Early adolescence is where gender inequality is most pronounced, according to new research of 40 low and middle income countries in Asia and the Pacific.

Research published in Global Health Lancet and led by researchers at the Burnet Institute and the University of Melbourne, is the first systemic analysis of gender inequality in childhood and adolescence.

Funded by UNICEF, the research focuses on 40 low and middle income countries in Asia and the Pacific, and includes an in-depth analysis of 87 indicators measuring health, education and the transition to employment, protection and environmental safety in where young people live.

The study found that young girls experienced the burden of poor sexual reproductive health, sexual violence and intimate partnerships, and were substantially more likely to marry as children. Although girls achieve equality in secondary education in many countries, they are less likely to transition to further education, training or employment and have less access to information technology than boys.

Boys were found to experience worse outcomes in several key areas – higher mortality, mainly from violence, injury and suicide, and overall higher rates of harmful drinking and smoking. Boys are also more likely than girls to be involved in child labor and hazardous work.

University of Melbourne Fellow Peter Azzopardi, Co-Head of Burnet’s Global Youth Health Research Group, said: “These findings suggest that for adolescents, puberty brings about a very different engagement with the world around them, with dangerous gender norms that create very different opportunities for girls and boys. Gender norms and patriarchal systems that assign lower status to girls and uphold narrow and rigid ideals of masculinity are detrimental to girls and boys. “

Dr Elissa Kennedy, Deputy Director of Maternal, Child and Adolescent Health at the Burnet Institute, said the study addresses significant gaps in our understanding of gender inequality during the first two decades of life. It complements the 2019 Lancet series on Gender Equality, Norms and Health, which focuses mostly on adult women.

“The preference for boys is evident in several countries, but we found slight differences by sex in health and well-being during childhood,” said Dr. Kennedy. “However, what is striking is how consistently gender inequalities emerge in early adolescence in various areas of welfare.

“From around the age of 10, there are very different risks, outcomes and opportunities for girls and boys, with this gender inequality continuing into adolescence and early adulthood.”

Apart from helping to better understand how gender inequalities arise in childhood and adolescence, this study is invaluable in providing important data for policy makers and programmers to inform country-specific investments.

“These data highlight the need to sustain efforts to address the preference for boys that persist in some places,” said Dr. Kennedy. “More broadly, this study identifies early adolescence as a critical period for overcoming gender inequality, because this is when significant differences emerge and when gender identities, norms and roles are consolidated.

“There is an unfinished agenda related to ensuring sexual and reproductive health, ending child marriage, and dealing with violence against girls. But the data also show that the implications of gender inequality for girls extend to economic participation, risk-taking behavior, and suicide in some settings. These data also highlight the need to include a focus on boys in gender programming. “

The main trends in data relating to education, nutrition, alcohol, drugs, HIV, self-harm, and several other indicators, include:

• Death: Boys experience a higher rate of death from all causes than girls during the first year of life in all countries except India, a risk that continues to increase with age. The largest difference was in children aged 15-19, although Pakistan and India were the exceptions.
• Suicide: Death due to self-injury is higher in boys in most countries in East and Southeast Asia, Central Asia and the Pacific, with the suicide rate for boys aged 15-19 years at least three times that of children women in Kiribati, Thailand, Myanmar, Malaysia and Indonesia. In contrast, girls aged 15-19 in Bangladesh, India and Pakistan have a suicide rate more than twice that of boys.
• Alcohol / Drugs: Boys are at greater risk of alcohol and other drug-related morbidity in all countries surveyed. Boys aged 10-19 years are twice as likely to report smoking as girls, four times more in East Asian countries.
• Nutrition: Girls aged 15-19 years are at higher risk of developing nutritional diseases than boys, including anemia.
• Education: Although educational equality exists in many countries, girls do not move on to further training or employment at the same rate as boys. The rate of girls receiving no education, training or employment is more than double that of boys in Thailand, Myanmar, Kyrgyzstan, Fiji, Sri Lanka, Bangladesh, and Pakistan, and more than 15 times higher in India.
• Child marriage: Despite a nearly universal commitment to ending child marriage, the majority of girls in the Asia-Pacific region are married by age 18, with the highest number of child marriages for girls in Bangladesh, Nepal and Afghanistan.
• Teenage pregnancy: Extremely high adolescent fertility rates are found in Nauru, Laos, Afghanistan, Nepal, Marshall Islands, Bangladesh, Vanuatu, and Papua New Guinea. Countries with higher adolescent fertility rates also have higher rates of adolescent maternal mortality, with the highest rates being reported in Afghanistan, Papua New Guinea and Pakistan.
• Gender-based violence: The high prevalence of physical or sexual violence on intimate partners in the past 12 months among once-partnered girls aged 15–19 years is evident especially in South Asian countries such as Afghanistan, Pakistan, India and Nepal, although the highest is in Timor – Leste.