Differences in women’s and men’s bodies due to their sex (biology) is playing a role in people’s risk of illness and death due to COVID-19. To attribute gender differences in COVID-19 outcomes solely to biology however ignores the role that social environments, structures and norms are playing, and obscures the actions that can be taken to address these drivers.

Further, sex-disaggregated COVID-19 data does not report or account for gender identity, therefore data are absent on the impact of COVID-19 on transgender and non-binary people. Some efforts are in place to redress this gap. Without this information, the specific health care needs of people with diverse gender identities cannot be identified, the health disparities they experience cannot be addressed, and important health care services may not be delivered.

Defining Sex and Gender Sex Refers to biological characteristics that determine risk and response to disease, for instance driving hormonal responses, immunological characteristics, and response to vaccines.

Source Gender The UN defines gender as what is expected, allowed and valued in a woman or a man in a given context. These attributes, opportunities and relationships are context/time-specific and changeable.

Source The ‘gender binary’ however is increasingly being rejected in many places to recognise, respect and embrace diverse gender identities.

Source Gender influences exposure to risk (air pollution, smoking, alcohol), likelihood of risk reduction (e.g. seeking health care), as well as who benefits from the resources available (e.g. who can access health services, or who is likely to be providing care). Health outcomes and health systems reflect and reinforce gender biases and restrictive gender norms, compromising the safety and wellbeing of providers and the health of communities. Gender and social inequalities (based on class, race or ethnicity, etc) intersect and multiply these negative effects on both the health system and the communities they serve.

Source Globally, there’s no clear trend in terms of who is most likely to become infected by COVID-19. However, across the vast majority of countries, a clear pattern in mortality has emerged; men appear more likely than women to die from COVID-19 once infected. This pattern varies by country and may be changing over time. Why do men appear to be at more risk of severe illness and death?

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