indigenous Peoples are based on federal boil water advisories, which do not disaggregate at household levels to identify who is most at risk within or between communities. A mixed methods approach was used to assess the level of water insecurity and perceptions of water access by gender and age for a sample of households in Six Nations of the Grand River First Nations in Ontario, Canada. A household survey captured water security using the Household Water InSecurity Experiences (HWISE) scale and Likert-type responses to perceptions of water access, contextualized using semi-structured individual and group interviews. From 2019 to 2020, 66 households participated in the survey, 18 individuals participated in semi-structured individual interviews, and 7 individuals participated in 3 semi-structured group interviews. The survey sample demonstrated high levels of household water insecurity (57.5%, n = 38). Interviews revealed that women were more dissatisfied with their drinking water situations due to quality, source, and cost, though they shared water sharing as a coping strategy. Women faced more physical and mental barriers accessing water for their households, due to their roles as caretakers of their family and knowledge protectors for their communities. Generational divides were found in interviews about what qualified as “good water,” with older participants understanding it as relating to traditional water sourcing, and younger participants wanting clean, accessible tap water. Taken together, the participants demonstrated a frustration with the sub-standard drinking water on reserve.
Intersectionality is used in academic and policy circles to show how mutually constitutive axes of power and social difference intersect to shape lived experiences of inequality. The concept has made inroads in investigations of participatory development to examine people’s engagement, participatory experiences, and outcomes. However, in doing so, there is sometimes a propensity to treat categories of difference as fixed or given. This myopic focus encourages generalizations around how people and groups experience power and difference, and obscures a complex understanding of how these are lived, enacted, and conditioned by diverse subject positions and embodied experiences and practices in participatory development- thus shaping intersectional subjectivity and project outcomes. This ethnographic case study shows how a tribal woman from an ethnic minority- named Purati- experiences, performs, and contests multiple aspects of difference and power in a participatory livelihood project in upland Tripura. Using feminist insights on intersectionality, interpellation, performativity, and feminist political ecology and resource governance literature, we show how multiple and shifting categories of differences are constituted in two encounters between Purati and those implementing the project. We highlight how aspects of difference and their intersections, constituted, and enacted in time and place, shape experiences of intersectionality in participatory development, and how navigating and variously responding to these can reassert and rearticulate intersectional power relations and subjectivity. This nuanced analysis of intersectionality further provides in-depth understandings of how the workings of difference and power shape participatory engagement, goals, and outcomes, and is key for debates and implementation regarding participatory development. Open access available here: https://dx.doi.org/10.14288/1.0443841
Sexual stigma has deleterious effects on the health and wellbeing of sexual minority women. In low- and middle-income countries, theories and research on stigma against sexual minority women largely focus on sexuality-related stigma processes, such as internalized homophobia or perceived or enacted stigma due to sexual identity, attraction or practice. Yet, there is considerable gender diversity among sexual minority women. Further, sexuality and gender identity may intersect with broader gender inequalities to influence the experience of stigma among some groups. In this study, we conducted 21 qualitative life-history interviews with self-identified toms in Bangkok, the capital city of Thailand, to evaluate whether and how gender identity, independent of and together with same-sex sexuality, influences experiences of stigma among gender non-conforming sexual minority women. We find that the pervasive experiences of stigma against toms derive as much from their assumed masculinity in Thai society, as from their same-sex sexuality. Notably, coercive feminization (attempts by others to orient toms toward sexual and gendered expectations of Thai femininity) and boundary policing (expressed hostility toward tom gender performance and sexual intimacy with feminine Thai women) were manifestations of concurrent gender non-conformity and sexual stigma, shaped in turn by the unique location of toms within the Thai gender/sex system. We propose that research and theories on stigma and health among sexual minorities systematically integrate a gender perspective, to elucidate the effects of gender identity and location within the gender structure on sexual minority experiences of stigma.
LGBTQ+ communities comprise 16 million individuals in the United States, yet this population is often rendered invisible within disaster policies. Bias in federal disaster response programs, lack of recognition of LGBTQ+ families, and the prevalence of faith-based organizations in disaster relief services together heighten the risks that LGBTQ+ individuals face. This review article describes the ways in which this combines with the contextual vulnerability of LGBTQ+ communities, whereby existing inequalities and marginalization are exacerbated during disasters and in their aftermath. As a result, the immediate trauma of a disaster, such as physical injury or loss of loved ones or possessions, is compounded in multiple ways for LGBTQ+ individuals, making them less likely to benefit from disaster relief services. To address these inequalities, we conclude our review with a set of policy recommendations to inform prevention, mitigation, and recovery planning, as well as reduce the impacts of disasters affecting LGBTQ+ individuals.
