It’s Time to Confront Sexism in Medicine

I was told often at school that I was “very good at maths…for a girl.”

It’s been a long time since then. I believe that gender stereotypes in science and maths are a little less rife today. We cannot afford to become complacent though, as unconscious biases still exist.

Now, in my work as a doctor, antiquated comments crop up regularly.  Patients will mistake female doctors, residents and students for nurses. This happens regardless of how a female doctor introduces herself. The idea that a woman could only possibly be a nurse is clear evidence of the sexism that pervades society.

In spite of the steadily increasing proportion of women in medicine, the culture of medicine has not caught up. It’s well-documented that women are vastly underrepresented in leadership positions, such as full professors and department heads.

Stereotyping also exists within specialty programs. Many assume that the nature of the work demands detachment from emotions and an ability to withstand long hours and grueling procedures. To be tough, resilient and to soldier on have traditionally been thought of as male traits.

Even though the number of women taking up surgery has significantly risen in recent years, surgery is still very much a male-dominated field.

Sexism in medicine is deeply ingrained.

It is difficult for most young doctors to gain visibility and recognition. The situation is even more complex if you’re a young woman. Misogynist jokes and remarks about physical appearance or potential are obstacles that many have to deal with.

One challenge I have frequently faced is assumed incompetence. As a woman, I have had to fight for people to take me seriously. I hear doubts like ‘Can she provide medical care or take critical decisions when required?’ Often, a patient asks to see ‘the real doctor’. Translation? The male doctor.

There is no easy fix. On one side, you should not let any of the gender stereotypes thrown at you affect you. But neither can you ignore the bias.

The #MeToo movement has shined a light on the many places in our society where insidious or obvious sexism have long gone unremarked.

Medicine is no exception. There have been moments when I have been interrupted by an irrelevant comment and I have had to listen to sexist jokes. I have had to work hard to be heard and recognized. I’ve had to go the extra mile to earn the trust of patients, and even to identify with the scientific community.

I am learning that the most important thing is never to lose confidence. I try to stay focused on what’s important: doing great medicine.

What the medical profession needs is a drastic culture shift.

Sexist comments and inappropriate behavior in the medical field are evidence of a much larger problem. They show the insidious misogyny in our culture.

Doctors do not exist in a bubble. We are, to a large extent, products of our society. This includes people who make sexist jokes or commit sexual harassment. It also includes people who laugh along or accept sexism as normal. A shift this great requires courage and concerted efforts.

As one of the underrepresented populations in STEM, I believe I am making a difference simply by existing. I believe that it is really important to #balanceforbetter. We must put forward diverse, inclusive visions of the kind of future we would like medicine to create.

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Nia Wilson: Say Her Name

On Sunday 22 July, an 18-year-old woman was fatally stabbed on a Bay Area Rapid Transit (BART) station platform in Oakland, California.

Her name was Nia Wilson. 

The following day, John Cowell (27) was arrested for the attack, which killed Nia and seriously wounded her sister, Latifah. He has been charged with murder and attempted murder.

Credit: Nichelle Stephens

In the days since, thousands of people have gathered to mourn Nia’s death and honour her life, and tens of thousands of social media posts tagged #NiaWilson, #JusticeForNia and #SayHerName have swept the internet.

Although the BART Police Chief has reportedly said that there is currently no evidence to suggest that Cowell is part of any terrorist or white supremacist group, Nia’s murder – along with the subsequent police and media response – have reignited national and international debates on race.

Celebrities, artists and all those horrified by the brutal, unprovoked murder of a young woman have been speaking out against the racism, white supremacy and misogyny that – as writer Elizabeth Gilbert posted“is so deeply embedded within our culture that we marinate in it at every level.”

In the past, when #SayHerName has been used to shine a light on murders of black women, I am ashamed to say that I have stayed silent. I’ve worried that it was not my time to speak, not my space to occupy – worried that I’d say the wrong thing. But I see now that those worries are privileges in themselves, and that the choice to remain silent is one that many women do not share with me when violence and fear remain threads woven tightly through the fabric of their daily lives.

As a white young woman, I cannot call myself a feminist if I don’t express the sorrow and disgust I feel about what happened to Nia with the same outrage, and at the same volume, as I would if a white 18-year-old was murdered where I live. Feminism that is not intersectional is irrelevant, and in this instance, silence is compliance.

