The sex difference in hygiene strictness

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In a recent study published in PLOS Global Public Health, researchers assessed the differences in global hygiene norms according to sex differences.

Study: Global sex differences in hygiene norms and their relation to sex equality. Image Credit: Nopphon_1987/
Study: Global sex differences in hygiene norms and their relation to sex equality. Image Credit: Nopphon_1987/

Various studies have suggested that women usually uphold hygiene standards and are hence believed to have stricter hygienic discipline. Yet, more systematic research is required to understand the variation in hygiene norms based on sex differences worldwide.

About the study

In the present study, researchers examined the differences in hygiene norms based on genders.

The team focused on hygiene strictness according to how individuals think one must behave. The researchers used the measures of cultural values which treat males and females equally or differently. The cultural measure provided by the World Values Survey was employed as the key independent variable in this study.

Another operationalization of sex equality was the global gender gap index (GGGI) which estimated the national gaps observed in outcomes among different cohorts of men and women. These gender cohorts were formed based on economic wages and participation, educational qualifications, political empowerment, and survival and health.

The team measured hygiene norms across 56 countries as part of the International Study of Metanorms (ISMN), which collected samples from almost 200 students per country and 100 non-students. The present study only included individuals who also reported data related to gender, which eventually resulted in a final sample size of an average of 281 participants per country. Almost 80% of the selected participants were students with a mean age of 25 years. Measurements related to attitudes toward sex quality were available for 49 countries, including Australia and three African, 10 American, 14 Asian, and 21 European countries.

The ISMN comprised 12 items that estimated normative beliefs related to handwashing and spitting. Participants were asked about their opinion on whether it was ‘inappropriate for people to spit,’ with tick boxes next to six locations: in the kitchen sink, on the kitchen floor, in the water in a public swimming pool, on the sidewalk, on the soccer field, and in the forest. Participants were also queried whether they thought persons ‘should wash their hands’, with tick boxes next to six locations: after shaking hands, when they come home, after urinating, after defecating, before eating a meal, and after eating a meal.       


The study results showed that women had stricter hygiene norms than men, while the differences between the sexes varied across contexts and behaviors. The extent of the effects ranged from negligible to moderately small. The team noted that for every norm, in countries having a negative national sex difference, men displayed stricter hygiene norms than women. However, in most countries, stricter norms were followed by women compared to men.

The team also observed that the internal consistency of the sex difference across a country for the six handwashing norms was adequate, which indicated that the aggregation of national sex differences was meaningful for the estimating handwashing norms. However, it was found that the national sex difference in the norms of washing hands after defecation was uncorrelated with the sex difference measures observed in the other handwashing norms.

Similarly, spitting norms related to spitting on the kitchen floor were uncorrelated to the national sex differences for the other spitting norms. The team noted that the men in Nigeria and Siberia displayed stricter handwashing and spitting norms than women.

On the other hand, handwashing norms showed that sex differences in hygiene strictness were positively correlated to sex equality. The effect of sex on strictness regarding handwashing and spitting norms increased with sex equality among the countries having below-average sex equality. However, strictness about spitting increased with equality among countries with above-average sex equality, while no such change was observed in strictness for handwashing norms. Altogether, the sex differences in hygiene strictness were not explained by any sex differences in participant age, response style, any threat of disease, or valuation of self-control.

Overall, the study results showed almost universal sex differences in strictness of hygiene norms across different cultures worldwide. The researchers believe that the global pattern in hygiene norms with respect to sex differences should be studied further with more detailed data.

Journal reference:
Bhavana Kunkalikar

Written by

Bhavana Kunkalikar

Bhavana Kunkalikar is a medical writer based in Goa, India. Her academic background is in Pharmaceutical sciences and she holds a Bachelor's degree in Pharmacy. Her educational background allowed her to foster an interest in anatomical and physiological sciences. Her college project work based on ‘The manifestations and causes of sickle cell anemia’ formed the stepping stone to a life-long fascination with human pathophysiology.


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