Gender as headline and subtext: problematizing the gender perspective in an occupational health project

Gender as headline and subtext: problematizing the gender perspective in an occupational health project

Gunilla Olofsdotter* and Angelika Sjöstedt Landén

Department of Social Sciences, Mid Sweden University, Sundsvall and Östersund, Sweden


The focus of this article is on how a “gender perspective” becomes lifted to the headlines as a solution to an organizational problem. The purpose of this article is to problematize how a gender perspective was employed in the everyday practices of an occupational health project in a Swedish municipality. The project’s stated aim was to construct and implement a new model for occupational health, targeting the municipality’s employees, and gender equality was seen as one means of reducing sick leave among the staff. Our focus was the participants’ perceptions of their participation and their reflections on the content and practices of the program. The information was gathered from focus-group interviews with participants in a management training program (MTP) and a rehabilitation program (RP) and from documents produced within the project. Drawing from feminist writings on gender subtexts defined as a set of concealed power based processes (re)producing gender distinctions in organizations, we have explored how power structures are created based on socially constructed differences. Our results demonstrate how gender knowledge could reproduce inequality and hierarchical distinctions between people in different positions in working life.

Keywords: Gender subtext; gender perspective; occupational health project; abstract worker; identification

Responsible Editor: Marianne Hedlund, Telemark University College.

(Published: 4 June 2014)

*Correspondence to: Gunilla Olofsdotter, Mid Sweden University, Sweden. Email:

©2014. G. Olofsdotter & A. Sjöstedt Landén. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC BY 4.0) License (, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

Citation: Vulnerable Groups & Inclusion.


Despite the current body of research and knowledge about how gendered patterns structure work and organizations and the many initiatives for changing such relations, there is a striking lack of transformation within organizations and workplaces (see for example Abrahamsson, 2000; Abrahamsson & Johansson, 2013; Acker, 1990; Kanter, 1993; Kelan, 2009; Kvande, 2003). We have studied how a gender perspective on occupational health practices was implemented in an EU project set up to reduce sick-leave rates among employees in a Swedish municipality motivated by statistics that showed that sick-leave rates were especially high for female employees. Consequently, the project management planned to integrate a gender perspective into all activities of the project. Although it was an ambitious plan to transform gender relations that were thought to contribute to causing the high sick-leave rates, we could also recognize how the project was organized in line with seemingly “neutral” organizational practices that—from our feminist research perspective—were still committed to underlying assumptions about gender relations. In this study, we argue that it is important to investigate how the implementation of a gender perspective was put into practice and what it came to mean to those that became involved in the project. The project form has become common in both private and public sector organizations as a way of changing organizations or implementing new ways of organizing work practices (Abrahamsson & Agevall, 2009; Cicmil, Hodgson, Lindgren, & Packendorff, 2009). Projects with the aim to change gender relations and increase gender equality are common in public sector organizations. However, it is not an easy task to change existing gender orders, and these projects are often met with internal resistance (see Amundsdotter, 2010).

The overall aim of this article is to problematize how a gender perspective was employed in the everyday practices of a project co-funded by the European Social Fund and a Swedish municipality between 2009 and 2011. First, we will investigate how a gender perspective was integrated into the project and how concepts such as “gender”, “gender equality”, “sex”, “gender mainstreaming”, and “gender knowledge” were articulated and given meaning in project activities and documents. Second, we will discuss underlying assumptions behind these concepts and project activities and how they interact with organizational hierarchies, structures, and hegemonic processes. Inspired by feminist writings of gender inequality and power relations in organizations (e.g. Acker, 1990; Benschop & Doorewaard, 2012), we focus on the participants’ perceptions of their participation and on their reflections on the content and practices of the project. We argue that gender knowledge was made explicit in particular ways that in turn were not only gendered but also imbued with a range of categorizations and adherent hierarchical relations. The theoretical perspectives therefore need to be able to deal with different analytical levels that will conceptualize how gender worked as headline and subtext at the same time.


The concept of gender subtext has been promoted as a way to rid organizational research from reproducing “malestream organizational theory” and analysis (Bendl, 2008, p. 50), and we are convinced that it is a continuously important task to analyze the gendered structures that the seemingly gender neutral conceptions of organizations, management, and malestream research reproduce. However, in this study, our empirical material consists of ethnographic data from a project of which the very aim was to acknowledge and highlight the underlying gender inequalities of the organization in order to then change current orders. The gender perspective was in other words lifted to the headlines and made explicit. It is therefore relevant for this study to conduct the analysis on multiple analytical levels.


As a first analytical step, we analyze how a “gender perspective” was articulated as central to the project. In documents and all kinds of presentations of the project, we observed how the incorporation of the “gender perspective” was surrounded by a range of concepts such as “gender” (sv. genus), “gender equality,” “sex,” “gender mainstreaming” and “gender knowledge.” But “documents are not simply objects; they are means of doing or not doing something” (Ahmed, 2012, p. 85) and the conceptualizations of the gender perspective was not only rhetoric. There was a sincere strive and wish to make things better by implementing a gender perspective in the project. When we write about the gender perspective as a headline of the project, our view is that it had a deeper meaning than just simply placing the words “gender perspective” at the center of project documents. It also meant something for the direction of the actions taken in the project. Sara Ahmed (2012) has written illuminating work about the labor, emotional investments and paradoxical feelings that awaken when struggles for equality are brought to the fore of organizational practices. Ahmed also problematizes how the work on documents may privilege particular doings and marginalizes others and addresses that although inequalities are brought to the headlines of organizational efforts, there is no guarantee that existing structures of inequality are going to be questioned or reworked. This is when the level of gender subtext enters our analytical framework and draws attention to the need to explore the interaction between what is made explicit on the one hand (headline), and merely taken for granted and made hegemonic and legitimate on the other (subtext) in order to problematize how a gender perspective is employed in organizational practices.


