'Kingdom of women' study reveals the real cost of traditional gender roles

Compared to other parts of the world — where female warriors are written off as myths and female scientists have had to fight for recognition — the villages of an ethnic group in Southwest China stand out. The Mosuo live in what's called a "kingdom of women."

In matrilineal Mosuo culture, women inherit property, plant crops, and run households. Grandmothers act as heads of households. Children take the mother’s surname. Perhaps the most famous feature of Mosuo culture are the “walking marriages” – arrangements where partners don’t live in the same household. Instead, women can choose as many or few male partners as they choose, and raise the children independently of their fathers.

The women run the show and it's having a profound impact on their health.

The cultural differences between matrilineal Mosuo and their counterparts, who live in patrilineal societies, are evident in the body according to a study published Monday in Proceedings of the National Academy of Sciences.

Mosuo women living in matrilineal societies tend to have far fewer markers of chronic disease – including lower blood pressure and signs of inflammation which can lead to heart disease or diabetes.

Siobhán Mary Mattison is the study’s senior author and the director of the University of New Mexico’s Human Family and Evolutionary Demography Laboratory. She tells Inverse that the Mosuo don’t have it easy in either matrilineal or patrilineal societies, but the women-dominated societies offer them one crucial ingredient that may be playing out in their long-term health: autonomy.

“Women work really hard doing day-to-day household labor in both settings, but in the matrilineal communities, they do so with help from their natal families and with significant autonomy in decision making,” she tells Inverse.

How does culture affect health? – Mattison’s study analyzed blood samples from 371 Mosuo women and blood pressure readings from 958 women who lived in either matrilineal or patrilineal societies. The team analyzed blood samples looking for signs of C-reactive protein, a marker of inflammation, while also taking blood pressure measurements.

In patrilineal societies, 8 percent of women showed signs of chronic inflammation — more than double that of men. The same pattern held for blood pressure measurements. Thirty-three percent of women had high blood pressure in patrilineal societies compared to about 26 percent of men.

In matrilineal societies, the pattern wasn’t just dampened. It was completely reversed.

In that case, 6 percent of men showed signs of chronic inflammation compared to 4 percent of women. Twenty-eight percent of men had high blood pressure compared to 26 percent of women.

This might look like men fare worse in female-dominated society, but the paper suggests that’s not the story these numbers tell. The statistical analysis showed that the detrimental effects of living in a patrilineal society for women were statistically significant. By comparison, the health effects of living in a matrilineal society on men weren’t as statistically strong.

In the paper, the authors argue this probably comes down to the fact that men still enjoy autonomy within matrilineal Mosuo societies and access to resources — suggesting that it is beneficial to have autonomy, regardless of gender. Being the head of a household — whether male or female — was linked to lower levels of C-reactive protein in the body, demonstrating a “protective effect” of autonomy, the authors explain.

However, the study shows that the “protective effect” of autonomy appears to be especially pronounced for women, says Mattison.

“Women in these matrilineal communities have a great deal of autonomy in decision-making and excellent social support," she explains. "Given that women tend to be at greater risk of chronic disease worldwide, the fact that they actually do better than men in this realm of health is telling."

Beyond the Mosuo – The daily lives of the Mosuo and the daily lives of people in Western societies don’t make perfect comparisons. But the underlying issues that link autonomy and health can play out in any context.

One reason that the Mosuo women may fare worse in patrilineal societies is that they experience more psychosocial stress and its consequences, Mattison explains. There are clear links between social injustices like racism and stress responses in the body. Even the anticipation of prejudice is linked to an increase in blood pressure, a 2012 study found.

“The stresses of patriliny for women — distance from family, lower autonomy, and control — may activate cortisol and other physiological pathways of the stress response that, over the long term, can take a toll on their bodies, including through inflammation and blood pressure,” she says.

The detrimental effects of a loss of autonomy and control, particularly when gender roles rob someone of that control, have been documented in Western societies too. A survey of 1,596 women conducted in 2017 found that 18 percent had experienced discrimination in health care, 41 percent experienced discrimination in obtaining equal pay and promotions, and 31 experienced discrimination while applying for jobs.

Mattison cautions that the experiences of one group of people are not enough to explain the diverse experiences of humanity. We need far more research to pin down how gender roles can influence health in cultures around the world. But culture itself is universal, as is the fact that it can influence our health.

“Nonetheless, the bottom line is: we ignore culture at the peril of science and health,” she says.

Not recognizing how deep culture can penetrate – into our cells, hearts, and minds – means we’re missing a key piece of the puzzle.

Abstract: Women experience higher morbidity than men, despite living longer. This is often attributed to biological differences between the sexes; however, the majority of societies in which these disparities are observed exhibit gender norms that favor men. We tested the hypothesis that female-biased gender norms ameliorate gender disparities in health by comparing gender differences in inflammation and hypertension among the matrilineal and patrilineal Mosuo of China. Widely reported gender disparities in health were reversed among matrilineal Mosuo compared with patrilineal Mosuo, due to substantial improvements in women’s health, with no concomitant detrimental effects on men. These findings offer evidence that gender norms limiting women’s autonomy and biasing inheritance toward men adversely affect the health of women, increasing women’s risk for chronic diseases with tremendous global health impact.