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The few previous studies investigating regulation of gender in trans-specific healthcare are mainly based on text material and interviews with care-providers or consist solely of theoretical analyses. There is a lack of studies analysing how the regulation of gender is expressed in the care-seeker's own experiences, especially in a Nordic context. The aim of this study is to analyse narratives of individuals with trans experiences (sometimes called transgender people) to examine how gender performances can be regulated in trans-specific care in Sweden. The conceptual framework is inspired by trans studies, a Foucauldian analysis of power, queer phenomenology and the concept of cisnormativity. Fourteen interviews with people with trans experiences are analysed with constructivist grounded theory. The participants' experiences indicate that gender is constructed as norm-conforming, binary and stable in trans-specific healthcare. This gendered position is resisted, negotiated and embraced by the care-seekers. Norms and discourses both inside and outside trans-specific care contribute to the regulation and limit the room for action for care-users. We conclude that a trans-specific care that has a confirming approach to its care-users, instead of the current focus on gender norm conformity, has the potential to increase the self-determination of gender performance and increase the quality of care.

Lack of safe space has been connected to ill health among people with trans experiences. This study analyses trans people’s experiences of being in public, semi-public and community spaces using the analytical concept of safety/unsafety in relation to perceived health. The analytic framework draws on the concepts of cisgenderism, orientation, lines and comfort. The material analysed consisted of 18 individual interviews with people with trans experiences, which were analysed using constructivist thematic analysis. The analysis resulted in the identification of three themes: straightening devices creating limited living space, orienting oneself in (cis)gendered spaces and creating safer (?) community spaces for healing. Experiences of unsafety ranged from incidents and fear of different kinds of violence in public and semi-public spaces to the lack of a transpolitically informed agenda in, for example, feminist spaces. Safer spaces helped participants to feel a sense of belonging, to share their experiences and to heal. Experiences of unsafety and discomfort are important as they will help us to understand the health situations of people with trans experiences. It is important to facilitate the creation of safer spaces to improve the health of members of this group.

This study analyses how sick leave among women and men are related to patterns of gender equality at the workplace. The study is based on register data from the  Longitudinal integration database for health insurance and labor studies (LISA), and includes 520 workplaces for 134 450 people. Indicators of gender equality at the workplace consist of women to men ratio in terms of number of employees, salaries, education and parental leave. Cluster analysis is used to identify patterns of gender equality. Differences in women’s and men’s sick leave are analysed by chi-square test and logistic regression analyses.

The analysis compares sick leave between six clusters of workplaces with different patterns of gender equality: 1) unequal with higher scores for men, 2) majority of women and equal salary, 3) equal salary and more parental leave for men, 4) unequal with equal representation, 5) equal in divergent spheres, 6) traditionally unequal. None of the clusters were completely gender equal, but the result of the analysis shows that the most gender equal workplaces have the lowest level of sick leave. For both women and men, the odds for sick leave are higher in workplaces with a majority of women that otherwise are relatively gender equal. For men, the odds for sick leave were higher at traditionally gender unequal workplaces.

An equal representation of women and men at the workplace does not necessarily imply gender equality in other aspects such as salary, education and parental leave. More gender equal workplaces yet have lower risk of sick leave for both women and men, even though women consistently have higher rates of sick leave. A multidimensional approach to gender inequality at the workplace is important for understanding the skewed distribution of sickness absence between women and men in the general population.