The concept of gender subtext was first introduced in organizational studies in the late 1980s by Dorothy Smith (1987, 1989, 1990). The concept was taken up by Acker who argues for continuous efforts of feminist research to “puzzle out how gender provides the subtext for arrangements of subordination” (Acker, 1990, p. 155, our emphasis). The concept has developed into a methodological tool for researching the reproduction of gender relations in organizational discourse that lay claim on “gender neutrality” (see e.g. Bendl, 2008; Benschop & Doorewaard, 1998; Sappleton & Takruri-Rizk, 2008). We agree with Benschop and Dooreward (2012) that gender subtext is a concept that is fruitful to revisit although insights of current research need to be integrated to contemporary analyses. Moreover, every study that undertakes an analysis based on the concept of gender subtext need some openness to the theoretical and empirical specificities and contexts of each study. In short, there need to be sensitivity to the variations of what gender subtext means in organizational discourses and settings (Bendl, 2008). In this study, we particularly pick up on some of the aspects of its theoretical resources that bring forth the power dynamics that emerge in our data.

A first definition of gender subtext offered by Benschop and Doorewaard (2012) in their revisiting of the concept is described as a “set of often concealed power based processes (re)producing gender distinctions in social practices through organizational and individual arrangements” (2012, p. 225). Mostly with acknowledgement to Acker’s work, they define some of the focal points of an analysis that emphasize the subtle processes of subtexts. We will specifically bring three of these concepts forward with regard to the aim of our study: the abstract worker, identification, and hegemonic processes and power.

In the literature, the abstract worker makes out an ideal type and an ideological image of the proper worker/employee/manager and the assumption is that characteristics of the abstract worker play a central part in gender subtexts. Previous research distinguishes how a full-time, highly qualified, work-oriented person is commonly presented in organizational texts as (gender)neutral (Acker, 1990; Benschop & Doorevaard, 2012). However, this is one of the cases where we argue that we also need to keep the analysis open to the variations of how characteristics of an abstract worker become assembled. We therefore think that the poststructuralist differentiation between the concepts of identity and identification may contribute with further clarification (see Glynos & Howarth, 2007; Laclau, 1990; Laclau & Mouffe, 1985). In our study, we do not regard the abstract worker as an ontological or fixed category, but rather as an identity that is always dependent on its relationship with other positions within a wider social structure (see Glynos & Howarth, 2007, p. 127). The abstract worker could thereby be regarded as an identity: a collectively imagined ideal position. This is where the distinction between identity and identification becomes important; because the idea is that the ideal position (of the abstract worker) only exists because of identification. If no attempts to identify with the ideal were made, it would cease to exist (see Laclau, 1990). Moreover, it stands out as a gendered ideal. Benschop and Doorevaard (2012) write that gender norms pertain to symbols, ideological images, rules, and values that “explicitly and implicitly steer, justify and sometimes question gender distinctions in the organization” (Benschop & Doorevaard, 2012, p. 227). However, in line with subsequent research, Benschop and Doorevaard (2012, p. 227) also write that gendered processes “focus on the role orientation of men and women in organization (task or social–emotional oriented), the characteristics of their status (unspecified or specific), the way they deal with sexual and non-sexual attraction and the patterns of information.” They distinguish “the role orientation” from “identification,” which relates to that “people are identified—and they identify themselves—as women and men” (Benschop & Doorewaard, 2012, p. 227). Inspired by post-structuralist thinkers, we possibly bring a somewhat different understanding of identification into the forthcoming analysis. To identify may very well imply to accept and reproduce “the physical and biological distinction between women and men” (Benschop & Doorewaard, 2012, p. 227), but we need to be careful to always keep in mind that such identification is not with the fixed categories “women” or “men” per se, but with the performance of a hegemonic heterosexual and dualistic gender norm. A core task of the analysis is thus to pay attention to how hegemonic processes and power orders are reproduced or come into being. Benschop and Doorewaard (2012, p. 228) define this as combinations between implicit rules and regulations and generally known customs and conventions. These are important aspects of hegemonic processes, but our approach also emphasize that studying how hegemony emerges in a particular context also contains the “displacement of research emphasis from mainly sociological categories, which address the group, its constitutive roles and its functional determinations, to the underlying logics that make these categories possible” (Laclau, 2000, p. xi).

The combination of the three aspects of gender subtexts: the identity of the abstract worker, the identification with the same and wider gendered norms, and power orders thereby enables the analysis to be pursued at different analytical levels. An example of this is how one of the explicit tasks taken on by the project that we studied was to train and equip the personnel (managers and other staff) with analytical tools to unveil the existing gender orders that have resulted in gender inequalities in terms of more women being on sick-leave. Our exploration could thereby contribute with an analysis of how these intentions “got stuck” in gender subtexts that impregnated the organization and in turn disabled the emancipatory ambitions of the project.


This section describes the context and background of the project we have studied. After that follows a description of the research method, empirical data, and analysis.

