Talking About Bias; Speaking While Female

Do we need feminism?/Does sexism still exist?

            A few months ago during a discussion regarding feminism and women’s rights, a friend of mine expressed the following: “What more is there for feminism to do?”

A crushing statement.  Ironically, this student plans to join me in the field of medicine, a profession known for its disparities and its patriarchal and paternalistic structure.  Numerous posts and articles have pointed out the gaps between males and females in science and math, starting back when we are children and continuing on into the professional world.  In her short essay, Dr. Arghavan Salles shares some of her experiences studying engineering, then medicine, and finally joining the ranks of the surgical residents.  Surgery is known to be a notoriously competitive field, for men and women alike.  As she notes, women have made big gains: more women are joining residencies and training programs.  However, the academic side has not seen the same increase:

Indeed, despite one third of surgical trainees being women, only eight percent of full professors in surgery are women. Even fewer of these women go on to hold important leadership positions such as serving as department chairs: there are only three women chairs of departments of surgery in the United States.

She negates the idea that men work harder than women or that men are more qualified than women and thus are more likely to succeed.  However, she discusses an interesting study which reminds me of an earlier post by Morghan.  As Dr. Salles explains:  

The article argues that women face a stereotype that their ability is inferior to that of their male colleagues. The stereotype leads to a taxing dynamic: there’s pressure to perform at the highest level — with patient lives at stake — while constantly feeling like others doubt your ability. My research shows that when women believe others endorse this negative stereotype, our mental health deteriorates. Likewise, when we believe men are better surgeons than women, we experience physical health problems, such as gastrointestinal distress or low back pain.

Morghan brought up a similar study where the "main finding suggests that job authority decreases men's depression but increases women's depression" and Morghan suggested a similar emotional strain could be affecting mental health.  Dr. Salles calls it “nuanced sexism.”  Not as overt as sexism might have been 50 years ago, but still damaging on an emotional and perhaps physical level.   

            A previous post by Morghan detailed her experience of being at the receiving end of this kind of nuanced sexism:

Then I found out that two significant people on the project thought my day-saving efforts were "bitchy" and, while ultimately appropriate, unacceptable on any future projects.  At first I thought I'd done something terrible, but after some soul searching I realized these people would not have responded this way if a man had acted as I had.  I remembered how often I'd been told to smile (not something you'd say to a man) and how they had loved me when I was nothing but a servile bucket of sunshine. 

Talking about sexism

            Sheryl Sandberg (COO of Facebook, author of Lean-In) and Adam Grant (UPenn) have teamed up to write a series of four articles regarding women and work.  Two of these have been published, the first titled “When Talking About Bias Backfires.”  Sandberg and Grant outline how spreading information about stereotypes can actually perpetuate and enhance them.  Disseminating this information can lead individuals to think discriminatory behavior is common, socially acceptable, and thus permissible for them to perform as well. They detail some studies exploring this phenomenon, and I suggest you check out the entirety of the article. 

            Their point is that talking about discrimination and sexism is not enough.  In fact, it could be dangerous and detrimental.  Instead, as shown by some follow-up studies, we need to talk about discrimination, express how it is wrong, and show how discriminatory viewpoints can be devalued.  Not only is this effective in changing perspectives, but it also motivates those being discriminated against to work beyond these external limitations.

When we communicate that a vast majority of people hold some biases, we need to make sure that we’re not legitimating prejudice. By reinforcing the idea that people want to conquer their biases and that there are benefits to doing so, we send a more effective message: Most people don’t want to discriminate, and you shouldn’t either.

But how to confront gender discrimination and sexism? 

Sandberg and Grant’s second article is entitled “Speaking While Female,” in which they follow the suggestions made in their first article.  They outline the stereotypes and current gender discrimination seen in the workplace, explain why this is problematic, and end with a call to action.

Studies (and personal anecdotes) show that when women do speak and assert their ideas in the workplace, they are commonly interrupted and spoken over.  Their ideas may be co-opted by male counterparts and subsequently receive more praise.  On this blog alone, we have had many posts and articles surrounding this balance of assertiveness being viewed as “bitchy and pushy.”  One study in the Sandberg/Grant article highlights this imbalance as such:

Male executives who spoke more often than their peers were rewarded with 10 percent higher ratings of competence. When female executives spoke more than their peers, both men and women punished them with 14 percent lower ratings. As this and other research shows, women who worry that talking “too much” will cause them to be disliked are not paranoid; they are often right.

            Other studies show how this creeping form of nuanced sexism leads society at large to devalue the ideas and opinions of a woman, due solely to the fact that she is a female.  Clearly, devaluing half the working population is an ineffective business model.  Women have indeed come up with fantastic new ideas and innovations, providing immense contributions to all genres of human achievement.  However, they need some time and space for the actualization of these ideas.