What can I do? What can you do?

Firstly, you can donate to the Wilson family’s ‘Justice for Nia’ page. Then…

– Ask yourself what you are doing to disrupt systemic racism, answer honestly.

– Challenge yourself to acknowledge the ways you have personally benefited, and will continue to benefit in the future, from that racism.

– Think about how, as a white person, you can use your words and actions and networks and finances to help make the world a safer place for black people.

– Call out people around you who demonstrate hateful or oppressive behaviour. Stop ignoring racist comments or laughing at racist jokes.

– Read and learn and be willing to change. Listen to people when they tell you about their experiences, while remembering that asking black people to explain racism, or for guidance on how you can help, is asking those already doing the majority of the emotional work to dismantle white supremacy to work even harder and carry an even heavier burden. Do your own work, challenge yourself and those around you.

– Notice when the media uses language to vilify black people, or to excuse white people.

– Educate yourself on the intricacies of white supremacy. Admit to yourself if you find it uncomfortable and difficult then carry on anyway.

– Remember that good intentions are not enough.

We have to do better. We have to stand with black women. Please share any other suggestions you have! None of us are free until all of us are free. 

Nia was 18. She deserved a full and long and safe and joyful life. Say her name.

Misogyny Kills: One Week on from Toronto

Minutes before driving a rented van into a street of pedestrians and killing 10 people, 25-year-old Alek Minassian posted on his Facebook page: “The Incel Rebellion has already begun! We will overthrow all the Chads and Stacys! All hail the Supreme Gentleman Elliot Rodger!”

One week on from the attack, the term ‘incel’ remains all over news sites and social media. Short for ‘involuntarily celibate’, it refers to online groups of men who believe they are unable to experience sexual relationships because women unjustly deny them sex. Within such communities, frustration seems to manifest into a blanket hatred of women (Stacys) and attractive men (Chads).

Elliot Rodger, the “Supreme Gentleman” referenced in Minassian’s post, killed 6 people and injured 14 in an attack in California in 2014. The 22-year-old released a ‘manifesto’ and a ‘retribution’ video shortly before turning his gun on himself. Both the document and the video outline Rodger’s belief that he was a victim of attractive women who refused to have sex with him.

Alongside incels, other online groups making up the wider male supremacist landscape include the ‘men’s rights movement’ and the ‘pick up artist movement’. As Jessica Valenti explains it, men in these spheres share a belief in the idea that women “owe them sexual attention”. They also share a belief in the idea that male desire is an inevitable force that we can – as a society – attempt to manage as best we can, but must ultimately bow down to due to its sheer power and importance.

Misogyny is something we still feel very uncomfortable talking about because to acknowledge a problem of such scale requires us to acknowledge the huge amount of time and energy required to fix it. It’s far easier and quicker to say there are a few awful, disturbed men out there in sad online forums.

In fact, much of the response I’ve seen to recent coverage on ‘incel’ groups is pity. I understand this reaction, because to say you feel sorry for someone strips them of at least some of their power. It’s also easy to mock an easily-recognisable trope from film and television – the ‘eternal virgin’, the loser who can’t get the girl. But one week on from a mass-murder fuelled by sexist ideology, laughing at members of these groups for being pathetic, porn-addled saddos starts to sound empty. It’s well past time to face up to the consequences of these ‘pathetic’ ideologies.

Over the last week, calls for governments to monitor more closely the online corners where extreme violence lurks have grown louder. There have been previous attempts to do so – in 2017, Reddit banned an incel group with 40,000 members because it was advocating for rape as a solution to men’s ‘celibacy problems’. But we need to stop this kind of hateful, violent way of thinking long before it reaches Reddit.

To focus all the attention on internet groups suggests that misogyny is contained in extremism. Perhaps that’s a comforting way to look at it, because it allows us to believe that by tackling the existence of the groups we can tackle the existence of the ideology. But violent misogyny is not contained in extreme corners of internet forums. It’s everywhere.

It’s in the homes of the hundreds of women around the world who are subjected to domestic violence every day and it’s on the university campuses where female students are groped and assaulted by peers. It’s in courtrooms where rape victims’ clothing is examined and it’s in the language we use to talk about female sexuality. It’s in the lyrics of the songs on the radio, it’s in the tweets directed at women in positions of power and it’s in the Whatsapp groups of rugby players. It’s everywhere. We have to stop acting surprised when somebody is beaten, or raped, or killed as a result.

