:
I am Carine Joly, an advisor at the Institute for the Equality of Women and Men. I am responsible for what we call the gender mainstreaming unit, that is to say, the mainstreaming of gender equality. The Institute is particularly responsible for overseeing the strategy.
My colleague Nicolas Bailly, who is also a member of the unit, and I will give you an overview of the implementation of gender mainstreaming at the Belgian federal level. After a brief introduction, I will present the key provisions of our 2007 act and its concrete implementation as part of the federal plan for gender mainstreaming. Before wrapping up, my colleague Nicolas will then introduce the gender test, which is an impact analysis instrument based on the use of gender statistics.
As an introduction, I will provide some background.
Following the Beijing world conference, a pilot project on integrating gender mainstreaming in federal policies was launched in January 2001. The assessment of this project supervised by an academic team led to various recommendations in 2003, which emphasized the need to institutionalize this process or strategy. The act of January 12, 2007, is the legal expression of the political will to entrench gender mainstreaming in the Belgian federal institution environment.
I will list the key provisions of this act.
This legislation sets out a series of obligations, both at the political and administration levels.
It sets out that each member of government will integrate the gender dimension in policies under his or her responsibility, meaning that the government member will analyze and determine the differences between the respective situations of men and women and take that into account when establishing policies.
The act also provides for the creation of an interdepartmental coordination group consisting of government officials and political representatives. I will come back to this.
This legislation also provides for the creation of a gender test, namely an analysis of the impact of bills and draft regulations on the respective situations of women and men.
The act sets out that federal administrations will produce gender statistics and gender indicators.
My colleague will elaborate on these two last points, namely the gender test and gender statistics.
The legislation also requires that the government submit to Parliament reports on the implementation of the act.
Lastly, the act provides that the Institute for the Equality of Women and Men will be responsible for supervising and supporting the gender mainstreaming process in federal policies.
Note that the implementation of the act was slowed by a political crisis that disrupted Belgium between 2007 and 2011. As a result, the first federal plan could not be adopted until 2012, once there was a government in office following the elections of June 2010.
In practical terms how do we organize the implementation of this legislation?
Overall, gender mainstreaming is intended for people generally involved in policy development. Therefore, our main objective is to ensure that members of strategic units, that is, the advisors to ministers and their ministerial cabinets and officials responsible for policy in the administrations, agree to reflect and get in the habit of reflecting on the impact of proposed policies on the respective situations of women and men.
To this end, two instruments were established specifically to implement the act.
First, there is the interdepartmental coordination group, which also provides for the adoption of a federal plan. This group was mandated by a decree to implement the law enacted in 2010.
The interdepartmental coordination group consists of members of strategic units, who are advisors to ministers and officials from the various administrations. The group is chaired by management of the Institute, which also acts as its secretariat. By virtue of its composition, the group requires the direct involvement of political actors and creates a dynamic between the political and administrative levels. I think this is an important point.
In particular, our mission is to prepare a draft federal plan, prepare and coordinate mid-session and end-of-session reports that are submitted to Parliament, and produce a semi-annual progress report following up on the implementation of the plan.
In addition, the decree provides that all members of this group will receive training on gender mainstreaming. The Institute organizes such training through an external expert company to ensure that the approach becomes truly operational. These courses are very practical. They are based on concrete examples and include practical exercises for members of the group.
In terms of the interdepartmental coordination group, the second largest support is obviously political commitment, the federal government's adoption of a plan. Although, theoretically, gender mainstreaming is intended to include all federal policies, it is important to set goals early in the session. At the Belgian federal level, these goals are reflected in a plan that was approved in July 2015, or a little less than a year ago.
This plan represents a commitment of the whole of government, as well as each individual minister, and involves the relevant administrations that are responsible for the practical implementation of the plan. The first part includes a series of commitments related to the act, and the second part, which we think is the most important, deals with the various government policies that will be prioritized for gender mainstreaming over the course of the parliamentary session.
To make things a little more concrete, consider the minister of justice's objective of integrating the gender dimension in the reform of matrimonial property regimes and inheritance rights. This is one of the goals for this session. For his part, the minister of security and the interior seeks to integrate the gender dimension in the prevention and fight against radicalization, a very important theme right now. The goal is to get the most concrete results possible by the end of the session in order to entrench the gender mainstreaming process in policy-making and to establish the maximum number of best practices that will serve to demonstrate the feasibility and usefulness of the approach.