Background: an occupational health project

Although we observed how the “gender perspective” was made central to the project, it was not set up as a means of changing gender relations in the municipality per se; the project’s stated overarching aim was to construct and implement a new model for occupational health, targeting the municipality’s employees. It was intended that a gender perspective should be integrated into all activities in the project, and this was promoted as one means of reducing sick leave among the staff. Gender mainstreaming is also a requirement for projects funded by the European Social Fund, and this project was framed as really getting into the gender perspective in comparison to other projects. The municipality where the project was set up serves a sparsely populated area in a northern region of inland Sweden and in total employs approximately 1,200 people, of which 1,000 are women. When the application for the project was formulated in 2008, approximately 11% of the employees were on sick leave. Of those on long-term sick leave, 93% were women. In terms of leadership, the majority of managers in the municipality were men (Application to the ESF, 2008). It was with such statistics as a point of departure that the project manager formulated the argument that a gender perspective on occupational health was needed in the municipality in order to break the trend of high sick-leave rates. As part of the contextualization of this project, we also have to note that these high local sick-leave rates follow a pattern in Sweden in general in which long periods of sick leave have been formulated in both policy and public debate as an acute problem for the country’s economy and labor market, and for the individuals on sick leave (Johnson, 2010; Michailakis, 2008; Olofsdotter Stensöta, 2009). National statistics indicate that men’s and women’s sick-leave rates follow different patterns (e.g. Hammarström & Hensing, 2008; Palmer, 2005; Sandmark, 2011). The issue of sick leave has thereby become part of a “gendered” discourse in debate and policy.1 The gender patterns in municipalities follow the same gender-segregated patterns as the Swedish labor market in general, where many women are found in the sector that cares for humans, while most men are found in the sector that cares for machines and buildings and so on (SCB, 2012; SOU, 2004). In the last 20 years, Sweden has been held up as a good example of an integrated gender mainstreaming approach focused on structural issues, equality, inclusion, and fairness (Daly, 2005; King, Barry, & Berg, 2008). But, even though Swedish gender policy has been admired, gender equality is far from having been achieved, and several studies demonstrate that an imbalanced gender distribution has existed and continues to exist in the labor market in Sweden (see for example, Charles, 2003; Melkas & Anker, 2001; SOU, 2005). In terms of occupations, hierarchies, and power relations, the mechanisms of segregation in the workplace are changing very slowly. How inequality takes place, to what degree, in what areas of life, and with what effects differ substantially throughout the country. Similarly, both women and men possess different opportunities in different places for altering, or coping with, their circumstances (Giritli Nygren, Olofsdotter, & Larsson, 2013). In the project, a gender perspective was expected to do something particular, namely to contribute to the decreaseof sick-leave rates among employees. The activities included in the project were similar to other projects promoting gender equality (Amundsdotter, 2010, 2012) and ranged from changing organizational routines to getting individuals to think and act in new ways.

We functioned as “interactive researchers” in the project. The approach was developed in close connection with ethnographic methods and action research. It differs, however, from traditional action research in that the responsibility for organizational change lies with those working in the organization (Callerstig & Lindholm, 2011, p. 86). Our work included giving feedback to the project managers and participants during the project, but we left it to them to decide how to act (or not act) upon our reflections. Without conceptualizing it as such at the time of constructing a research agenda for these projects, we have taken on what Lather (2001) refers to as a “within/against position.” This was particularly evident when we started to study the developments of the project and became continuously overwhelmed by different ideas about and approaches to, and knowledge about, gender.

Research method and data

We followed the project practices for 2 years (2009–2011). The activities were divided into programs directed towards managers, on the one hand, and employees on long-term sick leave, on the other. The data were gathered from focus-group interviews with participants in the programs and from documents produced within the project. Document analysis has provided research data on the context and background of the project. This information was used to contextualize data collected during focus-group interviews and also to help generate new interview questions (see Bowen, 2009). They have also been an important source for exploring the ways in which the gender perspective was made central to the project. Documents that have been analyzed are, for example, project proposals, applications forms, summaries, and memoranda. These kinds of documents are also interesting from the perspective that the project practices are guided by such documents and they also present ideal images of the expected outcomes (see Ahmed, 2012). Furthermore, the documents are important in relation to how the problem to be solved by the project became constructed in the first place and how the construction of a problem is an act of power (Bacchi & Eveline, 2010) and is thereby closely linked with the analysis of gender subtexts. For example, the construction of the problem of sick leave strongly affects what are seen as possible ways of organizing occupational health work (see also Sjöstedt Landén & Olofsdotter, 2013).

The focus-group interviews enabled the acquisition of rich data and a flexible exploration of research themes. We were able to draw on a number of individuals’ thoughts and experiences, while at the same time there were opportunities to further develop and deepen the line of argument in the course of the conversations (e.g. Fielding & Thomas, 2001; Lindlof, 1995). Methodologically, the focus-group discussions also allowed us to observe the interplay between participants, which makes for a very different kind of interview from those with single individuals (e.g. Morgan, 1988, Morgan 1993). When investigating the everyday practices of a project, the lived experiences of all participants at all levels of the project hierarchy are important (Cicmil & Hodgson, 2006; Hodgson & Cicmil, 2006). The focus-group interviews were therefore conducted on two occasions with two groups of managers and two groups from the rehabilitation program (RP) (see Table I).

Table I. The focus-group interviewees.
Group Gender First time Second time
Management training group A Female February 2010 October 2010
Management training group B Male February 2010 October 2010
Rehabilitation group A Female February 2010 October 2010
Rehabilitation group B Female/male June 2010 October 2010

All managers were employed by the municipality and were invited by the project management to participate in the management training program (MTP). The participating managers worked in different parts of the municipality administration, for example, in education, social services, property, maintenance, water supply, infrastructure, and childcare. The participation of managers was part of their additional training as managers and was conducted during their normal working hours. Many of the managers were also responsible for personnel who, at the time of the project, were on long-term sick leave.

The target group of the RP was employees on long-term sick leave. By their participation in the program, they were expected to be able to return to work after some training (see Table I). They were also invited by the project management. These participants were employed in education, maintenance, social services, and childcare, and differed in terms of age, occupation, educational background, and health status. Contrary to what was permitted for the managers, the training of these participants was conducted during their sick-leave period. Many of the participants in the RP were only on part-time sick leave. Some worked for as much as 75–80% of their full-time hours and needed to take time off to participate in the program as well as to attend the interviews that we conducted. The focus-group interviews were not part of the regular program activities. We contacted the participants in the programs by email or regular mail and asked if they wanted to take part in the study. They knew from the beginning of their participation in the program that the project was followed by researchers and that their participation in the interviews was voluntary, and they were assured confidentiality. The interviews with both managers and employees on sick leave were conducted in a conference room at the municipality’s central offices. This was the regular workplace for most managers, but most of the participants in the RP lived and worked in other places, which meant that they sometimes had to travel a long way to participate. The interviews were tape-recorded and transcribed verbatim. As a basis for the interviews, an interview guide with themed issues was used. The interview guide sought to analyze several topics with reference to the content of the programs, including their experiences as participants. Questions were asked about how knowledge about gender was communicated and made explicit (this enabled us to follow concepts such as gender, sex, gender equality, and the meaning attributed to the concepts in the analytical stages). We also asked about the content of the programs and how the activities were organized. The interviews took the form of a conversation, in which the informants could respond with their own words, and in which we as researchers could ask supplementary questions (Creswell, 2007; Fielding & Thomas, 2001). The focus-group discussions, which lasted between one and two hours, were conducted jointly by both researchers.

