Mapping gendered ageism in health care: concepts, contexts, and gaps

Abstract

While ageism and sexism are increasingly acknowledged as critical determinants of health and health care, the concept of “gendered ageism” remains under-theorised and empirically underdeveloped, with notable gaps in conceptual clarity and engagement with how age and gender co-construct discrimination in health contexts. This scoping review maps how gendered ageism is conceptualized and studied in health-related contexts, with particular attention to definitional patterns, analytical levels, intersectional framing, and empirical gaps. A scoping review was conducted to identify and categorize literature on gendered ageism in health-related contexts, focusing on its manifestations, consequences, lived experiences and analytical treatment across micro-, meso-, and macro-levels. A structured extraction framework was used to analyse study characteristics, conceptualisations of gendered ageism, levels of analysis, and patterns of exclusion. Fifteen studies were included. The evidence base is small, heterogeneous, and largely descriptive. “Gendered ageism” is frequently named but rarely defined. Three framings recur: (1) sexism-structured ageism, in which gender norms shape the content of age-based devaluation (e.g., credibility and appearance norms), (2) an age-gender disparity label that documents who is disadvantaged without specifying mechanisms, and (3) a smaller, intersectional strand linking age-gender disadvantage to racism, classism, ableism, heterosexism, and labour precarity. Across different domains, studies indicate diagnostic delays, dismissal, and poorer service at age-gender intersections, especially for midlife women, LGBTQIA+ older adults and ethnic minority women. Intersectionality is more often invoked than operationalized; and existing measures rarely capture gendered mechanisms across micro, meso, and macro levels. Evidence is skewed toward cisgender women, later life, and the Global North. Conceptual ambiguity and measurement gaps limit comparability and intervention design. Progress requires clearer construct specification, gender-sensitive and intersectional measures, multilevel mixed-methods linking macro discourse to clinical practice, broader inclusion across gender identities and life stages and comparative work beyond the Global North. These steps can help move the field from naming to reducing gendered ageism in the context of health. Not applicable.