In Sweden as well as in other western countries persons with trans experiences have to go through a clinical evaluation in order to get access to gender-confirming medical procedures. The aim of this study is to analyse care-users' experiences of navigating and negotiating access to gender-confirming medical procedures in Sweden. Biomedicalisation is used as a theoretical framework in order to analyse how technoscientific and neoliberal developments are parts of constructing specific experiences within trans-specific care. Constructivist grounded theory was used to analyse 14 interviews with persons having experiences of, or considering seeking, trans-specific healthcare. The participants experienced trans-specific healthcare as difficult to navigate because of waiting times, lack of support, provider ignorance and relationships of dependency between healthcare-users and providers. These barriers pushed the users to take responsibility for the care process themselves, through ordering hormones from abroad, acquiring medical knowledge and finding alternative support. Based on the participants' experiences, it can be argued that the shift of responsibility from care-providers to users is connected to a lack of resources within trans-specific care, to neoliberal developments within the Swedish healthcare system, but also to discourses that frame taking charge of the care process as an indicator that a person is in need of or ready for care. Thus, access to gender-confirming medical procedures is stratified, based on the ability and opportunity to adopt a charge-taking role and on economic and geographic conditions. Based on the results and discussion, we conclude that trans-specific care ought to focus on supporting the care-seekers throughout the medical process, instead of the current focus on verifying the need for care. There is also a need for increased knowledge and financial resources. A separation between legal and medical gender reassignment could contribute to a better relationship between care-providers and care-users and increase the quality of care.

Aim: The aim of this study was to analyse how changes in housework over the course of adulthood are related to somatic health in Swedish men and women.

Methods: Data were drawn from 2 waves of the Northern Swedish Cohort Study, response rate 94.3%, N1,001. A subsample of cohabiting individuals was selected (n328 women, 300 men). Outcome variable was functional somatic symptoms (FSS) at age 42. Associations were assessed in multivariate general linear models with adjustment for confounders and somatic health at age 30.

Results: Housework is primarily performed by women, and women’s responsibility for and performance of housework increased from ages 30 to 42. These changes were associated with elevated levels of FSS at age 42 in women. Men reported considerably lower responsibility for and performed less housework compared with women, the load of housework for men does not change substantially from ages 30 to 42 and no associations with FSS were identified.

Conclusions: The gendered division of housework means that women are particularly exposed to a heavy workload. Women’s responsibility for and performance of housework increase between ages 30 and 42 and this threatens to be embodied in the form FSS. We conclude that housework should be considered an important source of stress in addition to that from waged work and that a deeper understanding of the links between housework and health requires a gender theoretical analysis.

Ligesom i det øvrige Norden har kvinder og mænd i Danmark erhvervsarbejde i næsten samme omfang, men befinder sig i forskellige jobtyper og i forskellige positioner på arbejdsmarkedet (Fagan & Burchell, 2012). Samtidig er det kvinderne, der udfører hovedparten af det ulønnede arbejde i hjemmet (Harryson et al., 2012; Craig & Mullan, 2010). Uligheder på disse områder betyder, at kvinder og mænd udsættes for forskellige arbejdsmiljøer og ansvar på jobbet såvel som i hjemmet, hvilket igen kan medføre kønnede konsekvenser for sundhedstilstanden (Elwér et al., 2013, Harryson et al., 2012). I dette kapitel undersøger jeg relationerne mellem husligt arbejde, ligestilling og sundhed ud fra et folkesundhedsperspektiv og ved hjælp af kønsmagtteorier. Kapitlet består af tre overordnede dele. I den første del beskrives de teoretiske perspektiver, som bruges til at forstå, hvordan ulønnet arbejde i hjemmet kan være relateret til god eller dårlig sundhed. Denne del beskriver folkesundhedsperspektivet, kønsmagtteorier og sundhedsdefinitioner. Den anden del inkluderer en empirisk undersøgelse, som bygger på spørgeskemaundersøgelser, som kvinder og mænd i Danmark har besvaret. Her beskrives de analysemetoder, som er blevet anvendt, og de resultater, man har fundet frem til, bliver diskuteret. Kapitlet afsluttes med metodologiske refleksioner over, hvordan kønsmagtteorier og socialepidemiologiske metoder kan bidrage til at forstå betydningen af ulønnet arbejde i hjemmet ud fra et folkesundhedsperspektiv.

BACKGROUND: Gender inequality within paid and unpaid work exposes women and men to different environments and responsibilities. These gender patterns shape living conditions for women and men, either negatively or positively, by affecting the prospect of good health. Most public health studies of gender and housework are quantitative, and knowledge about the relationship between housework experiences and health for women and men is limited. The aim of this study was to explore the housework experiences and practices of women and men and their experiences of stress and perceived wellbeing from a gender perspective.

