12.1.

1 Gender and sex

Gender refers to what it means to be a male or a female in a given society and

culture. Thus, gender is social construct that determines the roles, behaviour,

activities and attributes that a particular society at a given time considers appropriate

for men and women, girls and boys. It is shaped by the sociocultural environment

and experience in addition to biology and vary widely within and between cultures

and often evolve over time.

Gender is not synonymous to sex; which refers to biological classification of

people as male or female based on physical and physiological features including

chromosomes, gene expression, hormone level and function, and reproductive and

sexual anatomy. The term “intersex” is used as an umbrella term for individuals

born with natural variations in biological or physiological characteristics (including

sexual anatomy, reproductive organs and or chromosomal patterns that do not fit

traditional definitions of male or female. Infants are generally assigned the sex of

male or female at birth based on the appearance of their external genitalia.

12.1.2 Sexual orientation and gender identity

There is tremendous variability in the ways that individuals express their gender and

in the ways, they express their sexual orientation. Accordingly, various concepts exist

to accommodate these variations and healthcare providers should be conversant

with them to appropriately use them when working with diverse clients.

Sexual orientation is a function of sexual attraction, identity, and behavior. Sexual

attraction is about the type of person an individual desire sexually, romantically,

emotionally, and in other sexual ways; heterosexual individuals are attracted to

people of the opposite sex, homosexual individuals are attracted to people of the

same sex, and bisexual individuals are attracted to both people of the opposite

sex and the same sex. Sexual identity is about how people present their sexuality

to others, with some people very private about their sexual identity and others very

open. Sexual behavior is about the sexual actions in which a person engages.
Some people choose to be celibate.

Besides sexual orientation exists gender identity, which is an individual’s sense

of maleness or femaleness and gender expression which is how an individual

expresses their own gender to the world, i.e., through names, clothes, how they

walk, speak, communicate, their roles in society and general behaviour. These may

sometimes not match societally accepted norms for their biological sex at birth. A

cisgender person has a gender identity that aligns with the sex assigned to that

person at birth. A transgender person has a gender identity that does not match

the sex assigned at birth.

12.1.3 Gender equality and equity

Gender being an array of socially constructed characteristics and roles, makes it

hierarchical and is surrounded with inequalities and inequities. Gender inequality

refers to unequal treatment or perceptions of individuals based on their gender.

It emerges when one of the two sexes is considered more valuable, capable,

powerful, and has more access to information, resources and opportunities than

the other and is an important factor for gender-based violence. Opposed to this,

is gender equality that refers to a state where there is no discrimination on the

basis of a person’s sex in the allocation of resources and in the access to various

services in a society. With gender equality, individual’s rights, responsibilities and

opportunities are not determined by the sex they are assigned at birth nor gender

identity or sexual orientation.

To achieve gender equality, some strategies and processes “equity” come in.

Gender equity therefore refers to fairness and justice in the distribution of

resources, opportunities, and benefits to women/girls in relation to men/boys. It

implies objectivity of treatment for all genders with regards to their respective needs

and strives to bring all the genders to an equal playing field. It recognizes that certain

groups face disadvantages because of historical and structural reasons therefore

contextual measures required to ensure that their disadvantaging situations are not
perpetuated.

12.1.4 Gender-based violence

Gender-based violence (GBV) refers to any act of violence that results in, or is

likely to result in, physical, sexual or psychological harm or suffering to someone

on the basis of their gender or sex. Although, this definition is applicable to both

men and women, the phenomenon of GBV mostly affects women. It roots deeply

in discriminatory cultural beliefs and attitudes that perpetuate inequality and

powerlessness, in particular of women and girls.

12.3. Types of gender based violence

a. Physical violence:

Physical violence is an act attempting to cause, or resulting in pain and or physical

injury through coercion. Physical violence in intimate relationships, often referred

to us as domestic violence, continues to be a widespread phenomenon in every

country. Acts of physical violence include beating, burning, kicking, punching, biting,

maiming or killing, or the use of objects or weapons.