I will now give the floor to my colleague Nicolas Bailly, who will present the gender test, namely a regulatory impact analysis.
As Carine has just mentioned, the act provided for the creation of a gender test, that is to say, an assessment of the impact of bills and draft regulations on the respective situations of women and men. At the federal level, other ex ante tests already exist and others were being prepared. Negotiations ensued and resulted in the establishment of a regulatory impact analysis. This analysis includes several components, including one that focuses on the equality of women and men.
This instrument is called RIA, or regulatory impact analysis. It is mandatory for all files submitted to the council of ministers. That said, the executive branch remains entirely free to accept or ignore the findings of the analysis. The purpose of this impact analysis, which is conducted by the regulators themselves, is to stimulate reflection. The goal is actually to get them to internalize the habit of reflecting on the impact of the regulatory proposals they put forward with respect to the situations of women and men.
Specifically, there are a series of open questions on the person in question and on the differences between men and women. The objective is ensuring that regulators have a clear idea of the respective situations of men and women in the area covered by the draft regulations, so they can then evaluate the impact of their proposal on the situations of women and men.
The law under which this impact assessment was created also mandated the establishment of a committee. The committee is composed of representatives of the five administrations touched by the various aspects of the impact analysis. This committee can offer advice if regulators wish to be advised on the quality of the analyses they performed. It also prepares a report analyzing in some way the quality of responses to questions posed as part of the analysis.
The findings of the first report prepared on the RIA as a whole are not very positive. Indeed, the RIA has not yet been truly integrated in the Belgian federal decision making process. The finding was that people spend relatively little time on it and tend to conduct the analysis at the end of the process. Ideally, the impact analysis should be performed as early as possible as part of the reflection leading to the adoption of draft legislation.
Therefore, the regulators and political and administrative officials have not yet—
[English]
Thank you so much for the opportunity to be here today.
You've asked us two questions about what New Zealand does to monitor the use of gender-based analysis in government processes, and also our view on what works to measure the impacts of government policies and programs in creating more equitable results.
I'll start by making the connection with our colleagues in Belgium. All government departments, every time a piece of policy is lodged with a cabinet committee that considers social policy advice, they have been required for nearly a decade to undertake gender analysis and reflect this in a gender implication statement. It's a ministry. The ministry for women used to provide gender analysis training.
I'd like to be honest with you, often the gender implication statement is done right at the end before the paper is submitted. With the gender analysis training we did, we had upwards of 500 policy analysts working on a range of issues across government. That evidence shows that the one-day training, or even the two-day training, was not being effective. While we think it's important to keep the gender implication statement, because it sends a powerful signal, it means somewhere in the process there is a benchmark with women when gender issues are considered. We've taken a different approach evolving to it as well.
In the ministry for women, we have what's called “a second opinion policy advice role,” which means we have the ability to comment on policy initiatives as they develop. We think we can be most effective by being quite targeted about where we would put our time and energy, so we can involve ourselves in policy processes right at the beginning, when we think we have the most gender impact. This seems to work for us well, so by the time the paper comes to SOC, a gender analysis is completely embedded in a policy process.
We've also found there are areas across government where we can make more of a difference and more impact, and perhaps that's more important to do. We work alongside our colleagues in a partnered process, and we're very technical, I guess, in where we put our resources. It's a macro-level in terms of monitoring the impact of government policies. We at the ministry have a statement of intent, which is a public accountability document that monitors how well we are doing and the how the government is doing across a series of indicators.
We also are about to produce an indicators report about the status of women in New Zealand that is overt across the priorities, and across what is happening, so each year we can be open about what is happening, and of course all of us are considering how we report at the SDG 5. As a country, we're taking it very seriously, as well.
In terms of our whole government, and in terms of how we are arranged and operating, we have some hard targets. The government has a 45% target for the number of women on state sector boards. We can happily report that we've just made 33.7%, which is the highest number ever, and there's a huge energy around this target.
