Chapter 3 48 person – the response options were woman/man/non-binary or a ‘none of the above’ with an open text option. Sex assigned at birth refers to the sex categorization of a person at birth, with the response options of female/male/intersex/other. Sexual orientation refers to the gender identity of those to whom a person is sexually and romantically attracted to, with response options of heterosexual/homosexual/bisexual/other. Gender roles Gender roles refers to stereotypical behaviours, roles and attitudes that are defined, in a specific cultural context, as more appropriate or desirable for men or women. Gender roles was operationalized through gender expression and gender role orientation. Gender expression refers to how feminine or masculine people see and present themselves. We measured gender expression with a unidimensional 7-point Likert scale, ranging from very feminine to very masculine.20 Gender role orientation refers a person’s orientation towards personality traits that are culturally associated with stereotypical masculine and feminine behaviours. The 60-item Bem Sex Role Inventory (BSRI) was used to assess people’s perceptions of their psychological gender role orientation. 21 The BSRI measures stereotypical masculine and feminine personality traits as independent dimensions, thereby making it possible to characterize a person as masculine, feminine, androgynous, or undifferentiated as a function of the difference between their endorsement of masculine and feminine characteristics. The instrument uses a 7-point Likert scale ranging from 1 (never or almost never true) to 7 (always or almost always true) for stereotypically masculine (n=20; e.g. ambitious, dominant) and feminine (n=20; e.g. affectionate, gentle) descriptors, plus neutral filler items (n = 20; e.g. sincere, conscientious). Individuals with an androgynous self-concept score high on both the masculine and feminine characteristics, while the undifferentiated individuals score low on both masculine and feminine characteristics. People with a strong masculine or feminine self-concept score high only one of these dimensions. Gender relations Gender relations define how people, according to cultural context, interact with others and how others relate to them, depending on their attributed sex or perceived gender identity.22 Gender relational experiences occur on personal and intimate levels as well as on societal and institutional levels.23. For this study, we focused on gender relations in the private domain and the medical domain. We operationalized gender relations in the private domain through living situation and childcare, division of household labor, relative household income, paid and unpaid labor. Living situation was assessed by asking participants about their marital/partner status (living with/without a partner/spouse) and whether they were taking care of children (With/ without children living at home).
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