Gender Transformative Programing in Adolescent Reproductive and Sexual Health: Definitions, Strategies, and Resources

Gender and Sexual Health Part Four

Practice Matters, January 2014

A publication of the Act for Youth Center of Excellence


by Lori A. Rolleri, MSW, MPH

About the Author

Lori A. Rolleri, MSW, MPH has designed, implemented, managed, and evaluated a variety of reproductive and sexual health curricula and programs for young people, parents, and professionals in the United States, Latin America, and Africa. She served as Team Lead and Senior Technical Advisor for the Gender and Men as Partners(R) program at EngenderHealth, where she oversaw the management of multiple USAID- and PEPFAR-funded programs in Africa. Prior to her work at EngenderHealth, she served as Director of the Center for Reproductive and Sexual Health Promotion at ETR Associates. Currently, she works as an independent consultant to multiple state, national, and international organizations. Lori can be contacted at This series is dedicated to the memory of Douglas B. Kirby, PhD.


Gender is a socially determined construct describing the characteristics, behaviors, and roles deemed appropriate and expected of men and women (and boys and girls) by a given society. These characteristics, behaviors, and roles are learned and reinforced through a socialization process beginning early in life that continues throughout the life cycle (Rolleri, 2013a). Individual attitudes and social norms about gender are important determinants of adolescent sexual risk taking behaviors (Rolleri, 2013b). Program developers and practitioners are in a strong position to address unhealthy and inequitable gender norms, transforming them into healthy and equitable ones. This article will explore ways that adolescent reproductive and sexual health program developers and practitioners can incorporate a gender transformative approach in developing or adapting curriculum-based interventions designed to prevent adolescent pregnancy and sexually transmitted infections (STI).

Applying a Gender Transformative Approach

In 2000, Geeta Rao Gupta, then the President of the International Center of Research on Women (ICRW), presented a continuum of gender programming designed to help program developers and program practitioners better incorporate a gender perspective to achieve greater program impact (Caro, 2009). Under this continuum, four approaches to integrating gender into programs are described: 1) gender exploitative, 2) gender blind, 3) gender accommodating, and 4) gender transformative.

Gender transformative programs also often take what is called a "gender synchronized approach." Gender synchronization recognizes that gender is a relational concept; that is, it is difficult to change male gender norms without also changing female gender norms and vice versa (Greene & Levack, 2010).

Examples of Gender Norms

Norms and beliefs about gender should be assessed for your particular community. Some examples of gender norms are:

Gender Transformative Programming in Action

Sexuality education curricula that use elements of gender transformative programing include SIHLE, Gender Matters, Wise Guys 2013, and Streetwise to Sexwise. All four raise awareness about unhealthy gender norms, use interactive activities that get students to question the costs of rigid adherence to unhealthy gender norms, and support participants in redefining unhealthy gender norms into more healthy ones. They encourage participation from peers, teachers, and parents in transforming gender norms -- three important forces in a young person's environment. Gender Matters also uses gender synchronized strategies in that it works jointly with young men and women to deconstruct unhealthy gender norms and create healthy definitions of masculinity and femininity.

Other Interventions that Include a Gender Perspective

Coaching Boys into Men (Futures Without Violence)

Engaging Men and Boys (EngenderHealth) - Available for free download

It's All One (Population Council) - Available for free download

Program H (Promundo) - Available for free download

Program M - Available for free download

The Strength Campaign (Men Can Stop Rape)

What's the Real Deal about Masculinity (Scenarios USA)

Mentors in Violence Prevention

Strategies for Strengthening Healthy Gender Norms, Attitudes, and Behaviors in Adolescent Pregnancy and STI Prevention Curricula

Below you will find a list of 12 strategies that program developers and practitioners can use to incorporate gender into curricula designed to prevent adolescent pregnancy and STIs. These strategies have been gleaned from the literature on effective and/or promising gender transformative programs from the United States and abroad (Rolleri, 2012).

