Background: The demographic and societal changes of the past decades, such as longevity and improvements in public health, have created new and often very distinct realities for men and women. However, these diversities have only marginally and fragmentally been the topic of research endeavours. There is a growing awareness of the societal phenomenon ‘feminization of old age’, yet the topic and its psychosocial and health-related consequences have not attracted the scientific interest they deserve. Due to scientific neglects and limitations, state of the art research in the field of gender, health and ageing is still sketchy and often contradictory. Objective: In the present article, the complex pattern of roles and values that define what is thought of as ‘masculine’ and ‘feminine’ and its significant impact on health-related lifestyles will be examined. Based on current research, we try to give answers to questions such as: ‘Do older women really have more physical and mental health problems than older men, or are these findings influenced by a gender bias, due to a different awareness and understanding of health and illness?’ It will be shown that it is impossible to find satisfactory answers to such questions without considering the cultural and social contexts of the individuals studied. The inclusion of gender as a social reality in the broadest sense is therefore an absolute prerequisite for gaining valid information. Conclusion: Gender has played only a marginal role in the hitherto existing geriatric and gerontological research and practice. Therefore, a gender-fair approach in research and practice is indicated, i.e. an approach that takes into account differences and commonalities of women and men and considers their differing circumstances and specific problems (gender mainstream). Gender mainstreaming entails on the one hand horizontal justice (denoting equal treatment and benefits for equal needs of men and women) and on the other hand vertical justice (indicating differential treatment and benefits for differential needs of the 2 sexes).