The analytical process involved the stages of thematic categorization and coding in order to identify patterns as well as inconsistencies in the data. The first step was to code the content according to concepts such as, for example, gender, sex and gender equality, expressions and recurring patterns (Strauss & Corbin, 1998). The next step was to categorize codes about the same phenomenon into themes, thereby reducing data into smaller units. This means that data was coded according to themes derived inductively from the empirical material itself as well as from the theoretical perspectives.

By exploring how the gender perspective was put into practice in the project, we could in turn analyze how ideas of gender in different ways, as subtexts or headlines, contributed to the creation of intersecting categorizations. This means that our analysis has not focused on whether the project succeeded in lowering the sick-leave rates. We were instead interested in how categories emerged in the interviews and in the organization of the project per se. This has made it possible to trace the unexpected aspects of the politics of rehabilitation and occupational health in the everyday practices of the project.


In the application to the European Social Fund, the municipality stated that all of its activities would entail “aspects of gender equality and gender mainstreaming.” The project management subsequently searched for subcontractors with documented experience of gender mainstreaming practices to carry out the programs. Because it was stated that gender would be “highlighted, analyzed and problematized” in the project (Application to ESF, 2008), the subcontractors needed to have a section in their offers in which they defined their views of “gender” and “gender mainstreaming.” The subcontractor for the MTP wrote in their offer:

We view gender as a social and cultural construct in a constantly on-going process, where individual, organizational and societal levels interact. (Offer MTP, 2009)

This consultant furthermore suggested that the MTP should contribute by “increasing knowledge and awareness of gender issues.” This should, for example, be done by presenting and discussing current research in the field, thereby leaving the level of “common sense” and instead gaining insight into the problems of “structures that are sometimes difficult to discern” (Offer MTP, 2009). The management program clearly had an academic ambition and expected course participants to question inequalities on a structural and abstract level and complied with the ambition of putting a gender perspective at the headline of the project’s activities.

However, in the offer for the RP detecting or problematizing structural or organizational aspects of gender was not mentioned. The offer from the selected subcontractor, for example, described what the program should do:

Show how men and women are encountered and how this can contribute to health or ill health. (Offer RP)

A range of complex concepts were also mentioned in the offer. Notions such as “gender perspective,” “sexes,” “gender equality perspectives” and “gender-neutral perspective,” “heritage” and “gender roles” were mentioned but never defined (Offer RP). Nor was it explained how the different concepts were related to each other, or what kind of values and perspectives the program would be based on. The project management of the municipality was not satisfied with this application but stated that it was the “least bad” alternative and therefore accepted the offer.2 This conceptual inconsistency and the subcontractor’s limited clarity of what a gender perspective meant for them also obstructed the possibility of putting the gender perspective at the forefront of the activities.

Although well intended, the strategy of inviting subcontractors with proven experience of gender mainstreaming was not easy to achieve. The bid by the chosen contractor for the MTP was perceived by the project manager to be unproblematic, but the project faced a situation in which none of the bids for the RP were up to the required standard in terms of a gender perspective. At this early stage of the project, the differences between the two programs had already become obvious in terms of addressing a gender perspective throughout the activities in both programs.

Although the programs were expected to be filled with different content, the structure of the two programs was similar with intense group activities in the beginning of the programs. The MTP ran for 18 months. The overall aim was to increase managers’ awareness of their own leadership and its influence on staff health. The program was to train managers in “self-knowledge, power of observation, communicative capacity, conflict management, analytical competence, organizational competence, and gender” (Presentation, MTP). The content was angled towards reflective practices, academic reading and writing and creating a vivid seminar culture to encourage discussions among the managers. They were required to analyze power regimes and structural inequalities on a societal level. The focus in the program was on managers’ own professional development as leaders, and not necessarily directly on the complexities of high sick-leave rates and the rehabilitation of their staff.

Meanwhile, the RP followed a model intended to prompt changes in the participants’ behavior. The program was run by an external occupational health service with two consultants: one male psychologist specializing in cognitive behavior therapy (CBT), and one female physiotherapist who could also give dietary advice. The pedagogy was based on a model used for people with, for example, addiction problems. The program ran for 1 year (Presentation RP). The group activities in the RP started with a 2-week intensive course with activities that ran from 8.30 a.m. until 12.30 p.m. Each day was structured in the same way during this period: two theoretical group sessions in the morning, with lectures and talks, and then a class of physical activity. This could be walking, walking with poles/Nordic walking, qigong or yoga, etc. Each day ended with a relaxation exercise and reflections on the day’s activities. After the intense 2-week period of group work, there was a phase in which the participants were expected to maintain the work by way of an individual program.

The very division of the project made by the project management into two different programs highlights a strong categorization of managers and employees on sick leave. In the subtexts of this division, an underlying logic is present that was based on expectations that these groups were not expected to be able to acquire the same kind of knowledge. In what follows, some examples of how gender subtexts came into conflict with the gender perspective in various ways in the project are highlighted and discussed.

The following presentation and analyses is structured according to the analytical framework of gender subtexts; the abstract worker, identification and hegemonic processes. The chosen excerpts from the empirical material illustrate different aspects of gender subtexts and how they interact with the explicit gender perspective. These three aspects are articulated as separate analytical categories for the sake of the analysis although they presuppose each other and could be articulated simultaneously.