METHODS: We conducted thematic interviews with four women and four men living in Sweden, and performed an analysis using the Grounded Theory method.

FINDINGS: We found that stereotypical gender practices in housework influenced experiences of stress and perceived wellbeing among women and men. Despite proposing gender equality in housework as a means of improving wellbeing, inequality was amplified by the way women and men handle the gendered division of housework. We call this recurring theme "The process of housework resignation", which also constitute the core category in our analysis. "The process of housework resignation" was theorised from the categories "Gender practices in housework", "Experiencing stress and wellbeing" and "Managing daily life".

CONCLUSIONS: Stereotypical gender practices in housework can increase experiences of stress among women and men. Challenging stereotypical masculinities can be a key for breaking the process of resignation in housework and for facilitating improved health among both women and men in heterosexual couple relationships within a Swedish context.

Ojämlikt uttag av föräldraledigheten inte bara cementerar föräldraskap och könsroller, det har även negativa konsekvenser för föräldrars möjligheter att uppnå välmående och hälsa. Åsa-Maja Augustsson och Lisa Harryson visar hur framförallt "det oändliga moderskapet" har förödande konsekvenser för såväl mödrar som fäder i heterosexuella parrelationer.

Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.

Background: Women and men in Sweden are in paid work to almost the same extent, but are found in different occupations and positions in the labour market. Still, women perform the bulk of the unpaid domestic work at home. Gendered inequalities in these respects leave women and men exposed to different work environments and responsibilities, which in turn can have gendered health consequences. In public health research there is a lack of studies on domestic work that include women and men, as well as a lack of qualitative studies exploring individuals’ experiences of domestic work and mental health. At the workplace level, few attempts have been made to analyse how several dimensions of gender equality at workplaces are related to health status and there is a lack of studies with a contextual approach combining many different variables that are at play simultaneously. Because of the cross-sectional design of previous studies on paid and domestic work there is a lack of analyses taking possible health-related selection into account, which makes it difficult to ascertain whether gender equality leads to better health or if good health is a prerequisite for gender equality.

Aim: The aim of this thesis was to analyse gender relations of work (at workplaces and at home) in relation to mental illness among women and men.

Methods: The thesis was based on data from the Northern Swedish Cohort. The baseline survey was conducted in 1981 when the participants were 16 years old (n= 1080, 574 boys and 506 girls), with follow-up at age 18, 21, 30 and 42. The response rate was 94 % throughout the last follow-up in 2007. Data from the Northern Swedish Cohort were supplemented with register data about the employees at the participants’ workplaces. The analysis methods for the questionnaire and register data were logistic regression analysis and cluster analysis. Interviews were performed with four women and four men in the Northern Swedish Cohort and were analysed with a Grounded Theory approach.

Results: Women had overall greater responsibility for domestic work. Gender inequality in responsibility for domestic work and perceptions of gender inequality in the couple relationship (after adjustments for background variables and previous psychological distress) were associated with psychological distress among women and men. However, among men the relation between domestic work inequalities and psychological distress was affected by socioeconomic position relative to the partner. Having less responsibility for domestic work and a partner with higher socioeconomic position was associated with psychological distress among men. The qualitative analysis showed that gender relations were an important part of how the domestic work was unequally organised and related to experiences of mental illness among women and men. Among women the high burden of domestic work was experienced as an obstacle to experiencing good health. Among men the experience of being trapped in an outmoded masculinity was related to feelings of stress. At the workplace level, patterns of gender inequality were associated with psychological distress among women, but not among men. However, the most gender-equal pattern was related to lower as well as more similar levels of mental illness among women and men, which supports a convergence in health when women’s and men’s work conditions become more similar.

Conclusion: Gender equality at home and at work is central for reducing mental illness among both women and men, but also for achieving a good average health status in the population, which is a central public health target. When investigating social inequalities in health, gender perspectives are of great importance for deepening the understanding of how and why gender inequalities in paid and domestic work are related to mental illness. Integrating gender perspectives into public health policy could be a way to acknowledge power relations that hinder good public health.