Some classifications also include human trafficking and slavery in the category

of physical violence because initial coercion is often experienced, and the people

involved often end up becoming victims of further violence as a result of their

enslavement. Physical violence in the private sphere also affects young people. As

mentioned above, witnessing the abuse of one parent by another leads to serious

psychological harm in children. Often, children and young people who are present

during an act of a parent abuse like spouse abuse may also be injured, sometimes

by accident and sometimes because they try to intervene.

b. Verbal violence and hate speech

Verbal violence can include issues that are specific to a person, such as putdowns

(in private or in front of others), ridiculing, the use of swear-words that are

especially uncomfortable for the other, saying bad things about the other’s loved
ones, threatening with other forms of violence, either against the victim or against

somebody dear to them. At other times, the verbal abuse may be relevant to the

background of the victim, such as their religion, culture, language, (perceived)

sexual orientation or traditions. Depending on the most emotionally sensitive areas

of the victim, abusers often consciously target these issues in a way that is painful,

humiliating and threatening to the victim.

Most of the verbal violence that women experience because of being women is

sexualized, and counts as sexual violence. Verbal gender-based violence in the

public sphere is also largely related to gender roles and it may include comments

and jokes about women or may present women as sex objects (e.g. jokes about

sexual availability, prostitution, rape). A great deal of bullying is related to the

perceived sexuality of young people (especially boys).

The regular negative use of words such as “queer” or “fag” is often traumatizing for

those perceived as gays and lesbians. This is very likely one of the reasons why

many gays and lesbians only “come out” after secondary school.

Verbal violence may be classified as hate speech and can take many forms i.e.

words, videos, memes, or pictures that are posted on social networks, or it may

carry a violent message threatening a person or a group of people because of

certain characteristics.

Many cultures have sayings or expressions to the effect that words are harmless,

and there is a long tradition that teaches people to ignore verbal attacks. However,

when these attacks become regular and systematic and purposefully target

someone’s sensitive spots, the object of the attacks is right to consider themselves

victims of verbal abuse. Gender-based hate speech mainly targets women (in this

case, it is often called “sexist hate speech”).

Gender-based hate speech can take many different forms i.e. jokes, spreading

rumors, either using internet using online messaging, threats, slander, and

incitement of violence or hate. It aims at humiliating, dehumanizing and making a

person or group of people scared. As with any type of violence, gender-based hate
speech is usually very destructive for the person targeted. People who experience

hate speech often feel helpless, and do not know what to do.

c. Emotional & psychological violence:

All forms of violence have a psychological aspect, since the main aim of being

violent or abusive is to hurt the integrity and dignity of another person. Apart from

this, there are certain forms of violence which take place using methods which

cannot be placed in other categories, and which therefore can be said to achieve

psychological violence in a “pure” form. This includes isolation or confinement,

withholding information, disinformation, and threatening behavior. In the private

sphere, psychological violence includes threatening conduct which lacks physical

violence or verbal elements, for example, actions that refer to former acts of

violence, or purposeful ignorance and neglect of another person.

d. Sexual violence:

Includes actual, attempted or threatened (vaginal, anal or oral) rape, including

marital rape; sexual abuse and exploitation; forced prostitution; transactional or

survival sex; and sexual harassment, intimidation and humiliation. Furthermore,

sexual violence comprises engaging in non-consensual vaginal, anal or oral

penetration with another person, by the use of any body part or object; engaging in

other non-consensual acts of a sexual nature with a person; or causing someone

else to engage in non-consensual acts of a sexual nature with a third person. Marital

rape and attempted rape constitute sexual violence.

Examples of forced sexual activities include being forced to watch somebody

masturbate, forcing somebody to masturbate in front of others, forced unsafe sex,

sexual harassment, and abuse related to reproduction (e.g. forced pregnancy,

forced abortion, forced sterilization, female genital mutilation).

Certain forms of sexual violence are related to a victim’s personal limits, and are

more typical of the private sphere. The perpetrator deliberately violates these

limits: examples include date rape, forcing certain types of sexual activities. One

common example of such violence in the public sphere includes the isolation of
young women or men who do not act according to traditional gender roles. Isolation

in the public sphere is most often used by peer groups, but responsible adults such

as teachers and sports coaches can also be perpetrators. Most typically, isolation

means exclusion from certain group activities. It can also include intimidation, in a

similar fashion to psychological abuse in the private sphere withdrawal of sexual

attention as a form of punishment, or forcing other(s) to watch (and sometimes to

imitate) pornography.

e. Socio-economic violence

Socio-economic deprivation can make a victim more vulnerable to other forms of

violence and can even be the reason why other forms of violence are inflicted.