For our other policy areas, we have a series of what are called better public services targets—we can provide more information around this—which guide our social and economic policy. In each of those, there is a gender component. For example, there are a series that are about the education levels young people achieve. We have worked hard to make sure there is a gender analysis that's at a very macro and strategic level within government. The ministry can be true to these with some specific projects that are completely focused on women.
If I would leave you a few key messages, it would be we think it's important to have the benchmarks or the rigour around a gender implication statement, but our experiences are that we have to move further than this. We find that, particularly as a ministry, we get results by working with and alongside our colleagues in the policy area right at the beginning. We are focused and targeted on what will yield the most results or the best progress for a women in gender issues in New Zealand. This model very much aligns with our indigenous peoples' philosophies about what it is to be a leader, to walk alongside others, and to advance as we go.
Would you like to comment some more on this?
:
The policy analysis was before my time, but this is my understanding of what happened.
When the gender implication statement was introduced, the Ministry for Women created a gender analysis training program for policy analysts. We can share with you what that looked like. It was implemented through the government agencies, but we found, and we know from all the research about how learning happens, that a one- or two-day course really isn't effective to ensure that people have the tools, the ability, and the awareness to do good quality gender analysis.
To put it candidly, we know this isn't the way to learn. Probably for those who are already inclined to think through a gender lens, it advanced them. It also provided a framework for agencies grappling with these issues. But because we found that within the policy community there was a lot of turnover, a lot of this depends on the attitudes of the leaders and the policy managers, and again it is quite a lot of change.
We're not convinced it was a fully useful way of ensuring that gender analysis came through. We can share all our materials with you, and as I've said, we've taken the approach that our research should actually be selective around the policies that we engage with and engage with in some depth.
Rather than kind of taking what we would colloquially call a spray paint approach, i.e., to try to touch everybody lightly, we've gone for a process that's really deeply embedded in some of the key policy initiatives. It's a strategy, which from our perspective, has been more impactful for New Zealand women, because we actually have quality gender analysis coming through very key pieces of work.
:
Madam Chair, thank you for the opportunity to present today.
I am pleased to share Health Canada's experience, and I hope the committee finds it useful.
Health Canada has a long history of considering sex and gender as a way of advancing both gender equality and sound science. In the early 1990s, we focused on women's health. In 2000, Health Canada adopted a policy on gender-based analysis, which has since been revised. I'll speak more about the policy in a minute. Also in 2000, the Canadian Institutes of Health Research was established, and with it, the institute of gender and health. The institute is a key partner, and it has had a tremendous influence on our understanding and our approach to this work.
In 2009 we shifted from a focus on women's health to a sex- and gender-based analysis approach. A gender and health unit was created with responsibility for oversight of the health portfolio for sex- and gender-based analysis policy.
Going forward, I'll refer to sex- and gender-based analysis as SGBA, which should shave about two minutes off this presentation.
As you know, Health Canada is part of the health portfolio, which includes the Canadian Food Inspection Agency, the Canadian Institutes of Health Research, and the Public Health Agency of Canada. In 2009, portfolio deputy heads approved the health portfolio's SGBA policy. The policy requires that SGBA be applied to all research, policies, programs, and services in the portfolio.
You'll note that our terminology is a bit different from that of some other departments. We distinguish between sex and gender. Sex refers to biological characteristics, such as body size, shape, hormones, and so on, which distinguish males from females. Gender refers to the array of socially constructed roles, relationships, and relative power and influence that society ascribes to the two sexes, which we tend to think of as masculine and feminine.
For example, if we consider the use of medication, sex is a key consideration in the biochemical response. It may be different in men and women. Gender would be a consideration in how the patient reports the symptoms and how that patient is perceived by the practitioner.
We have established a health portfolio working group to foster a consistent approach and collaboration across the portfolio. This includes agreement on a common goal to embed SGBA as a sustainable practice, and common indicators to measure employee knowledge and use of the policy. We collaborate on employee awareness training and sharing of best practices.
Happy gender-based awareness week, and happy anti-homophobia, anti-biphobia, and anti-transphobia day. We picked a good day to come. In any case, this week we're co-hosting a science panel with the Public Health Agency and with the institute of gender and health. Three eminent researchers will share their experience in applying the concepts of sex and gender and the impact this has had on their own research as well as in their fields.