We have to agree that receiving regular death and rape threats on social media is not a condition of any single job in the world. We have to agree that online communities with tens of thousands of members coming up with strategies to rape as many women as possible are more than just gangs of weird losers who can’t get a date. We have to understand that such deep-rooted sexism damages men and boys and prevents them from living life as full human beings. We have to stop treating violence against women in any form, on any scale, as unfortunate and tragic yet ultimately inevitable.

What happened in Toronto last week was fuelled by misogyny. Until we can acknowledge and address the existence of the pervasive hatred of women that underpins this tragedy, it won’t be the last of its kind.

When Security is Sexist

I was surprised, and yet not surprised, to be flagged as a high-security risk on my latest trip to the United States from the Middle East. I’ve received the infamous red “SSSS” stamp on my boarding pass before, the four letters that stand for “secondary security screening selection,” and I’ve gone through finger prints and pictures and pat-downs before getting on a plane. Resigned to the scrutiny, I usually don’t give it much thought.

But this time the secondary screening was more invasive, more intrusive, more dehumanizing. Was it that the Trump administration heightened precautions and narrowed definitions of rights? Was it that someone, somewhere disapproves of the patchwork of stamps from conflict-ridden places in my passport? Was it that I was traveling alone and therefore I, with my long hair pulled up in a bun and dangling earrings, seemed like an easy way to reach a quota of people screened?

Whatever it was, I was pulled aside for my bag to be searched by a man who insisted on calling me “girl.” Out of all of the suspicious items – including a laptop and two cell phones that would have provided a mountain of information were I actually a threat – this man focused on my toiletry bag. After smearing my lipstick on the table and blowing onto my powder, he smirked as he unwrapped each of my menstrual pads, ran his hands over them and then held them up for his male colleagues.

Let that simmer. He unwrapped and touched each and every pad and held them up for his male colleagues.

This was supposed to embarrass me. I didn’t flinch because working with adolescent girls means I talk about menstruation as comfortably as most people order lunch. So instead I stood there, responding to his smirk with a cold glare, as he played a sex-intimidation game that had no place in an airport, no place during entry to the United States, no place anywhere. After having spread bacteria over something that was once sanitary, he ordered the more invasive “body search.” The woman who ran her hands up my bra was apologetic, but the men who looked on were not.

This experience was an infuriating reminder that women’s bodies – and all bodies of people who have been othered – remain battlegrounds, sites of search and seizure, sites of exploitation and sites of terrorism. If we differ from the socially constructed norm, we reflect something that must be checked, controlled and owned. For women and girls, our bodies have been made sites of customized-by-culture abuse and exploitation.

In the United States, intimate partner violence makes the most dangerous place for a woman her own home. In Jordan, victims of rape are imprisoned if not killed by family in the name of so-called “honor.” In China, there are more men and boys than women and girls due to sex-selective abortion that eliminates girls before they are born. And in airports, check-points and other spaces in-between, women can be touched and groped and fondled under the guise of security.

This airport encounter is more than crude behavior; this is one of many transgressions so intertwined with daily life that it is difficult to tease it out as a transgression. It doesn’t seem horrifying in that this kind of thing happens all of the time. And as I tackle the big and bold issues impacting marginalized girls, I fall into the pattern of accepting the transgressions in my own life as both inevitable and relatively harmless.

But they are not inevitable. And they are not harmless. These small acts violate human dignity and reflect a larger, systemic sexism and misogyny that is directly connected to those big and bold issues.

I always seem to have a solution in my work. I can talk about solutions to end child marriage and strategies to curtail trafficking for hours, but I can be speechless when it comes to everyday sexism and misogyny. We’ve named the big issues, we’ve shed light on them and we’ve developed (somewhat of) a consensus that issues like child marriage and trafficking must be addressed. But it is somehow still OK to catcall, harass, coercive and intimidate girls and women, especially when done by those in power, because these issues are more nebulous and are made out to be benign.

The conclusion I can draw is that silence normalizes; words disrupt. And so we must speak loudly and boldly to disrupt the normalcy of sexual intimidation, coercion and abuse. These nebulous issues must be given a shape by our words. We cannot fight the threat that exists in the dark, but we certainly can fight the one we’re shining the light on.