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Disparities in access to basic needs and resources such as water is largely borne out of power imbalance across scale. In examining these power dynamics in the context of health inequalities, scholars have deployed Feminist political ecology analytical framework to situate gender and other forms of vulnerability as emerging from unequal power relations, and political ecology of health to emphasise the health implications of inherent relational power in the distribution of resources. Although appealing, the two theoretical frameworks over time have proven to be limiting in the study of intersectional vulnerabilities such as gender-based violence and water insecurity which reflect multiple dimensions of unequal power structures. This study expands the theoretical space for the study of inequalities in health geography by demonstrating the utility of incorporating feminist political ecology with political ecology of health to form an integrated theoretical framework – Feminist Political Ecology of Health (FPEH). This proposed theoretical framework gives guidance for engaging with a suite of questions and methods related to multifaceted problems such as water insecurity and gender based-violence. The paper highlights these theoretical issues and then discusses how FPEH can enrich research on water security and gender-based violence in Low-and middle-income countries (LMICs).
Water security entails ensuring every citizen with the amount of quality water they need to safely live their everyday life (Narain, 2010). In urbanized areas, unrestricted population growth (Falkenmark and Widstrand, 1992; Ravell, 2014), poor governance (Bakker and Morinville, 2013; Biggs et al., 2013; Cook and Bakker, 2012) and mismanagement of the water supply system (Piesse, 2015) as well as social inequality (Blanca, 2016; Goff and Crow, 2014; Jepson et al., 2017) are among the factors that cause and influence water insecurity. In addition, superordinate physical processes like effects of climate change accelerate the insecurity of water (Bar and Stang, 2016; Turral et al., 2011). Overall, urban water security (UWS) can be conceptualized as being the result of socio-economic activities in metropolitan, urban and sub-urban areas (Grey and Sadoff, 2007).
This review aims to raise awareness of the role of on-street public toilets in urban sanitation and to identify gaps in understanding and guiding future research. Although the literature shows a diversity of viewpoints with regard to solutions, sanitation in public spaces was shown as indispensable for providing universal access to safe, accessible, and inclusive public spaces, particularly for women, transgender people, children, elderly, and people with disabilities. The provision of sanitation services in public spaces can be guided by further research, inclusive engagement, and the elements of the normative policy framework provided by the United Nations.
Accounts of White male violence in the Americas are often profoundly ahistorical. While sociocultural analyses have sometimes framed this violence as a contemporary, emergent, and rapidly worsening problem, scientific approaches have sometimes alternatively framed male violence as a consequence of deep evolutionary processes. Both these approaches have tended to neglect the ways in which the ties between maleness, masculinity, and violence shift in historically contingent ways, including in relation to histories of colonization. Writing in connection with queer, Two-Spirit, and Indigenous feminist thinkers, this article takes up the role of White male violence in both the foundation and ongoing existence of colonial states and traces colonial masculinity as a gender formation that is born of that violence. Given these historical contingencies, I work to shift questions on the nature of male violence from the biology of maleness to the material conditions that colonial masculinities bring into being, tracing some of the emerging molecular ecologies of the colony. © 2021 by The Wenner-Gren Foundation for Anthropological Research. All rights reserved.
The connections between gender and water, sanitation, and hygiene (WASH) are profound, and the sector is beginning to explore the integration of gender-transformative principles into WASH programming and research. Gender-transformative approaches challenge inequalities and move beyond an instrumentalist approach to gender in development interventions. Through a critical review of academic empirical studies, this paper explores the last decade of WASH-gender literature (2008–2018). Trends were visualised using an alluvial diagram. The reviewed literature was underpinned by a diversity of disciplines, yet was dominated by women-focused, water-focused studies. Although the studies addressed many important gender considerations, few studies engaged with transformational aspects of gender equality. The majority of the studies were based in rural sub-Saharan Africa and South Asia, indicating opportunity to explore contextual dynamics in other areas of the global south. Lastly, the studies primarily focus on women of productive age; only a few studies touched on gender dynamics relevant for a diversity of women, and men and boys were mostly absent. Insights from this analysis can inform future studies at the intersection of WASH and gender. Researchers and practitioners are encouraged to include a diversity of voices, reflect on the strengths and limitations of research disciplines, and incorporate gender-transformative concepts.
Water is imperative for nutrition and health, economic productivity, and political stability; it also holds cultural and symbolic meanings and functions. Household water insecurity is an emerging construct that captures lived experiences with water access, use, and acceptability. Although the plausibility of household water insecurity to “get under the skin” and shape human biology is high, these relationships have not been systematically investigated. Therefore, in this article, we set out to examine how household water insecurity and allied concepts affect health and human biology throughout the life course. We first lay out the various ways that water insecurity can act as a deleterious exposure, that is, through problematic quality, excess, and shortage. Next, we posit how water insecurity directly shapes human biology, as well as indirectly, via psychosocial stress precipitating cortisol exposure, with potential intergenerational effects. We highlight a range of established and plausible biological consequences using evidence from human and animal model studies. These include diarrheal prevalence, dehydration, stunting, food insecurity, gut microbiome alteration, malnutrition, psychosocial stress, adverse birth outcomes, lower cognitive function and performance, hypertension, and chronic kidney disease. We also discuss the mechanisms by which household water insecurity may shape human biology across the life course; however, these pathways are just beginning to be understood. Longitudinal studies that simultaneously quantify household water insecurity and biological outcomes using comparable metrics in diverse environments and across generations will provide necessary evidence to establish causal relationships. Given the current global water crisis and its potential health consequences, such studies are urgently needed.
