In the last decades different phenomena have emphasized the relevance of gender research in relation to stress and burnout. The growing numbers of burnout and psychological illnesses reveal the importance of the related fundamental research [1]. Additionally, the increasing entry of women into the labor market and the ongoing war for talents in the industrial countries [2] reinforce the need for more appropriate approaches to address these health issues by occupational medicine and psychology. To sensitize the public to the issues of sex and gender research the European Research Council hosted a special workshop in November 2020 [3].
Proceeding research shows a tendency for higher stress and burnout levels as well as poorer psychological health scores for women compared to men [4, 5]. In most studies stress coping strategies and health strains have been compared for female and male groups, also considering the gender congruency of the individuals and their work environment, e.g. female employees with male supervisors or women in male-dominated teams and organizations [4]. These studies were based on individuals’ biological sex and gender as a cultural and social role, not differentiating within gender groups, which does not consider diversity among women and among men.
Another research direction provides a more specified view on gender-related characteristics since the 1970s, as feminity and masculinity as personality dimensions are focused on, instead of the very rough differentiation of sex or gender groups. Our study follows this scientific argumentation, also picking up the idea of lacking congruence between the individuals and their work environment as a possible stress factor. Accordingly, individual and work environment feminity and masculinity were used to calculate two fit scores analyzed as predictors for subjective health strain measures, hair steroids as biological stress markers, and work engagement.
Person-Environment Fit
The construct Person-Environment fit can be generally explained as congruence between the individual and its environment [6]. Theory of Work Adjustment [7, 8] describes it with the term correspondence, other theories refer to it as fit. Most of the person-environment (P-E) fit models focus on the relation between the employee’s needs, wishes, goals on the one side and the benefits, conditions, and supplies a job is offering on the other side. A few P-E fit models characterize the relation between employees’ abilities, experience, skills and job demands or workload. More sophisticated P-E fit models treat congruence as a dynamic, developing, and interactive process [9, 10, 11]. In conclusion, different types of P-E fit refer to various aspects of work environment e.g., person-group fit, person-supervisor fit, or person-organization fit as well as demands-abilities fit, so P-E fit can be described as a multidimensional construct. The observed outcomes in these models are usually job satisfaction [7, 8] and employee stress along with health measures like burnout [12].
Person-Environment fit is usually operationalized by calculating a fit index, subtracting an individual score from the environment score. There are at least 13 different ways for computing fit indices in P-E fit models [13], each resulting from different variables and components. To name an example, a fit index is often calculated by squaring the difference mentioned above. Thus, P-E fit score indicates the level of fit - disregarding if the environment score was higher than the individual score or vice versa. This needs to be noted critically, as a deficit could lead to a different attitude as an outcome then the same amount of an oversupply. It becomes evident that by calculating a fit index some information can be discarded, which could lead to different complications in the research process.
Gender-Role Orientation
In the present study, two P-E fit scores are calculated based on the two dimensions of the gender role orientation. Gender-role orientation or gender identity describes the individual self-perception in relation to femininity and masculinity. It reflects how strongly an individual identifies with gender stereotypes and gender roles. The psychosocial aspects culturally associated with feminity and masculinity refer to the bi-polar constructs communion and agency [14, 15]. Communion focuses on relationship-oriented characteristics such as participation, community, focus on others, forming connections, affirmation of feelings, and is stereotypically related to feminity. Agency follows principles like individualism, focus on self, forming separations, mastery, self-assertion, discipline, suppression of feelings, and can be described as task orientation, which refers to masculinity. Other frequently used terms are expressivity (for feminity) and instrumentality (for masculinity) [16], in this article the terms feminity and masculinity are applied consistently. Two prevalent questionnaires, Bem Sex Role Inventory (BSRI) [17] and Personal Attributes Questionnaire (PAQ) or Extended Personal Attributes Questionnaire (EPAQ) [18], are used for measurement. Based on these instruments Gender Role Orientation Scale GTS + containing socially desired adjectives was developed in German [19].
Most studies reveal best mental health [20, 21], highest self-esteem scores [18, 22, 23], highest levels of social competence [24] and better adjustment [25] for individuals with both high feminity, and high masculinity. In this context the term androgyny is applied for balanced and high individual levels of feminity and masculinity.
