Whether children live in Baltimore, Beijing, Nairobi or New Delhi, by the time they are 15, boys are told to go outside and have adventures, while girls are told to stay indoors and do housework. Furthermore, most girls are told that if they are raped or have sex, they are the ones at fault. A new study by adolescent-health specialists interviewed 450 poor children and their parents about gender expectations in a total of 15 high-, low- and middle-income countries. The children included in the study, the first of its kind, were between the ages of 10 and 14. "When we started this work, there was no research at all, no understanding at all of young adolescents," said Robert Blum, director of the Global Early Adolescent Study at Johns Hopkins University in Baltimore, Maryland. "There was an assumption that these were young children, and they aren't cued into gender-based violence, gender messages, rape and things of that nature. "What we see is that around the world, young people have keen awareness, and they're very cued in to what's going on." The key finding was that rigidly held and enforced gender expectations are linked to increased lifelong health risks — everything from HIV and depression to violence and suicide. Messages internalized "We found children at a very early age, from the most conservative to the most liberal societies, quickly internalize this myth that girls are vulnerable and boys are strong and independent," Blum told VOA. "And this message is being constantly reinforced at almost every turn, by siblings, classmates, teachers, parents, guardians, relatives, clergy and coaches." The researchers found that in most cultures, by the time girls are 10 years old, they have been taught that their key asset is their physical appearance. Lead researcher Kristin Mmari said no matter where they are, girls are concerned about their bodies, and others' attitudes to them. "In New Delhi, the girls talked about their bodies as a big risk that needs to be covered up, while in Baltimore, girls told us their primary asset was their bodies and they need to look appealing, but not too appealing." Venkatraman Chandra-Mouli of the World Health Organization said violence against women is so pervasive that one in three women experience violence from their husbands or other sexual partners. "Social norms accept that a woman has to be beaten," Chandra-Mouli said. He and other researchers involved in the study of adolescents' gender norms discussed their findings at the National Press Club in Washington. Pressure on boys The researchers found that boys do not emerge unscathed from gender expectations. They found that the pressure boys face to become physically strong and independent make them more likely to be victims of physical violence and homicide, and more likely to take up unhealthy habits like tobacco, drug and alcohol use. The study was a collaboration between the Johns Hopkins Bloomberg School of Public Health and the World Health Organization. The Journal of Adolescent Health has published a supplement to its October issue incorporating a number of articles on the subject, along with commentaries by Blum, Chandra-Mouli and others. Adolescents are torn between opposing expectations, the study showed, especially girls. In Shanghai, for example, girls are told they should be economically independent, and that they should not rely on men for financial support. At the same time, girls are told their husbands will divorce them if they don't do housework. The goal was to understand the factors in early adolescence that predispose young people to subsequent sexual health risks and promote healthy sexuality. The conclusion was that societies wishing to have healthier adolescents and young adults, free of gender stereotypes, must intervene, where necessary, before children reach age 10. Chandra-Mouli said WHO hopes to use the data from the study to shape programs to change misunderstandings about gender norms. Blum said the researchers will measure changes in their subjects three times over five years to see how perceptions of gender affect individuals' lives and how programs change the outcome.