Gender 101 Series: Intro and 'Doing Gender'
- Kae Edgcomb, OTD
- Jul 3
- 6 min read
More Than Pronouns: The Unwritten Rules of Gender
Let’s talk about gender! Not in the “What are your pronouns?” kind of way, but in the bigger picture. The social expectations like “pink is for girls, blue is for boys” and the way gender is understood is reinforced socially. More than likely when we discuss or think about gender, it is around an individual’s identity and how they want others to see them. But today, the challenge I am giving to you is to think about gender as much bigger.
Gender lives in the expectations, actions, and behaviors that we all do. You know, the part of life where there is an understood set of rules or patterns that tell us what kind of jobs, hobbies, and even clothes we’re supposed to like or not like. And yes, even if you go against these “rules” you are still participating in gender.
If you asked someone to list the “rules” for how to be a “woman” or what it means to “man up,” you'd likely get a mix of cultural expectations, stereotypes, and personal opinions. These so-called rules are not written down anywhere, they have been studied, theorized, and reinforced over time. Gender functions kind of like a never-ending group project that society has been working on for centuries. And like any group project, some people do most of the work, others just show up and take credit, and some may even “fake it” through charisma and charm.
In this imaginary group project everyone gets “graded” — individually and socially. That grade depends on how closely you follow societal norms, how your actions align with the set expectations, or whether you try to redefine the rules entirely. Still with me? Basically, gender is something done at the individual level but is shaped and understood at much bigger, social level.
A Framework for Reflection
Before we dive deeper, I want to offer a few reflection tools.
First, I ask that you zoom out. Start thinking on the bigger scale of society, rather than focusing only on individual experiences. Individual choices are often deeply influenced by the broader social environment. That is to say we’re all shaped by it, even if we don’t always realize it. Outliers exist, of course, but our focus here is on those big, shared patterns.
Sociology challenges us to “see the strange in the familiar.” Try to take a HUGE step back and pretend you are looking at humans for the first time. Imagine you are an alien from a far-off planet. What would stand out the most? Who are these strange creatures? Why do they act like that? Why do the keep doing that?
Second, try to lean into any discomfort that may come up while reflecting on your professional practice or personal bias/ opinions. We all have some amount of implicit bias, and that is ok! This blog is an invitation to learn, pause, reflect, and consider your role in how gender shows up in healthcare spaces.
And finally, let’s keep in mind the professional standards that guide us. Our core values and guiding ethical principles come from those set by the American Occupational Therapy Association (AOTA), not politics or personal opinions. Occupational therapy (OT) is evidence-based and is guided by research and published literature. You may find the full document here.
Gender: It's What We Do
West and Zimmerman (1987) introduced the concept of “doing gender.” This specifically separates gender away from identity. Gender isn’t just something we are—it’s something we do. From the way we walk and talk, to the clothes we wear, to the jobs we apply for— we’re constantly doing and reinforcing gender. Whether we realize it or not, the expectations are there, and we tend to follow them. Some may choose to intentionally subvert these expectations, but that still acknowledges the “rules” exist to be broken. And when those rules are broken, we are likely to feel, or be reminded of, the consequences.
As occupational therapy practitioners, we are in a unique place to not only observe “doing” through occupational performance, but also to facilitate it through doing in occupation-based treatment activities. The important piece is here is to begin to understanding that gendered-choices are not natural— they're social. Gender becomes real through the repetition of actions. Once there is a pattern in place, it tends to repeat and eventually become automatic. Sound familiar? It’s a lot like how motor patterns work — except gender is a social pattern, not a physical or mechanical one.
West and Zimmerman also discuss the accountability of gender— we’re constantly being socially evaluated (and evaluating others) based on how well we “do” gender. In OT, this may show up in subtle ways. A client might hesitate to use a certain device or try a new task because it conflicts with gender norms. For example, losing independence due to disability or aging may be perceived as “not-masculine,” and needing extra help with childcare during an injury may feel “not-feminine.”
Of course, gender isn’t the only factor at play, but it can't be discounted. Imagine going to the storage closet and finding that the only 2-wheeled walker left has pink or glittery accessories. Would your older male client hesitate or even refuse to use it because of how it looks? Now imagine if the walker had a camo bag or a sports logo — it might suddenly become more acceptable. We often do this kind of customization with children’s assistive devices, but we may overlook the same approach with adults.
The tricky part, or course, is to avoid assumptions and stereotypes. Client-centered care is the goal. So, this can be a tricky balance. Not all women want pink and glitter, and not all men will reject them. For example, my grandma is reaching her late 80s and is fiercely independent. She grew up on a rural working farm in Northern Illinois and worked as a no-nonsense ICU nurse for most of her life. She'd likely choose the cow or barn walker bag over one with hearts or daisies. My dad’s favorite color is purple, and if he’s offered a wearable medical device in that color, he’ll pick it every time, despite the “girly” associations. I also know my cousin would always choose the glitter and flowers if she were given the choice.
Why “Neutral” Isn’t Really Neutral
Going “gender neutral” might sound like the perfect workaround—but it’s not always the solution. More times than not, what we call “neutral” is more masculine by default: think plain colors, basic designs, and no frills. Those choices are rarely neutral. More than likely, it's just less obviously feminine.
Choosing to ignore gender doesn’t make it disappear. It may unintentionally signal that a client’s gendered experiences don’t matter or should not be acknowledged. Instead of aiming for one-size-fits-all “neutral,” we should aim to offer options that allow each person’s comfort and preferences to be front and center. So ultimately, it’s about taking individual preferences into account.
When someone says, “I don’t like it” or you re faced with a refusal, consider it might not just be about style — it could be about deeper discomfort: “This doesn’t match how I’m expected to be.” And those expectations are real, even if they’re unspoken.
What’s Next?
This blog will continue to explore the intersections of gender and occupation, as well as gender and occupational therapy. I have at least two more theory-based articles. Some posts will be light and fun; others will require deeper self-reflection. With time, the blog may branch out beyond gender— who can really predict the future?
I hope you’ll stick around, ask questions, suggest topics, and join in this ongoing conversation. I’m learning and evolving just like everyone else, and I’m bound to make a few mistakes along the way. No matter what, I will stay curious, and do my best to accurately communicate information to you.
Catchy slogan or sign-off pending… (Suggestions welcomed!)
For now, thanks for spending some of your valuable time here, and I hope you'll come back what what's next!
Kae, The Alt OT
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