One of the panellists, Dr. Jeff Mogil, who is the head of McGill's pain genetics lab was recently on the CBC's The Current speaking about the importance of testing on female mice as well as male mice. Researchers are learning that even in the animal world it's important to look at both sexes because that will have implications for humans.
[Translation]
At Health Canada, we have taken an incremental approach to implementing sex and gender-based analysis. We started with the intention to build the habit of using comparative analysis first, and then to deepen the competency.
First we had to understand our starting point, so in 2009, we conducted an employee survey to get a baseline on levels of awareness and understanding.
Based on the results, we implemented awareness-raising and training sessions. We now find it more efficient to encourage employees to take the online training offered through the Status of Women Canada, as well as the health research training modules that have been developed by the Institute of Gender and Health. While training is not mandatory, it is strongly encouraged through blitzes with prize incentives.
Other methods include “Did You Know” postings through our broadcast media, and this year we launched a micro-assignment program with the Gender and Health Unit.
From this same survey, we identified Cabinet and Treasury Board documents as our first priority. The survey showed that sex and gender was not always considered in the preparation of Memoranda to Cabinet and Treasury Board submissions. We therefore developed a checklist tool. The Gender and Health Unit played a challenge role.
We found that sex and gender was being introduced too late in the process and that it was a challenge to access sex and gender information relevant to the file. We then made changes to ensure that the Gender and Health Unit was engaged earlier in the process. We strengthened our requirements to seek more qualitative information.
There is still more to do, but we are pleased that this has led to an almost 100% compliance in considering sex and gender in these documents.
[English]
More recently we've focused on our science community. Health Canada hosts an annual science forum that brings together about 500 researchers and scientists. This has been a key venue for us to educate and target the researchers and scientists.
Last year we introduced a sex and gender component in the call for abstracts to be presented at that forum. We followed up with the scientists who had included sex and gender to learn more about their initiatives, to play a bit of a challenge function, and to build our evidence base. It's important to know what research is under way and available so that we can make good use of it.
Our research ethics board has integrated a sex and gender requirement into the application and review process. The board has a training package so it can now more routinely ask questions about sex and gender and do so with confidence.
I'd like to just give a flavour and touch on a few other examples.
In 2011 the Canadian Centre on Substance Abuse, which is funded by Health Canada, developed and released Canada's low-risk alcohol drinking guidelines that provides Canadians with information on how to minimize risks for their own and others' drinking. The guidelines include safer drinking tips and recommendations on consumption amounts for men, women, teens, and pregnant women.
In 2013 we revised our regulatory guidelines on clinical trials. We had done this in 1997 to ensure that women were included in equal representation in clinical trials so that we could overcome the errors of results of trials that were done solely on men and generalized to women. What we found after redoing the guidelines was that, while women were included in these clinical trials, the findings weren't necessarily considered or reported in a sex-disaggregated fashion, so in 2013 we did another review to make our expectations explicit.
In 2015 we conducted an SGBA on views and expectations toward end of life and palliative care. We learned that the concept of a good death, at home surrounded by loved ones, was not shared across all sectors. We were looking for sex differences, we were looking for differences with respect to gender roles and caregivers, but what we found in fact is that ethnic background played a more dominant influencing role. This is an example of GBA+ that takes social context and diversity into consideration.
My primary observation on barriers and challenges would be that a rigorous SGBA takes effort and needs to be integrated from the beginning. It requires access to reliable evidence or the capacity to conduct the research at the outset of a policy or program development.
The research community is changing, and while every day more research is available with sex- and gender-specific information, it's not the case in every instance. In the absence of reliable evidence to inform our analysis, we're limited to committing to do so over the life of the file. The institute of gender and health has been a gold mine in that regard in terms of hooking us up with research expertise.
While Health Canada makes a point of looking at sex and gender, it's been our experience that there's much more progress on the sex aspect than there has been on gender, which is much nuanced and complex.
On best practices I would offer the following comments. Having a policy sets a tone, but it's not sufficient on its own. Supporting continued guidance is needed to embed the practice, for example through a dedicated resource such as the gender and health unit.
Monitoring and measurement tools are critical. Putting in place a performance measurement framework, especially at the portfolio level, was not easy, and it took considerable expertise.