Typical forms of socio-economic violence include taking away the earnings of the

victim, not allowing them to have a separate income (giving them “housewife”

status, or making them work in a family business without a salary), or making the

victim unfit for work through targeted physical abuse.

Socio-economic violence in the public sphere is both a cause and an effect of

dominant gender power relations in societies. It may include denial of access to

education or(equally) paid work (mainly to women), denial of access to services,

exclusion from certain jobs, denial of pleasure and the enjoyment of civil, cultural,

social and political rights. Some public forms of socio economic gender-based

violence contribute to women becoming economically dependent on their partner

(lower wages, very low or no child-care benefits, or benefits being tied to the income

tax of the wage-earning male partner). Such a relation of dependency then offers

someone with a tendency to be abusive in their relationships the chance to act

without fear of losing their partner.

f. Domestic violence or violence in intimate relationships

Domestic violence includes acts of physical, sexual, psychological or economic

violence that occur within the family or domestic unit or between former or current

spouses or partners, whether or not the perpetrator shares or has shared the same

residence with the victim. Domestic violence, or intimate partnership violence, is

a relational type of violence, and the dynamics are therefore very different from

violent incidents that occur among strangers.

The fact that domestic violence was long considered to be a private, domestic

issue has significantly hampered recognition of the phenomenon as a human rights

violation. The invisibility of the phenomenon was reinforced by an understanding

of international human rights law as applicable only to relations between individual

and the state (or states). However, it is now recognized that state responsibility

under international law can arise not only from state action, but also from state

inaction, where a state fails to protect citizens against violence or abuse (the “due

diligence” principle).

Although the vast majority of domestic violence is perpetrated against women by

men, it actually occurs in same sex relationships just as frequently as in heterosexual

relationships, and there are cases of women abusing their male partners. Domestic

violence such as rape, battering, sexual or psychological abuse leads to severe

physical and mental suffering, injuries, and often death.

g. Harmful traditional practices and sexual harassment

Include female genital mutilation/cutting (FGM/C); forced marriage; child marriage;

honour or dowry killings or maiming; infanticide, sex-selective abortion practices;

sex-selective neglect and abuse; and denial of education and economic opportunities

for women and girls.

Sexual harassment defined as any form of unwanted verbal, non-verbal or physical

conduct of a sexual nature with the purpose or effect of violating the dignity of a

person, in particular when creating an intimidating, hostile, degrading, humiliating or

offensive environment. Verbal examples of sexual harassment may include making

sexual comments about a person’s body, making sexual comments or innuendos,

asking about sexual fantasies, preferences, or history, asking personal questions

about someone’s social or sex life, making sexual comments about a person’s

clothing, anatomy, or looks, repeatedly trying to date a person who is not interested,
telling lies or spreading rumors about a person’s sex life or sexual preferences.

Examples of non-verbal harassment include looking a person up and down

“elevator eyes”, following or stalking someone, using sexually suggestive visuals,

making sexual gestures with the hands or through body movements, using facial

expressions such as winking, throwing kisses, or licking lips.

12.5. The primary victims and survivors of Gender Based

Violence

Both the terms of survivor and victim are used for a person who experienced

GBV and often used interchangeably. The term “victim” is often used in the legal

and medical sectors, recognizing that many forms of GBV are crimes. The term

“survivor” is generally preferred in the psychological and social support sectors

because it implies resiliency.

Gender-based violence is a widespread problem that affects males and females.

It disproportionately affects women and girls as a result of power imbalances

stemming from gendered power structural perceptions of masculinity and femininity

that create a rank order of gender.In case of domestic violence, children can be

affected by violence committed against their mothers, and they themselves can be

abused by the perpetrator, which can often be their fathers or stepfathers.

Persons who have been separated from their family or community, and or lack

access to shelter, education and livelihood opportunities, are among those most

at risk of GBV. This includes Children, especially unaccompanied minors, fostered

children, female and child heads-of-households, boys and girls in foster families or

other care arrangements, persons with mental and or physical disabilities, persons

in detention, house girls, single mothers, economically disempowered people, junior

staff, students, less privileged community members particularly those of minority

groups, asylum seekers, refugees and internally displaced people and girls and

boys born to rape victims/survivors. Women are the primary victim of GBV because

they are usually second class, culturally considered inferior.