Among subjects with one-sided gender-role orientation, study results show higher health and well-being scores for individuals with high levels of masculinity and low feminity compared to individuals with high feminity and low masculinity. Additionally, masculinity shows higher effects on health measures than feminity and stronger positive relationship with self-esteem and adjustment [18, 22, 24, 25, 26].
Previous scientific debate gives various explanations in this matter. Among other reasons, in general masculine characteristics lead to a more positive self-evaluation and higher self-esteem. As Cook describes it “masculinity has a more powerful impact on how positively you see yourself” (p. 477) [27]. Additionally, a positive self-image is possibly overrated in health research, while feminine dimensions such as ability of emotional self-reflection and emotional expressiveness are ignored in their value for psychological health [28]. Thus, perceived and expressed negative feelings in health questionnaires are possibly connected to less health, and suppressed emotions behind an optimistic attitude would result in higher psychological health scores. Nonetheless, unprocessed mental stress could lead to psychosomatic symptoms and unhealthy stress coping behaviors. This interpretation of relations between masculinity and mental health is called masculine supremacy effect [27] or a “masculine bias” [29].
Another model explaining the interdependency of feminity and masculinity is introduced by Helgeson [30, 31, 32]. The model explains health problems arising in individuals with a high score in one of the dimensions and a low score in the other. In such cases, the model refers to the terms unmitigated communion and unmitigated agency [14]. Unmitigated agency (focus on oneself and exclusion of others) would lead to physiological reactivity and should manifest in biological measures [33]. Unmitigated communion (focus on others and neglect of oneself) would enforce psychological distress, which should become evident in subjective health ratings [34]. This is especially interesting regarding our study focusing effects on subjective and biological stress measures.
Burnout
Besides other theories, burnout is described as a two-dimensional construct in the Job Demands-Resources (JD-R) model [35, 36, 37]. The two dimensions are exhaustion with physical fatigue symptoms, and cynicism, which leads to cynical and negative attitudes towards work. A common instrument measuring both dimensions is Oldenburg Burnout Inventory (OLBI) [38].
Job Demands-Resources assumes that personality dimensions and social processes at work are operating as job resources and demands. According to the JD-R model, job demands mostly affect employees’ burnout while job resources mainly have effects on work engagement [39, 40].
Some specific variables related to burnout were identified – among those low support, high job demands and high workload, low autonomy or job control, low reward, and job insecurity [42, 43]. Another job demand related to burnout is high role conflict [44, 45]. Role conflicts appear in job positions with contrary and conflicting work requirements, conflicting goals, and behaviors.
Work Engagement
In JD-R theory work engagement is described with three dimensions. Two burnout-contrary dimensions are vigor and dedication. Vigor is described by a high energy level and readiness to invest in work even in challenging situations. Dedication refers to meaningfulness seen in work, as well as perceived enthusiasm and inspiration. The third work engagement dimension is absorption, meaning a state of high concentration and immersion in work [46]. One of the most popular work engagement questionnaires is Utrecht Work Engagement Scale (UWES) [47], also published in a short version [48].
Research reveals positive and negative impacts of work engagement. Highly engaged employees report positive emotional states connected to their work, and proactively change their work environment to create job resources. They show better performance, have better health, less accidents, and their clients report a higher customer satisfaction [39, 40, 49].
Nevertheless, diverse studies proved that individuals with high work engagement tend to have more overtime-work, which can lead to health strains. In fact, studies reveal a higher work-to-family-conflict for highly engaged employees as well as a raised risk of burnout. In short, there seem to be special conditions on a personal and on the organization level, where work engagement may lead to a negative development [49, 50].
Steroid levels in hair as stress biomarkers
Another way to determine individuals’ stress reaction is the usage of biological measurements. Assessment of steroid levels in bodily fluids secreted by the activity of the hypothalamus–pituitary–adrenal neuroendocrine axis during the physiological stress response plays an essential role. While short-term steroid measurements extracted from blood, saliva, urine, or feces are strongly influenced by different factors like nutrition, exercise, nicotine and alcohol consumption, acute stress and circadian rhythm, these also do not have essential harmful effects on health. Human hair has been used for long-term toxicological analyses since the development of applicable methods in the 1980s, due to the known hair’s ability to store substances temporarily present in blood. As human hair grows 1 cm/month (0.39 in) on average [51] hair analysis gives – depending on hair length –information about substance exposure during last months or years. The most common techniques in substance detection are immunochemical techniques, Gas Chromatography–Mass Spectrometry (GC–MS), and Liquid Chromatography-Mass Spectrometry (LC–MS) [52]. The ongoing further development of these methods also enabled detection of steroids like cortisone, estradiol, testosterone, dehydroepiandrosterone (DHEA), progesterone and others in human and animal hair samples [53, 54, 55, 56, 57].
