Primary author: Sarah Abney

The theory of gender and power (TGP) was developed by Robert Connell in 1987 and is based off of philosophical writings that explore the depths of sexual inequity as well as gender and power imbalance (Wingood & DiClemente, 2000). There are three social structures that make up the theory of gender and power: sexual division of labor, sexual division of power, and the structure of cathexis. These three constructs are distinct but are overlapping, and work together to define and explain the heterosexual relationship between men and women and have an influence on women’s health (Connell, 1987). There are two levels at which these constructs of the TGB exist, the societal level and the institutional level. In the context of public health, these constructs of the TGP identify exposure and risk factors as well as biological factors in relation to issues that adversely affect women’s health such as HIV and STD risk in relation to condom usage as well as violence against women (Wingood & DiClemente, 2000). The TGP has been used by researchers to address women’s health issues and look deeper into the gender-based inequalities and disparities in women’s health. The TGP can be used in public health research by examining risk factors and biological factors as well as economic, physical, and social exposures also known as acquired risks as they relate to women’s health.

The sexual division of labor, at a societal level, divides women and men into gender specific occupations where women are assigned to unequal, lower paying positions. At the institutional level, women are often assigned to do “women’s work”, uncompensated responsibilities such as childrearing, housework, and caring for the sick and elderly and are assigned less value because they are not income generating. Due to the uncompensated nature of this work, the economic divide that favors men over women has a profound implication on women’s health and well-being. Furthermore, women who are disadvantaged socioeconomically such as minorities and younger women and those with economic risk factors such as those who are living in poverty, have less than a high school education, and those who do not have health insurance, are more at risk for experiencing poorer health outcomes that result from the sexual division of labor than those women who do not have these risk factors (Wingood & DiClemente, 2000).

The basis for the sexual division of power begins at the societal level with the inequality of power between men and women. The sexual division of power, at the institutional level, is maintained by abuse of power, authority, and control (Wingood & DiClemente, 2000). In a study done by Raj, et al, (1999) on heterosexual relationship abuse, they hypothesize those relationships where jealous accusations by the man to the woman, are more likely to be characterized by abuse. Men who abuse women often see the woman’s feelings and concerns as being less worthy than their own and lack empathy for these women, often believing that the woman should care more about how the man feels rather than her own feelings. In terms of public health and in relation of HIV risk, behavioral risk factors that are a part of the sexual division of power include history of drug and alcohol abuse, poor condom use skills, low self-efficacy to avoid HIV which leads into low or no perceived control over condom use (Wingood & DiClemente, 2000).

The structure of cathexis is also referred to as the structure of social norms and affective attachment (Wingood & DiClemente, 2000). Connell developed this structure to address the affective nature of relationships. At the industrial level, this structure defines the culturally normative roles for men and women and may further weaken women’s role and increase the inequality felt by women in a heterosexual relationship (Raj, Silverman, Wingood, & DiClemente, 1999). At the societal level, the structure of cathexis characterizes the sexual attachments that women have towards men and this dictates appropriate sexual behavior from the woman. In the realm of public health, women are adversely affected by this structure in the case of HIV risk, they may have limited knowledge of HIV prevention and they may also not perceive themselves to be vulnerable to HIV (Wingood & DiClemente). In addition women may not perceive themselves as having power over the decision to use condoms, thus making them more vulnerable to HIV and other STDs. The structure of cathexis, along with the structures of the sexual division of labor and the sexual division of power are all integral parts of the TGP and can be used to address other women’s health issues and should be considered when designing behavioral health interventions that address issues that adversely and/or disproportionately affect women.


Raj, A., Silverman, J. G., Wingood, G. M., & DiClemente, R. J. (1999). Prevalence and Correlates of Relationship Abuse Among a Community-Based Sample of Low-Income African American Women. Violence Against Women, 5(3), 272-291.

Wingood, G. M., Scd, & DiClemente, R. J. (2000). Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav, 27(5), 539-565.