From the above descriptions of the different programs an ideal worker emerges: the majority of managers were men in the municipality, the managers were expected to be able to do the academic and analytical highly qualified work, they were already in the geographical center of the organization which enabled them to a larger extent than participants in the rehabilitation program to live up to the ideals of disembodied workers. Traditionally, the characteristics of the abstract worker include a full-time, available, highly qualified, work-oriented and disembodied worker presented in organizational texts as abstract and (gender) neutral. This does not mean that managers identifying as female cannot work according to the ideals of abstract workers. However, the argument put forward in feminist organizational research (Acker, 1990; Benschop & Doorewaard, 2012, p. 227) is that the characteristics correspond to the assumed characteristics of male workers rather than to those of female workers in day-to-day reality. In the following, we explore the role of this abstract worker in our data; an ideal image that seemed to work as an ideological node around which “others” were organized.

The “ideal” manager and the “others”

The whole point of the project was to create a health-promoting organization and to support people returning to work from sick leave by implementing a gender perspective in occupational health practices. The managers were expected to take on an important role in this process. They were supposed to “increase their awareness of their own leadership and how it influences staff’s health” and increase their knowledge about “the relation between leadership, work, health and gender” (Presentation MTP). In the group interviews, we asked the managers about their views on their roles as managers in relation to their staff, whether sick or not.

If it’s the case that my way of being a boss and a manager means I have an unhealthy attitude that triggers more people into being off sick […] that I’ve come to the realization that I should change in myself, then of course it’ll affect it, the group I lead, or the business. (Male managers)
I think the manager is so important, especially important with this thing of getting back to work, for example. And then it’s important to have a good grounding as a leader. (Female managers)

The importance the interviewees placed on managers encouraging people on sick leave to return to work was made explicit in the interviews. This highlights certain expectations of their behavior based on what appears to be a gender-neutral image of the ideal manager that “manages” the healthy workplace. In spite of this awareness, they also talked about how the managers’ knowledge of what was going on in the RP was limited.

I can say that all I know is what the participants themselves have said. But I know very little. […] But, really, what do they do? They draw up plans for the year to come, and they have to document every day, yes well, stuff. But I’m not at all up to date with how they work … (Female managers)

This lack of awareness unveils the presence of a hegemonic power process in which managers with limited insight into the everyday practices of the RP are still those who are responsible for facilitating workers’ return to work. Nevertheless, the managers also questioned the reason for placing managers and employees on sick leave onto different programs with different content. One of them even suggested that it would have been an advantage if everyone had participated in the same activities:

Well, the best thing would’ve been if employees had had to go through the same things, because there are misgivings because we, the managers, always get the leadership training. (Male managers)

They discussed that emphasizing differences in the content of the different programs might worsen mutual understanding and communication in the organization.

If, purely strategically, so to speak, you’d looked at leadership, then sure, you have the basics, the understanding, but then again employees also need to have the basics as well. It’s then we come together, and that’s where leadership—employeeship—will harmonize with each other. Otherwise the risk is that we, so to speak, end up on different wavelengths. That’s when we don’t talk to each other. (Male managers)

The above citation express a desire for the sort of management built on reliance and mutuality instead of on authoritarianism. This kind of insights are supported by research about equality promoting practices that states that in order to achieve sustainable change it is important that all actors participate in the activities and gain similar knowledge about gender and inequalities (e.g. Abrahamsson, 2000; Ekman Philips, Ahlberg, & Huzzard, 2003; Vänje, 2005). The differences in content could serve to produce and reproduce inequalities and “othering” of those that did not as easily live up to the ideal of the abstract worker within the organization. In summary, the categorization between managers and employees on sick leave was made explicit in the division of the programs, but there were also distinctions within the group of managers, which we will discuss in the following.

One of the activities in the management program was to analyze films and works of literature. The participants were asked to critically examine the ways in which categorization based on gender becomes meaningful in social relations. After reading a novel by Ernest Hemingway, one male manager stated:

Informants: It’s almost a shame to analyse Hemingway the way we did [laughter]. No, well I mean, eh, why can’t he be allowed to be macho? [Laughter] […]
Interviewer: Were you asked to use certain tools for the analysis, or were you free to do whatever you liked?
Informants: Some key words like … power, hierarchy […] Informal power, gender. Yes, we were given some things to think about and mull over.

The business of thinking about literature in terms of power and gender was sometimes seen as excessive and far-fetched; yet doing so with the help of the analytical concepts foregrounded in the program could also be seen as a tool that could come in useful in everyday situations. Still, these reflections were mostly used for managers’ personal development. However, after discussing a film, the group of female managers expressed a great many thoughts about how to handle their own leadership and how much they should engage in the personal lives of their staff.

These [situations in the film they had analysed] might be real events for our staff. We don’t know, what it is … I felt that, but how can you know what their private lives are really like?
And how it can influence their work.
Yes, how it might influence work.
What they bring with them …

They went on to talk about how their thoughts of being an emphatic manager that tried to put themselves in employees’ position were suppressed by the consultant responsible for the management program. He made it clear that managers should set clear boundaries between what goes on at work and employees’ private lives. But the group of female managers was doubtful, and reflected on the influence private life can have on working life. This highlights a gender subtext that underscores a traditional view of the best practice of management: a hegemonic masculinity based on goal orientation, rationality and the separation of work and private life (Acker, 1990; Collinson & Hearn, 1994; Lindgren & Packendorff, 2006).

The content of the MTP was based on reflecting on and having critical discussions about power, hierarchy and gender issues. The gender perspective was put at the forefront of the management program and was promoted as a guiding headline for all activities. Nevertheless, an image of the “ideal” manager based on male hegemony became visible in the interviews and made explicit how a gender subtext came in conflict with the idea of a gender perspective as encompassing the project. As the above discussions show, a gendered subtext worked in different ways in the program by making distinctions between managers and staff, but also between male and female managers. It is apparent that the MTP was intended to enhance managers’ gender awareness, but, as Höök (2001) would ask, was the program really contributing to the questioning of existing power structures?

In search of the disembodied worker? Physical training and other embodied practices

When we interviewed participants in the RP, they confirmed the image given by the managers that there was a lack of interaction between the programs. But much of the interviews also came to address the content of the program and how it was organized. The intense 2-week period of group work was followed by a phase that lasted for several months in which the participants were expected to maintain the work by way of an individual program. This included an individual action plan of physical exercise and other objectives and regular feedback to the consultants by email. It was also supposed to involve feedback over the telephone from the consultant. After 5 months, a new meeting took place to follow up on how everyone was doing.

