Sexism can take different forms, some of which are disguised as protectiveness and flattery. Nevertheless, sexism, in whatever form, has a negative effect on how women are perceived and treated by others and by themselves. The theory of, and research on, ambivalent sexism, which encompasses attitudes that are overtly negative (hostile sexism) and those that seem subjectively positive but are actually harmful (benevolent sexism), have made substantial contributions to understanding how sexism operates and the consequences it has for women. One review published recently in Nature Reviews Psychology summarized the predictors of ambivalent sexism and the impact on women’s health.

Various Forms

Sexism is a type of prejudice that specifically ranks women lower than men. Although it can take overtly negative — and in some cases even violent — forms, sexist attitudes toward women may not be overtly negative. Indeed, women will often be described in a more positive light than men. However, the positive descriptions of women tend to be limited to traits linked to empathy (women are sociable and kind), whereas men are described more positively in areas such as agency and competence, which determine status and power in society (men are brilliant and capable).

The theory of ambivalent sexism accounts for these specific circumstances and postulates that sexism combines antipathy (hostile sexism) with subjective benevolence (benevolent sexism) in its attitude toward women to maintain the dominance that men hold over women.

Sexism and Health

Although women and men can experience sexism, women are more commonly the target of this type of prejudice, despite the perceived progress made in women’s rights over the last decade. Because of its pervasiveness, sexism toward women has been conceptualized as a daily “hassle” that may have dire implications for women’s mental and physical health.

Despite the lack of consensus on whether to incorporate or even investigate sex and gender differences in treatment paradigms, research investigating social determinants of health has uncovered evidence that women’s symptoms are often barely acknowledged or even dismissed by medical professionals (medical sexism). This has inspired research and interventions aimed at reducing the biases displayed by health care professionals, with the goal of reducing sex disparities in healthcare management.

Sexism and Illness

Despite being the main cause of death worldwide in women each year, cardiovascular disease (CVD) in women remains underrecognized, underdiagnosed, and undertreated. For example, in comparing data from the National Health and Nutrition Estimation Survey (NHANES) III (1988-94) and NHANES IV (1999-2002), more postmenopausal women were hypertensive than age-matched men. Moreover, fewer postmenopausal women than men had their blood pressure controlled to goal.

It has been hypothesized that, based on the NHANES data, it’s likely that either women are not being treated as aggressively for their CVD, or other mechanisms that are not common in men may contribute to their CVD. The positive association between experiences of sexism and posttraumatic stress disorder, psychological distress, and the frequency of smoking and drinking behavior among women should incite researchers to examine it in more depth as an additional cardiovascular risk factor in women.

Furthermore, cardiovascular warning signs may be detected in women targeted by benevolent and hostile sexism, with heightened cardiovascular reactivity to hostile sexism experiences, but also after benevolent sexism experiences with impaired cardiovascular recovery in returning to baseline functions.

Sexism may also be a notable factor of physical stress, and experiences of benevolent and hostile sexism are associated with an increase in self-reported anxiety and rage, with relatively stronger associations for hostile sexism than for benevolent sexism. Even today we still find it difficult to know how to discriminate between the specific emotional and psychological aftereffects of exposure to various forms of ambivalent sexism, and this will be one of the aims of future research in the field.

This article was translated from Univadis Italy, which is part of the Medscape Professional Network.

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