Taking an incremental approach has been effective for Health Canada, and the requirement for an annual report from the deputy minister level adds impetus to the collection and sharing of evidence and success stories.
A lesson learned for us has been that SGBA is not a one-time task. It's an analytical strategic competency that works best when applied continuously over the life of a project or file. It's not enough to “do it” if at some point in time, typically at the beginning or the outset of a policy or file, the results really need to be applied in the decisions to have effect.
In conclusion, I would offer that, while we're confident we've made good progress, we know that we have much more to do. We look forward to continued collaboration with our partners and to meeting these challenges.
[Translation]
I would be happy to answer any questions.
Thank you.
:
Thank you, Madame Chair.
I would like to thank the committee for inviting me to discuss the issue of sex- and gender-based analysis and to speak to you on how the Canadian Institutes of Health Research is supporting the integration of sex and gender in its research and its programs.
[Translation]
The Canadian Institutes of Health Research, or CIHR, is the Government of Canada agency responsible for supporting health research excellence in universities, hospitals and research centres across Canada.
To achieve its mandate, CIHR supports research through a unique interdisciplinary structure made up of 13 institutes. The mission of CIHR's Institute of Gender and Health, of which I am currently the Scientific Director, is to foster research excellence regarding the influence of gender and sex on the health of women, men and gender-diverse people throughout life, and to apply these research findings to identify and address pressing health challenges.
[English]
It's pretty well established that sex- and gender-based factors affect health practices, outcomes, and access to health care, yet these important factors—as my colleague showed you—are often not taken into consideration. For example, the majority of basic science research is conducted on male-only animals; women continue to be under-represented in clinical trials; and, issues such as depression and suicide have been poorly studied and poorly addressed in men and boys here in Canada.
As a physician, treating patients gives me first-hand experience of how research excellence can lead to better health for men, women, boys, girls, and gender-diverse people. Daily I am reminded that to truly transform the health outcomes of Canadians, we need more scientific discoveries, treatments, and effective translations of the evidence that account for sex and gender in meaningful ways. To me, this idea is at the core of personalized medicine. After all, what trait is more personal to each of us than the sex we were born with or the gender we identify with?
CIHR has made important progress towards addressing these health and research gaps. For example, as of December 2010, after the SGBA policy came into effect, all researchers applying for CIHR funding, regardless of discipline, are asked to consider how sex and gender are accounted for in their study.
I heard a question about baseline measurement before. At baseline, what proportion of CIHR applicants do you think said “yes, we think of it”? Any takers?
It was 10%. Ten per cent of CIHR applicants reported that they had incorporated sex and gender into their research design. By last year, that number had increased to 50%. The main barrier, it seemed, for conducting SGBA was a lack of knowledge, a lack of skills, and the confidence to actually conduct the analysis and incorporate it into their research.
What did we do about this? We developed our interactive online training modules, which were launched this week, to promote competency among the researchers and also among the peer reviewers, the people who evaluate and decide if people get funded, on whether sex and gender are appropriately integrated into the research study. The launch of these modules has been highly anticipated and positively received, and I could, if you'd like, show you evidence of effectiveness in the first 300 users.
Even before the official launch this week, the National Institutes of Health in the U.S. shared the link to our modules with their 11,000 followers on Twitter. For this reason, as well as our role at the gender advisory board of the European Union, Canada is becoming an international leader in the science, implementation, and evaluation of SGBA.
When researchers understand the importance of sex and gender and apply a sex-and-gender lens to their research, Canadians benefit. That's why CIHR works to translate research findings into evidence-based practices, programs, and policies.
For example, a few months ago, we were invited to a CIHR “Best Brains Exchange” in Halifax, Nova Scotia, which I facilitated, on the topic of keeping older adults healthy and engaged in their community, socially and economically. Researchers from across Canada came together with policy-makers to share best available evidence on innovative, evidence-based, sex- and gender-responsive interventions to help inform the Nova Scotia government's seniors' framework and action plan.
We call these researchers who provide evidence our “sex and gender champions”. Later I could talk a little bit about how we're operationalizing that.