Because it was a part of everybody’s planning—physical exercise and behaviour goals, how to get fit, and so on. This was what it was all about, that you should exercise and improve your strength. (Rehab)

In the group interviews, the participants were critical of the standardized program, which included little adaptation to individual needs and conditions. Physical activity was one of the most important elements, and some of the participants were doubtful about whether increased physical training would make it possible for them to return to work.

But she [the physiotherapist] said that it was for our own sakes. That you should think about it. Yes, why haven’t I done any exercise for 2 weeks? Why am I unable to get into the routine? (Rehab)

The formal control and reports—exercise diaries, time sheets and attendance reports—to be submitted to the municipality’s administrative office and the occupational health service took up much of the RP’s time, especially compared to the MTP. This was described as somewhat stressful:

Because we all had plans, exercise, name, efficiency goals, behaviour goals, and it was …
Everyday goals. Yes, everyday goals. It was actually … That’s where everybody had to fit in. (Rehab)

Participants reflected over the rigid structure of the program. Some wondered what would happen if someone did not fit into any or all of these models that focused on molding bodies, this, especially since their participation in the program also was linked with their acquirement of sick-leave benefits. The emphasis on the individual body in the program emerges clearly in the following quotation:

You should breathe in … You should close your eyes and breathe in, and then count—one, two, three, four—and hold your breath, and then breathe out. And then you take another breath and count to four and hold your breath, and then you go on like that. You can calm yourself down by breathing properly. (Rehab)

The structural or organizational reasons for excessive stress (överbelastning) at work were not emphasised in the RP. The primary focus of the program was the individual taking responsibility for their own health and body and labor-market participation by changing their behaviors accordingly. The very organization of the program and the contents of the practices targeted the (female) body as problematic. With the theory of the abstract worker in mind— “the bodiless worker, who occupies the abstract, gender-neutral job” where emotions and the life outside work is not taken into account (Acker, 1990, p. 151)—a first interpretation could be that the focus on the worker’s body in the RP as a way of shaping the workers to fit with the ideals of disembodiment. Moreover, despite the ambition shown by the project management and the written documents to integrate a gender perspective into all parts of the project, we found that in practice the participants in the RP were not expected to deconstruct these power orders that they were part of in the way that the managers were expected to do.

The organizational divisions between managers and employees on sick leave also gave the impression that managers were not the ones to get sick, something that could make managers’ need for health reforms and rehabilitation invisible. Landstad and Vinberg (2013) have studied female managers’ experiences of working conditions and health in Swedish public services, which resemble the conditions for managers in the municipality we have studied. Ironically, the managers in their study stated that when it came to “investing in their own health, such as wellness training and participating in social networks outside of work,” they lacked the time and the opportunities (Landstad & Vinberg, 2013, p. 9) and just like some of the participants, we often wondered why employees and managers could not be offered the chance to participate in the same program during the time of the project.


In the following section, we give examples of how the way in which men and women were conceptualized in the project reduced the possibilities of identification to hegemonic gender norms and worker ideals.

Male and female behavior

Our collected impression from the interviews with participants in the RP was that the lectures, practices and modes of interaction focused firmly on differences between biological sexes.

Male and female behaviour. We’ve talked about it, and that a man might step over things on the floor, or …
But not much …
No, not much, but on a couple of occasions these past weeks.
At the first meeting I had, they mentioned it—‘How are things at home?’—yes …

Differences between the sexes were in turn connected with particular “reactions” and behaviors. In the interviews with participants in the RP, they frequently returned to the description of stress and relaxation in relation to differences between men and women:

Relaxation, stress management. Differences between women and men. Why we react the way we do. It has to do with this stress and gender perspective. (Rehab)

The above excerpt shows how the “gender perspective” in this case relies on the emphasis of biological difference. Another participant recalled her first contact with the cognitive behavioral therapist and the physiotherapist from the occupational health service who organized and managed the program.

Informant: We talked a little bit about my problems, that they are a bit, yes, well, female, so to speak, that can be [inaudible] to do so well all the time.

Interviewer: Did you think about why they thought it was important to bring that up?
Informants: It’s a part of my problem, of course. If you’re brought up by a mother who stayed home and did everything, and then I became a mother myself, I wanted to be just as good, even though I had a full-time job as well … But I don’t remember us talking much more about that.
I know that you [name] brought it up at some point, and they only said, ‘But we’ll talk about that later.’

This excerpt is an example of how the participants’ identification with the traditional image of women as caretakers was taken for granted by the therapists as well as the participant. In turn, this made the illness stand out as naturalized and a “female problem.” The activities in the RP did not support the participants questioning gendered norms and expectations in the way that the management program aspired to do. In the RP, gender aspects were first and foremost understood as differences between men’s and women’s behavioral patterns. The discussion in the interview was contradictory. On the one hand, female gender was targeted as a problem that could produce certain symptoms, such as stress. The participant talked about it almost as if being a woman was a disease. On the other hand, gender was made invisible by referring to individual responsibility. The gendering of problems, as the informant mentions above, was also articulated by participants in more unexpected ways. In one of the interviews with one of the rehabilitation groups, the participants started to reflect on what gender meant when they came back to the workplace after the program had been completed.

One thing that I have seen as very, very different is how we have been received at the workplace after the intense period in the programme. I have a colleague and we have both participated in different groups in the programme, but we have been received very differently by our manager.

The informant was not sure about why they had been treated differently, but she had noted that she was a woman and her collegue was a man.

I don’t know if that’s the reason, but we are of different sexes […] It’s usually the case that men are more visible in society, but in this case it’s exactly the opposite.