This article is categorized under:
• Engineering Water > Water, Health, and Sanitation
• Science of Water > Water Quality
There is a well‐established connection among water quality, sanitation, and physical health. The potentially important relationship between water and mental health is considerably less studied. Reviewing evidence from ethnography, geography, folklore, indigenous studies, rural medicine, drought research, and large‐n statistical studies, we argue there is now good theoretical rationale and growing evidence of water insecurity as a possible driver of mental ill‐health. Furthermore, some nascent evidence suggests that emotionally meaningful interactions with water might improve mental health outcomes. Leveraging these literatures, we address the many ways in which mental health outcomes are conceptualized and operationalized in water research, including as emotional distress, perceived stress, depressive symptoms, anxiety symptoms, somatic symptoms, and quality of life. We outline arguments supporting seven possible (and likely interlocking) mechanisms that could explain such a relationship: (a) material deprivation and related uncertainty, (b) shame of social failure, (c) worry about health threats, (d) loss of connections to people and places, (e) frustration around opportunity losses and restricted autonomy, (f) interpersonal conflict and intimate partner violence, and (g) institutional injustice or unfairness. However, we explain that as most existing studies are ethnographic, qualitative, or cross‐sectional, a causal relationship between water and mental ill‐health is yet to be confirmed empirically. More research on this topic is needed, particularly given that poorly understood connections may create barriers to achieving Sustainable Development Goals 3 (health) and 6 (water). We further suggest that tracking mental health indicators may provide unique and as‐yet underappreciated insights into the efficacy of water projects and other development interventions.
This article is categorized under:
• Engineering Water > Water, Health, and Sanitation
• Human Water > Water as Imagined and Represented
Household water management is often women's responsibility, as related to the gendered nature of household roles. Ethnographic data suggest that household water insecurity could increase women's exposure to emotional and physical forms of intimate partner violence (IPV), as punishments for failures to complete socially expected household tasks that rely on water (like cooking and cleaning) and the generally elevated emotional state of household members dealing with resource scarcity. Here, we test the associations between sub-optimal household water access and women's exposure to IPV, using the nationally-representative data from Nepal Demographic and Health Survey, 2016. Drawing upon the intra-household bargaining model as the theoretical framework, we run instrumental variable probit regression, to test the association between household water access and prevalence of IPV against women. After controlling for other known covariates of IPV such as women's empowerment and education, the findings substantiate that worse household water access consistently elevates women's exposures to all forms of IPV. This suggests that improvements in household water access may have additional ramifications for reducing women's risk of IPV, beyond currently recognized socioeconomic benefits. While both household water access and IPV have known health consequences, linking them provides another pathway through which water could affect women's health.
A biocultural approach provides an emerging framework for clarifying the mechanisms that connect water security to human health and wellbeing. Five basic tenets of the biocultural approach are outlined: The focus on the local, the centrality of culture, the notion of embodied disadvantage, a concern with proximate mechanisms as a means to test theorized pathways, and recognition of intersecting and potentially amplified (syndemic) risks. From a review of both new and dispersed biocultural literature on household water, four key themes emerge: (a) individual vulnerabilities to the biological effects of water insecurity are shaped by cultural practices; (b) water insecurity is a powerful biocultural stressor on mental health; (c) water insecurity mediates between low power and worse health within communities, and through multiple mechanisms; (d) the household is a nexus for food–water interactions, each likely worsening each other and health through syndemic relationships. This sets an agenda for a biocultural approach to the household as a localizing nexus for manifesting the very human costs to mental and physical health of managing under conditions of extreme household resource insecurity.
This article is categorized under:
• Engineering of Water > Planning Water
• Human Water > Water Governance
• Human Water > Water as Imagined and Represented
The Human Rights to Water and Sanitation (HRWS), adopted as UN Resolutions since 2010, contemplates key elements that seek to ensure equal and non-discriminatory access to water and sanitation, including the elimination of gender inequalities. Working in populations with socio-environmental vulnerabilities, this study aims to assess gender division of labor in households of two rural communities in the North and Northeast Brazilian macroregions and identify why greater impacts occur on the lives of women when compared to men, resulting in human rights concerns. A qualitative analysis was carried out through semi-structured interviews and direct observation. The study showed that in the two rural Brazilian communities there is a clear labor division for water and sanitation access in a gender perspective. Men undertake more specialized work, sometimes requiring greater physical effort. As for women, they are assigned functions related to the domestic environment, including activities concerning water and sanitation. When facilities are inadequate, women suffer disproportionately impact on their health and quality of life, showing that the non-compliance with the human rights to water and sanitation often results in more harmful consequences for them.