Bakgrund: Kvinnor och män i Sverige yrkesarbetar i nästan samma sträckning, men återfinns i olika yrken och positioner på arbetsmarknaden. Samtidigt utför kvinnor merparten av det obetalda arbetet i hemmet. Könade orättvisor i dessa avseenden innebär att kvinnor och män utsätts för olika arbetsmiljöer och ansvarsområden, vilket kan medföra könade hälsokonsekvenser. Dock är det få folkhälsovetenskapliga studier om obetalt arbete i hemmet och hälsa som inkluderar både kvinnor och män. Det är också en brist på kvalitativa studier som undersöker individers upplevelser av det obetalda arbetet i hemmet och psykisk hälsa. På arbetsplatsnivå har det gjorts få försök att analysera hur olika dimensioner av jämställdhet på arbetsplatser är relaterade till hälsostatus, och det är en brist på studier med en kontextuell metod som tar hänsyn till hur flera olika variabler samspelar. Tidigare folkhälsovetenskapliga studier som undersökt förvärvsarbete och hemarbete har framförallt använt sig av en tvärsnittsdesign, vilket gjort det svårt att utreda riktningen av samband mellan jämställdhet och psykisk hälsa, det vill säga om jämställdhet leder till bättre hälsa eller om god hälsa är en förutsättning för jämställdhet.

Syfte: Syftet med denna avhandling var att analysera genusrelationer i arbete (på arbetsplatser och i hemmet) i förhållande till självskattad psykisk ohälsa bland kvinnor och män.

Metod: Avhandlingen bygger på data från Luleåkohorten. Baslinjeundersökningen genomfördes år 1981 då deltagarna var 16 år (n=1080, 574 pojkar och 506 flickor). Uppföljningar har genomförts vid 18, 21, 30 och 42 års ålder och svarsfrekvensen var 94% under det senaste uppföljningen år 2007. Data från Luleåkohorten kompletterades med registerdata om anställda på deltagarnas arbetsplatser. Analysmetoder för enkät- och registerdata var logistisk regressionsanalys och klusteranalys. Intervjuer har genomförts med fyra kvinnor och fyra män i kohorten och analyserats med grundad teori.

Resultat: Kvinnor hade totalt sett ett större och män ett mindre ansvar för det obetalda arbetet i hemmet. Upplevelse av bristande jämställdhet i ansvar för obetalt arbete i hemmet och i parrelationen hade ett samband med psykisk ohälsa bland kvinnor och män (även efter justering för bakgrundsvariabler och tidigare psykisk ohälsa). Att ha mindre ansvar för det obetalda arbetet i hemmet och en partner med högre socioekonomisk klass hade även ett samband med psykisk ohälsa bland män. Den kvalitativa analysen visade att genusrelationer var en viktig del i en ojämställd organisering av hemarbete och relaterade till upplevelser av psykisk ohälsa bland kvinnor och män. En hög belastning av hemarbete var ett hinder för kvinnor att uppleva en god hälsa. Upplevelser av att vara instängd i en omodern maskulinitet innebar en stressfull situation bland män. Mönster av ojämställdhet på arbetsplatser hade ett samband med psykisk ohälsa för kvinnor, men inte för män. Däremot visade sig de mest jämställda arbetsplats-mönstern vara relaterade till lägre och mer liknande nivåer av psykisk ohälsa bland kvinnor och män, vilket stödjer en konvergens i hälsa när kvinnor och mäns arbetsplats förhållanden är likvärdiga.

Slutsats: Jämställdhet på arbetsplatser och i hemmet är viktigt för att minska psykisk ohälsa både bland kvinnor och män, men också för att uppnå en god genomsnittlig hälsa i befolkningen, något som är ett centralt folkhälsomål. Vid analyser av social ojämlikhet i hälsa är genusperspektiv av stor betydelse för att fördjupa förståelsen om hur och varför ojämställdhet i på arbetsplatser och i hemmet är relaterat till psykisk ohälsa. Att integrera genusperspektiv i folkhälsopolicy kan vara ett sätt att ta hänsyn till de maktrelationer som förhindrar en god folkhälsa.