This event also highlights the interest from the participants and the need to problematize gender in the RP and to integrate the gender knowledge from the management program into the actions taken at the workplace after the completion of the programs. Gender was not the object of problematization, and whenever it was addressed it was in terms of gender roles, reflecting an idea of rather fixed relations between men and women. Therefore, it never took gender knowledge to the level of societal structuration as it did in the MTP.

Taken together with the strong focus on the correction of the participants’ physical bodies, the lack of deconstructive approaches constructed the participants in the RP and the management program as essentially different. The participants in the RP also noted in the interviews that the program did not take a comprehensive view of working life and health that could account for what happened outside work. Several of the participants had attended similar programs before that offered a clearer connection between, for example, family life and working life. This weakness could be interpreted as yet another way of making gender invisible in the program; certainly, the program aimed at teaching the individual how to manage their anger, their pain or their character failings. The problematization of gender (as stated in the project documents) was more or less non-existent. This was also a source of frustration for the project management, which worked intensely to change this. However, this struggle only made more visible how the organizational structure of occupational health companies affected the possibilities for changing gendered patterns in the municipality’s program. No matter how many stress-management techniques the participants in the rehab program might have learnt, there will still be everyday situations at work that will resist being solved by individual stress management. In discussion, the participants stressed that strategies designed to manage the individual may not be enough to solve the problems of an unequal division of labor in the workplace. This is a reflection that in itself was revealing of the gendered subtexts that they were a part of as participants in the program.

In the earlier section about the abstract worker, we suggested an interpretation of the focus on the worker’s body in the RP as a way of shaping the workers to fit with the ideals of disembodiment. However, what we have explored in this section could also lead us to the interpretation that the focus on, and identification with, biological sexes rather reinscribed employees on sick-leave as embodied workers. In that case, the organizing of the project could also be interpreted as committing to a Tayloristic logic of scientific management through the “binary opposition between the thinking managerial mind and the working body on the embodied subjectivities of workers” (Bahnisch, 2000, p. 65). This leads us on to a further discussion about the hegemonic processes at work in this context and how they became gendered processes.


In this final part of the analysis, we would like to give an example of the subtle processes through which the abstract worker could continue to be hegemonized and masculinized, and show how this could also happen even through the very conceptual tools constructed by feminist critical scholars.

Gender knowledge—discussing power structures

We have already illustrated that the managers were equipped with a vocabulary to name power structures and the ways in which these structures could take on a concrete form. This vocabulary consisted of words such as gender, power, hierarchy, and domination techniques.3 In the interviews with managers, we could observe how these concepts were used to reflect on their situation:

But these domination techniques, that’s something we’ve discussed and had some examples of as well, and it becomes obvious … or I think I see it every now and then.
Me too, often.
You also need to think about how you act, how I act myself, in terms of domination techniques.

They went on to discuss their own experiences of being discriminated against:

Informant: I’m used to it, but I often notice it, often, often.
Interviewer: Is it something you discuss then?
Informant: I haven’t, but I’ve thought about bringing it up.
Interviewer: Have you discussed it with your boss?
Informant: I’ve been thinking I should bring it up any year now [laughter]. (Female managers)

The female managers discussed whether these experiences had to do with their gender or whether these discriminating tendencies had to do with different management positions in the municipality, where some positions were seen as more important and of higher status than others, often correlated with male- or female-coded areas of work. The women continued to discuss their situation and what strategies they could apply to change their treatment by their male colleagues:

But in such situations, it’s both identifying what it is that’s happening and then having the strength to draw attention to it. Because you’re often a bit worn down. (Female managers)

The interviewees discussed how hegemonic power processes were present in their everyday work and in relation to their male colleagues. Their identification as female managers with specific experiences of discriminating action implicitly reproduce a gender subtext of women as “the other” in contrast to the male “norm” (see Bendl, 2008; Benschop & Doorewaard, 2012).

Domination techniques were also discussed by the male managers, but in a slightly different way. They did not talk so much about experiences of being subjected to discrimination. Instead, they described domination techniques as something others might be subjected to and something that they themselves hopefully did not use:

We’ve generally discussed domination techniques, and many times the discussion was about what is male and female, and whether you would have acted the same way in another situation. So we had to train this kind of thinking … (Male managers)

When asked whether they had started to see things differently or behave differently after being introduced to this line of theoretical reasoning, one of the men replied:

No, not really. No, I don’t think so. OK, there’s a pretty short period like that, but it’s more that you’re more aware and perhaps don’t try, yes, you might try harder to think about it. So that you don’t, that it’d be different for girls than for guys. But to some extent it would be anyway. (Male managers)

The male managers seemed to position themselves in relation to “others” (such as “girls” sv. tjejer). Although the men expressed a willingness to change accustomed habits and behavior, this goes in line with shaping an organizational rationality that is at its core masculine (e.g. Acker, 2006; Collinson & Hearn, 1994; Watts, 2009) and the hegemonization of the abstract worker as the masculine manager became quite striking in the subtexts of the project.


The focus of this article has been on how a “gender perspective” became lifted to the headlines as a solution to an organizational problem of high sick-leave rates among staff. The gender perspective was supposed to be integrated into all activities in the project. However, we found that it was employed in different ways in the programs for managers and in those for employees on sick leave. The analysis implies that despite the well-intended aim, the gender perspective promoted as a headline in the project came in conflict with gendered subtext in different ways.

In planning and starting up the project, subcontractors were assigned to take the lead in the different programs. Nevertheless, there were significant differences in their gender knowledge and how they were going to address the gender perspective. The project management took the problems with the RP seriously and worked to enhance the gender perspective in the program. These problems were, furthermore, referred to as lessons that the organization learnt: that the contracting of occupational health services needed to be better monitored and managed by municipality in order to live up to the relevant standards, which resulted in new routines for contracting and a new occupational health service that took over after the project was finished. However, it was the failure to commit to the gender perspective in the headlines that the managers of the project could influence, and successfully so. The more subtle things that went on, for example in the management program, were more difficult to pinpoint. The set-up of the management program was seen as somewhat unproblematic, at least in relation to the RP. Nevertheless, gender subtext worked in different ways in both programs in ways that “both the persistency of gender inequality and the perception of equity emerge from the gender subtext” (Benschop & Doorewaard, 2012, p. 226).