            This is the point where the Sandberg and Grant article falls flat for me, as their proposed methods of change leave nothing for concrete the motivated individual.  Sandberg and Grant outline two new strategies: 1) increasing the number of women in leadership roles and until then, 2) encouraging current leaders to incorporate gender equalizing practices.  Right now, business leaders can enact new models of teamwork and evaluation, such as blind auditions, no interrupting pitches, etc.  Then, following our current trend of increasing female leadership roles, women in power can enforce an equal playing field and provide an effective barrier to the nuanced sexism smog infiltrating the professional workplace.

            However, I am left wondering… What can women do now to improve their situation?  The two strategies outlined above leave the current female population dependent on the motivation of their bosses (who are most likely male) or waiting to reap the benefits of future change.  This state of dependence is almost as debilitating to the feminist cause as is being talked over in business meetings.  In Laura’s earlier review of #GIRLBOSS, she highlighted the following strategies from the book:  don't apologize for ambition, there is no shame in learning, draw strength from other women (and men).  While these tenants provide a real-time strategy for change, but I am concerned.  Will my assertiveness and directness only earn me negative evaluations and the title of “bitchy?” 

Feminism in medicine and the workplace

            A commenter on one of the Sandberg/Grant articles, Dr. Srinivasan, writes:

Medicine is a bastion of prejudice against women. Mild mannered men and "foreign doctors" are targeted too for the type of behavior described in this article and in Medicine, when women are not allowed to speak, patients suffer...  At medical conferences women can have their hands raised for ever to speak and be ignored. When they are allowed to speak they are often rudely interrupted…What is worse, female speakers and females in power practice the same prejudice against women that the men do. Men and women in power are threatened by the ambitious, knowledgeable and up and coming lower echelon … This behavior is practiced to disconcert, divide, enervate and deliberately frustrate underlings and those who don't belong to the "tribe" or network in power. It comes from the belief that sharing power is the equivalent of diluting power. Audacious questions, probing ones, dissenting opinions and contentious or discomfiting observations are not brooked from either gender, especially if those talking and dissenting are not "important."

            Medicine may be unique in its hierarchical structure, but as Dr. Srinivasan and Dr. Salles point out, gender discrimination (among other types) is a medical prevalent issue.  Just as minimizing female contributions can limit the effectiveness of business teams, reducing the thoughts and concerns of the female health professionals effects patient care and health.  This is not an issue to be taken lightly.  What Dr. Srinivasan talks about is a conscious/unconscious method of "dividing and conquering" to maintain control, ultimately holding medicine in a stagnant, backwards state.  Reduced efficacy in screenwriting sessions may mean we have poor quality programming, but reduced efficacy in hospitals and doctor's offices means that patients die.

            I would also like to point out something from both Dr. Srinivasan's comment and the Sandberg/Grant article: gender discrimination can come from both males and females.  Dr. Srinivasan writes, "What is worse, female speakers and females in power practice the same prejudice against women that the men do."  Studies quoted by Sandberg and Grant mention "When female executives spoke more than their peers, both men and women punished them with 14 percent lower ratings."  This calls into question one of Sandberg and Grant's methods of change, namely that increasing the numbers of women in leadership roles will provide a more female-friendly work environment.  Multiple factors can underlie this phenomenon: perhaps only the most competitive women have succeeded thus far, competitive women who are ill-equipped to provide a nurturing work environment.  Whatever the reasons, this questions the effectiveness of Sandberg and Grant's recommendations for future change.

            Thus, what is the best way for me, as student and later a resident, to talk about and confront the nuanced sexism I may encounter?  How can I speak out and be effectively heard by those who are not interested in listening?  How can I speak out without negatively affecting my performance evaluations and ruining my career aspirations? How can I use my skills (as a female) to advance medicine and provide the highest quality care for my patients?

Herein lies the paradox,

To break down the barriers that hold women back, it’s not enough to spread awareness. If we don’t reinforce that people need — and want — to overcome their biases, we end up silently condoning the status quo. (Talking About Bias)

But..

when women challenged the old system and suggested a new one, team leaders viewed them as less loyal and were less likely to act on their suggestions. (Speaking While Female)

           Society at large, like my friend, may not understand why feminism is still necessary.  This "nuanced sexism" may be more hidden and subtle, but it is nonetheless damaging to the physical and emotional health of women.  It is also damaging to our workforce and the efficacy of our health services.  Thus, we need to talk about bias and discrimination; we need to talk about feminism. We need to find effective ways to have female voices heard without remaining dependent on the theoretical change-of-heart of professional leaders or future changes to our hierarchical structure.  I am still perplexed as how to find these viable strategies. Perhaps what we need is a male/female brainstorm session where both sets of ideas are equally valued ... but how we get to that point is beyond me.