The Psychology of Gender 4th Edition

Sex Differences in Health: Evidence and Explanations 349

headache also increase among adolescent girls

(Sweeting & West, 2003). In a study of 11- to

15-year-olds across 29 European and North

American countries, girls reported more

health complaints (e.g., headache, stomach-

ache, depression, dizziness) than boys (Tor-

sheim et al., 2006). The difference appeared

in all countries and for each of the nine health

complaints. As shown in Table 10.5, the sex

difference (i.e., odds ratio, such that higher

numbers mean more females than males) in-

creased with age and decreased in countries

where women had more education and in-

come (i.e., higher gender development index).

Health care utilization rates reflect the

changes in female and male morbidity over

adolescence. During childhood, boys visit

health care professionals more frequently

than girls, but during adolescence, girls visit

health care professionals more than boys.

Health care utilization in childhood, how-

ever, does not reflect children’s behavior

alone; adults are more likely to be making

the decision to seek health care. Thus it may

be that parents, in particular mothers, are

more likely to take boys than girls to see a

doctor when they are young. Parents might

take boys’ complaints more seriously be-

cause they expect boys to be less likely than

girls to complain of symptoms; admitting ill-

ness violates gender-role norms for boys.

pain, and distress, women’s ratings of their

health are lowered.

Women also report moreillness be-

haviorthan men, that is, behaviors that sig-

nify illness. For example, women report more

days in bed due to illness, more days in which

they restricted their activities due to illness,

and greater physical limitations (Pleis &

Lethbridge-Cejku, 2007). Among employed

persons, women take more sick days from

work (Smeby, Bruusgaard, & Claussen, 2009).

Women report greater disability and greater

functional limitations than men, and this dif-

ference persists throughout adulthood and

increases with age (Gorman & Read, 2006).

One aspect of illness behavior is seek-

ing medical care. Women report a greater

use of health services compared to men

(Koopmans & Lamers, 2007), which is often

taken as an indication of women being sicker

than men. Sex differences in the use of health

care services peak during women’s childbear-

ing years. When reproductive-related reasons

are taken into consideration, sex differences

in hospitalization become more similar, but

women still receive greater outpatient care

than men. One reason women use more

health care is that women have a greater num-

ber of chronic conditions. Some of women’s

higher morbidity rates are related to gyneco-

logical problems, but even when these prob-

lems are taken into consideration, women

have higher rates of morbidity than men.

Interestingly, sex differences in mor-

bidity do not appear until adolescence. For

example, chronic illnesses, such as asthma

and migraine headaches, are more prevalent

among boys than girls during childhood, but

by early adolescence, this sex difference re-

verses itself (Sweeting, 1995). Not only does

depression increase among girls during ado-

lescence (discussed in Chapter 13), but physi-

cal symptoms such as stomach problems and

TABLE 10.5 ODDS RATIO OF WOMEN HAVING MORE

HEALTH SYMPTOMS THAN MEN

Low

GDI

Medium

GDI

High

GDI

11-year-olds 1.56 1.17 1.18

13-year-olds 1.88 1.70 1.56

15-year-olds 2.27 1.91 1.88

Note: GDI = Gender Development Index, high GDI

signifies women have higher education and income.

Source: Torsheim (2006).

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