In the management program, the male and female managers expressed different experiences in their role as managers. They identified in their role as managers with a seemingly gender-neutral image of the abstract “ideal” manager. But this was an image with gendered subtexts implicitly present that were based on the notion of masculine connotations (see Benschop & Doorewaard, 2012). In the MTP, it was assumed that men and women would acquire gender knowledge in different ways and were therefore divided into gender-homogeneous groups. In the RP, this was not seen as a problem, since the groups consisted almost exclusively of women to begin with. The practices of the RP were thus related to being sick as a “female problem.” Gender was thereby made invisible in the sense that it was taken for granted that the program practices would be directed at women. Male participants were on the one hand treated as one among others, yet on the other hand they were expected to relate and respond to the content in different ways from the female participants.

However, in the management program, the female managers expressed experiences of being subjected to discriminating actions by their male colleagues. The women reflected on their position as female managers and the difficulties of trying to change such inequalities. They also reflected on their own position in relation to their staff and how problems and situations outside the workplace might influence the staff’s work life. The male managers seemed to have a more distanced attitude towards discriminating practices, as something others might be subjected to. In their discussion, women and staff were constructed as “the other,” a position that highlights the male norm (see Bendl, 2008). The gender segregated groups could thereby contribute to further homosociality (although some men expressed being uncomfortable with being divided into groups on the basis of gender). The division between private life and work life is, as Acker (2012) points out, built on the image of a “gender neutral, abstract worker who has no body and no obligations outside the workplace.” Already in 1990, Joan Acker urged that a sincere acknowledgement of gender relations in organizational practices and in research would “require the end of organizations as they exist today” (Acker, 1990, p. 154) in that “the rhythm and timing of work would be adapted to the rhythms of life outside of work” (Acker, 1990, p. 155). Discouragingly, when we research work life relations today, we get the impression that the utopia Acker wished for seems to float further and further out of reach. On the one hand, gender equality and diversity programs have become institutionalized, but on the other hand such initiatives are often made subordinate to the goals of productivity, effectivity and economic rationalization of organizations (see Benschop & Doorewaard, 2012; Wittbom, 2009; Zanoni, 2010).

We have explicitly mentioned the ways in which gender subtext and power structures come into being in the data, but it is our firm conviction that in the project as a whole, the gender perspective was incorporated in intersecting systems of stratification where categorizations were constructed. It was for example incorporated into systems of social class in terms of hierarchical positions as managers and staff, since access to academically oriented practices in which gender was problematized was reserved for the managers. The academically oriented gender knowledge and gender practice were thus reserved for people in the top positions of the organization. The kind of gender knowledge incorporated in the RP was not incorporated into an academic structure of seminars and the critical examination of texts and situations. Instead, gender was sometimes addressed as an explanation of why the participants in the RP were sick. The inability of individuals to manage the gender roles accorded to them was thus the focus for problematization, not how gender could structure the everyday business of unequal relations. This means that the RP had an individual approach instead of addressing structural problems, something which after all is the point of gender mainstreaming (see Bacchi & Eveline, 2010; Rees, 2005). Our results demonstrate how gender knowledge was used to reproduce inequality and hierarchical distinctions between people in different positions in working life. The critical and academically oriented kind of knowledge about gender in organizational practices thereby became the privilege of the already privileged.

Benschop and Doorewaard (2012) call for a more profound intersectional analysis to be developed in studies of gender subtext. And we completely agree with this. We suggest that the emergence of categories such as “managers” and “employees on sick leave” could provide good starting points for intersectional analysis that could attempt to untangle the intermingling of categorizations such as gender, class, age, sexuality and nationality and their inevitable embodiment and spatiality. Although we greet that the work of Acker takes social class seriously, it tends to take gender as a categorization for somewhat granted and does not deconstruct ideologies and norms sufficiently (see also Winker & Degele, 2011, p. 53). We have drawn attention to the ways in which knowledge about gender becomes utilized as a means of transforming a public sector organization in Sweden. The headline of “gender perspective” attempted to theorize and question the construction of subordination, but was, paradoxically, also utilized in the organization as a way of rationalizing and changing employees’ behavior to correspond with economic and policy requirements. Related to the call to trace ideological movements in gender subtexts, the ideological lines of gender mainstreaming (which is required in all projects funded by the European Social Fund) could, for example, be further acknowledged in this context. Page (2011) has, for example, noted how “gender mainstreaming is based on an uneasy alliance between the dual agendas of business-driven efficiency and the moral case for women’s equality, and the tension between these agendas” (Page, 2011, p. 319), forming yet another dimension of the clashes between gender headlines and gender subtexts.


1. The explanations for the high sick-leave rates have been much studied and debated but no clear answer has been found. Over the years, everything from recession to the working environment has been mentioned as a possible reason for escalating rates of sick leave (e.g. Lewis & Mathiassen, 2013; SOU, 2005; Vänje, 2013). Other explanations are, for example, organizational and management structures, the character of the relevant work and specific working conditions (Palmer, 2005). The substantial downsizing of the public sector has been brought forward as one possible explanation behind the increase in sick leave for women (Hammarström & Hensing, 2008; Sandmark, 2011; SOU, 2005).

2. The process of bidding for the rehabilitation program was very complicated. One of the contractors that was rejected because they did not account for the gender perspective filed an appeal against the municipality to the County Administrative Court. The municipality won the case and the occupational health services (cited in the offer for RP above) were chosen to run the rehabilitation program even though the project manager told us that their offer was not of the quality the municipality had hoped for.

3. The theory of “suppression techniques” or “domination techniques” was developed by Berit Ås as a tool for women (and others) to identify what happens when they are not listened to, for example, or when they are overlooked or ignored.


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About The Authors

Gunilla Olofsdotter
Mid Sweden University

Department of Social Sciences

Angelika Sjöstedt Landén
Mid Sweden University

Department of Social Sciences

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