Previous research could prove cortisol levels in hair provide a valid and reliable biomarker of the crucial long-term stress explosion [58, 59]. However, apart from cortisol, study results do not present a consistent picture about correlations between physical, mental, and subjective stress and raised levels of other steroids yet.
Effects of P-E Fit in Feminity and Masculinity
Studies regarding gender congruence between individual and work environment focus on the social role differences between men and women based on their biological sex. Consequently, in this research gender-congruency between the individual and supervisor or individual and team refers to men and women working in male or female-dominated working environments, none of them indicating differences in feminity or masculinity. Tough, as higher expressivity scores could be proved for women and higher instrumentality levels for men [32, 60, 19], similar results can be expected for individuals with high P-E fit scores in feminity and masculinity.
Previous research verified that women in male-dominated industries had more stress and poorer mental health scores then male employees in the same job-settings [61]. Other studies showed that subjective stress levels were higher for women in male-dominated working environments [62, 60] as well as elevated sick leave levels among women in extremely male-dominated occupations [63]. A higher sickness absence was also found among men in female-dominated work settings [60, 63]. However, a meta-analysis of 183 studies showed that gender differences do not occur in occupations dominated by the same gender [4].
In conformity with P-E fit theories, a low person-environment fit can lead to an increased adjustment effort resulting in higher levels of perceived stress. Therefore, the higher a P-E fit score (meaning lower fit), the more stress, burnout or other health complaints can be expected.
P-E fit research focuses on subjective stress measures as outcomes and provides no studies on hair steroid levels in this context. Nevertheless, above explanations lead to the conclusion that, a higher P-E fit related to gender-role-orientation leads to higher levels of subjective stress, and this should manifest in physiological stress measures. As hair cortisol is a proven biomarker for long term stress levels [58, 59], higher P-E fit scores in feminity and masculinity (indicating a lower fit) should be related with higher hair cortisol levels. The interdependency with other hair steroids needs to be specified, as previous research provides no consistent picture.
P-E fit related to gender-role-orientation has not been explored regarding work engagement. A general person-organization value congruence and work engagement were proved to be positively correlated with each other [64]. Person-organization value congruence could be proved as a moderator between engagement and burnout. For non-managerial employees, it enhanced the negative relationship between job engagement and burnout. Thus, low levels of person-organization value congruence appear along with lower engagement and higher burnout scores. On the other hand, for employees in managerial positions the opposite was observed. Managers with a high person-organization value congruence report more engagement and – enhanced by person-organization value congruence - higher burnout levels [50].
Present study goals
The observations described above lead to the following hypotheses as shown in Fig. 1. The first hypothesis (H1), which claims that P-E fit feminity and masculinity have positive effects on burnout and psychosomatic complaints after considering age and work characteristics. The second hypothesis (H2) declares that P-E fit feminity and masculinity have positive effects on steroid measures in hair after considering age and work characteristics. The third hypothesis (H3) states that P-E fit feminity and masculinity shows an effect on work engagement and enhances the negative relation between work engagement and burnout as a moderator variable in a sample of non-managerial employees.
All hypotheses are proved in hierarchical linear regression models to analyze if P-E fit in feminity and masculinity still add significant variance explanation after considering age and work characteristics. To explain more variance of the outcomes, mediator and moderator effects are examined.
In the study, two P-E fit scores are calculated by subtracting individual femininity and masculinity from related characteristics of work environment in order to analyze their effects on target variables. This is reasonable regarding the mere gender group recording in stress research because in this way a gender-related diversity within the gender groups can be considered more specifically.
This also might offer an alternative to stress and burnout cause research, since gender groups are not used as predictors but gender-role-related characteristics of individuals and the work environment. A distinction of the stress and burnout values among gender groups only allows a descriptive comparison. By identifying effects of P-E fit in femininity and masculinity, appropriate and more specific approaches in stress and burnout prevention and promotion of work engagement can be developed.
Another special feature of the study is that reference is made to subjective stress values (e.g. burnout) as well as hair steroids as stress biomarkers.