Gender Disparities in the Gift of Life: Exploring Altruism and Sociocultural Factors in Living Kidney Donation

Gender Disparities in the Gift of Life: Exploring Altruism and Sociocultural Factors in Living Kidney Donation

Sarthak Kukreja1, Ojasvi Meena2, Koushik Sinha Deb3, Swati Kedia Gupta4, Rohit Verma3

1. Senior Resident, Psychosomatic Medicine, Department of Psychiatry, AIIMS New Delhi
2. Senior Resident, Department of Psychiatry, AIIMS New Delhi
3. Professor, Department of Psychiatry, AIIMS New Delhi
4. Assistant Professor, Department of Psychiatry, AIIMS New Delhi

Introduction

Worldwide, gender disparity exists in kidney donation with females surpassing males and therefore it becomes crucial to understand the multifaceted factors influencing this imbalance to achieve transplant equity. The investigation, using validated psychometric tools, aims to understand sociocultural dimensions of both receiver and sender, including t decision-making processes, perceived social support, and gender-related beliefs, to be able to provide insights essential for developing targeted strategies to address inequities in living kidney donation.

Methods

We included adults aged 18–75 years undergoing evaluation as prospective kidney donors after psychiatric clearance. Data collection utilized a semi-structured sociodemographic proforma alongside validated instruments: the Self-Report Altruism Scale, Decisional Conflict Scale, and the Multidimensional Scale of Perceived Social Support, for comprehensive assessment of motivational, decisional, and social dimensions.

Result:

The study included 48 living kidney donors, with majority being females (n = 33; 68.75%) . Majority were married (n = 47; 97.92%). Significant difference (p<0.01) was found in educational level with female donors having lower education as compared to males. Employment status among donors showed that 35.42% (n = 17) were employed (13 males vs. 4 females); rest of the females were homemakers and the remaining two males were unemployed. The majority of donors were parents (54.17%, n = 26), followed by spouses (18.75%, n = 9), and siblings (10.42%, n = 5). Recipients were predominantly male (79.17%, n = 38). Among parent donors, mothers (n = 17) outnumbered fathers (n = 9). Cross-tabulation of donor and recipient gender showed male donors donating to male recipients (n = 8) and female recipients (n = 7), while female donors primarily donated to male recipients (n = 30) versus female recipients (n = 3). Fisher's Exact Test revealed a significant association between donor and recipient gender (p < 0.01) indicating a non-random pattern in gender pairing during donation. Decisional conflict scores were uniformly low (<25) for all donors reflecting strong confidence and clarity in their decision to donate. In majority of participants, except seven females, perceived social support was high. Composite altruism scores were significantly higher (p = 0.016) in female donors (mean = 27.88) than males (mean = 22.67) suggesting greater altruistic motivation among female donors.

Conclusions:
Female donors significantly outnumber males in living kidney donation, a disparity associated with greater altruism and entrenched gender norms. These findings highlight the need for targeted research on sociocultural barriers limiting male donation and the long-term health consequences for donors, to optimize transplant policies and support equitable donor participation.
Keywords:
Living kidney donation, gender disparities, female donors, altruism, gender roles, kidney transplant policy

Sarthak Kukreja