  1. Increase knowledge/awareness about existence of gender norms (Barker et al., 2007). Assess for the common gender norms in your community and raise awareness about the existence of these gender norms for girls and boys. For example:
  2. Increase knowledge about the costs of adhering to rigid gender norms (Barker et al., 2007). Use critical questioning to surface the reasons why these gender norms exist and what the costs are to men and women if we choose to abide by them. Critical questioning uses open-ended questions and challenges whether a belief is true, partially true, or false. Youth are encouraged to use evidence to support their point of view. Some examples of critical thinking questions are:
  3. Redefine unhealthy gender norms into healthy ones (Barker et al., 2007). Create opportunities for youth to redefine harmful, inequitable gender norms into healthy, equitable ones.
  4. Increase skills needed to behave in a more gender equitable way. Even if knowledge and attitudes are changed to support more equitable gender norms, some youth will need skills to behave in a gender equitable way. For example, if girls are conditioned all their lives to be passive communicators, they will need training on how to communicate assertively. If boys are conditioned to deal with conflict using violence, they will need training on how to resolve conflict using non-violent methods.
  5. Strengthen models of gender equality in the learning environment you're creating. Model gender equality and gender equity in your words and actions. Young people learn from what they observe. Some questions to ask yourself:
  6. Cultivate empathy. Create situations where girls and boys are able to empathize with each other's experience. Empathy is the ability to recognize, understand, and respond to another person's thoughts or feelings. By understanding the pressures, costs, and impact of living by a set of socially constructed gender rules, youth may feel greater motivation to treat each other in gender equitable ways.
  7. Integrate gender into other learning activities and content. While it is good to have a dedicated lesson(s) on the topic of gender, do not stop there. Learners' awareness of gender and questioning/challenging of gender norms will be amplified when gender is integrated into as many learning activities and topics/content areas as possible. Integrate gender into learning activities like: myths and facts, forced choices, perception of risk for pregnancy/HIV, role plays, etc.
  8. Present clear, consistent, and equitable messages about gender (Kirby et al., 2011). Repeat these messages throughout the curriculum. It is best to test these messages with the youth you intend to serve to make sure they resonate before promoting them. Some examples are:
  9. Consider alternating between same sex and combined sex learning groups. Consider separating the sexes for some discussions and then bringing them back together to share. Same sex discussions may be appropriate when:
  10. Avoid unintentional gender exploitative approaches (Caro, 2009). Avoid activities or practices that may unintentionally reinforce harmful stereotypes about gender.
  11. Consider other forces in the learners' environment. Consider ways that you can complement the curriculum with activities that impact other forces and perceptions of gender that exist in a youth's environment. For example:
  12. Use a social norms approach (Kirby et al., 2011). A social norms approach involves contrasting students' perceived norms about a certain issue with the actual norms experienced among their peers. When we can demonstrate to youth that the actual norms about a particular issue (e.g., binge drinking, condom use, norms about gender) are more in sync with their personal beliefs, rather than the norms they believe to be real, they will more likely want to behave in ways that they believe are both right for them and common among their peers. One way to surface actual vs. perceived norms is through the use of classroom surveys that collect anonymous data from youth about how they think about gender norms and how they think their peers think about gender norms. This can be done using pen and paper or through automatic electronic response systems such as: TurningPoint or Qwizdom.

Examples of Possible Social Norms Survey Questions

1. a) How likely do you think it is that students in your school who are having sex will use a condom the next time they have sex? (perceived norm): Highly Unlikely, Unlikely, Likely, Highly Likely

1. b) When you decide to have sex, how likely is it that you will use a condom? (actual norm): Highly Unlikely, Unlikely, Likely, Highly Likely

2. a) Most people my age who are in romantic relationships with boys have to do things sexually they would rather not do in order to keep their boyfriend. (perceived norm): Highly Unlikely, Unlikely, Likely, Highly Likely

2. b) If I were in a romantic relationship with a boy I could see myself doing things sexually I would rather not do in order to keep him as my boyfriend. (actual norm): Highly Unlikely, Unlikely, Likely, Highly Likely


Inequitable and unhealthy attitudes and norms about gender are important determinants of adolescent sexual risk taking behavior. There is a continuum of programming approaches that have been used by program developers to change unhealthy gender attitudes and norms ranging from "exploitative" to "transformative." Transformative approaches aim to raise awareness about unhealthy gender norms, question the costs that men, women, and communities pay by adhering to these unhealthy gender scripts, and work to replace these unhealthy norms with more equitable, healthy ones. There are multiple strategies that practitioners can use to make programs more gender transformative such as including activities that develop empathy between the sexes; critique gender messages received by family, friends, and society; and build skills that level the playing field for boys and girls.

While making more sustained change on gender often involves an ecological approach, curriculum-based interventions can play an important role within a more comprehensive campaign to promote healthy and equitable gender norms in the United States, which in turn will contribute to healthier sexual behavior among adolescents.

Resources: U.S. Organizations that Work on Gender

CHANGE Center for Health and Gender Equity

Futures Without Violence

Interagency Gender Working Group

National Council on Gender

One Circle Foundation

True Child


Men Can Stop Rape

A Call to Men

The Gender and Sexual Health Series by Lori A. Rolleri

This series is dedicated to the memory of Douglas B. Kirby, PhD.