The researchers shared best practices for improving not just the health and prosperity of older adults; we also addressed gender equity issues. I'm not sure how many of you are familiar with what the World Health Organization calls “gender transformative” policies and programs as opposed to “gender unequal” or “gender blind” approaches. Gender transformation is currently the gold standard, we hope, to apply SGBA to health policies and programs here in Canada.
As a leading contributor to the health portfolio's sex- and gender-based analysis policy and to the tri-agency policy statement on equity, CIHR is undertaking a thorough review of its operations to inform an SGBA implementation plan and support performance measurement in this area. Through these activities, CIHR will be able to report against its multilateral commitments to Status of Women Canada, the tri-agency working group on equity, and the health portfolio's SGBA policy under a single lens.
CIHR also works with its sister granting agencies, as well as the Social Sciences and Humanities Research Council and the Natural Sciences and Engineering Research Council, to plan and host gender summit 2017, which will be held in November in Montreal. You're all invited.
[Translation]
In closing, Madam Chair, let me assure you that CIHR is committed to ensuring the research it funds benefits women and men equally, and to applying sex- and gender-based analysis to its programs, processes and policies.
Again, I wish to thank you for the opportunity to speak on this important issue.
I will be pleased to answer any of your questions.
:
You raise an excellent point.
The answer to the first part of your question is, yes, we're multidisciplinary. The institute of gender and health takes a bio-psychosocial approach to everything including animal research where, actually, the research assistant's sex can influence the way the animals respond to pain. There's even literature out there saying that animals have gender, which is fascinating but not the topic today.
Whether we're working with universities and social scientists to look at how the questions are asked, I'd say half our researchers are social scientists. I'm thinking particularly of Greta Bauer and Elizabeth Saewyc, who are particularly looking at the questions around gender, gender identity, and what came out of the transgender youth survey.
I don't know if you all responded to the census, but I wrote my own comment, and I'm sure you saw not just to tick off male and female, which is particularly relevant to the bill tabled today. We're suggesting probably a two-step approach, for instance, about the sex that you were assigned at birth versus what gender you currently identify with.
The second part of your question regards systemic bias in questionnaires. Many of the depression questionnaires that are used ask, “Are you crying more often?” Well, men, aren't going to answer that. Men actually have a lot more physical symptoms. They may feel more anger and be more irritable, so there is bias in the data collection methods, absolutely.
Our second course, called sex and gender in primary data collection with humans, addresses those issues that you very wisely raised.
:
From a research perspective, it's hard to actually correlate who took the training and what their research discovery was. Sorry, but I'm a scientist, so correlation does not imply causation. That's a tough question to answer.
As for what I can tell you, I brought our little infographics to be handed out. They're infographics around “what is sex?” and “what is gender?”, because I do think that's helpful. We have a flyer about the training. I actually have some questions for you all to see if you know how to do sex- and gender-based analysis, so you'll tell me if filling out these questions improves outcomes here in Parliament. We could do a little study there.
On the answer to your question, I'll give you an example from the transgender youth survey: training and awareness about gender diversity has led to less stigmatization around expressing your gender identity. One of our funded researchers did a survey looking at how transgender youth feel. Are they able to talk about it? Are they able to express it? The results of that survey in the media led to schools putting into place inclusiveness policies and gender-diverse extracurricular groups and support groups. Also, there's some evidence that this reduces dropout from schools and possibly even suicidal ideation and suicide.
I don't know if that was a good example. The training has only been in place for a few years. For the data that I talked about, we have a pretest and then a test after the training. For instance, at the beginning of the training, we might ask people, if this is a gender-related variable, is this practice gender transformative, gender blind, or gender unequal? They'll say, oh my gosh, they have no idea what that means. They get a score and then they do the training. After the training, we see if they respond correctly to those questions. We can see if knowledge improves. We ask them how confident they feel, on a scale of zero to 10, that they could do SGBA. At the beginning, most people say.... I don't know what you guys would say. Zero means being not at all confident, with 10 being yes, totally confident. At the end, we see if their score has improved.
Finally, we ask people to evaluate publications and protocols and comment on the impact and knowledge translation of that evidence. We're able to compare the before-and-after answers to see if they're able to do that in an appropriate fashion. I could give you more examples of positive things, but I think it's education, education, and education.