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Gender Discrimination and Sexual Harassment in the Lives of Women
Ophthalmologists
By Anne MacLachlan, Ph.D.
" When I went to our medical honor society sponsor for a medical
school
reference for an internship position, he tried to become amorous and the
session
ended with him chasing me around the desk wildly in his office."
Is this typical treatment for women in ophthalmology, the most prestigious
of eye specialties? Or the following: " Gender discrimination is a
pervasive problem and one that affects all of us. Does it affect our
careers? Yes, on every level and on a daily basis . . ." To
learn the sustained effects of discrimination and sexual harassment on the
lives and
careers of its members, Women in Ophthalmology (WIO), a 400-member
subgroup
of the 10,000-member American Academy of Ophthalmology (AAO), commissioned
a study in 1997.
Of the total WIO membership, 128 returned usable questionnaires
(33%). Not
all questions were answered and less than half of the respondents provided
written
commentary. Of those who responded, the oldest is 72, the youngest 32; 109
are
white, 11 are Asian, 2 are Hispanic, and 3 are African American. Their
medical
schools and residencies are distributed throughout the United States and
they
earned their MDs between 1950 and 1993. The current positions held by the
respondents overlap in several ways, but a preponderance have academic or
part-
time academic positions. Forty-six (36%) have full-time academic
positions, 45
(35%) private solo positions, 9 (7%) have both. There are 50 (39%) in
private group
practice, 8 (6%) in both private group and academic practice.
Despite high dissatisfaction levels with earlier training and practice, 96
(75%)
are satisfied with their current positions, 26 (20%) are dissatisfied,
half of this
number, 13 are in academic positions. Key reasons for satisfaction with
academic
positions are the diversity of cases, the research and the challenges of a
demanding
and complex environment. For those in solo positions, being ones own boss
is a
frequent source of satisfaction (especially if the respondent had been
mistreated in
an earlier partnership). Dissatisfaction most commonly arises from an
inadequate,
even declining salary, managed care, and administrative hassles‹some from
discriminatory treatment. The emphasis in these remarks is much more on
the
structure of medicine today. But even of those who declared themselves
satisfied in
their current position, a large percentage (76% or 73 out of 96) still
reported gender
discrimination.
There is a noticeable discrepancy between answers to questions
about
experiences of gender discrimination or sexual harassment. Respondents
often
answered "no" to the general question about whether ones career
was affected,
yet provided clear and often high scores on specific questions about
discrimination
and harassment. The commentaries give the strong impression that many
women
prefer to deny or minimalize the impact of their negative experiences, so
the results
presented here are likely to reflect underreporting. Indeed, the woman who
was
chased around the chief surgeons desk wrote that she had to be reminded of
the
incident by her mother!
To measure gender discrimination fourteen behaviors common to
the
lives of most professional and academic women were listed on the
questionnaire, such as "treated as invisible" and "earn
less than men in similar
positions." Respondents were asked to assign a numerical score from 1
to 5 for each
experience, 1 being the least intense, 5 being the most intense. For
sexual
harassment seven categories were listed. The location (medical school,
residency,
current position, etc.) of the experiences was also asked.
Gender discrimination The most stunning result of this
study is that
102
respondents or 80% agreed that they had experienced gender discrimination
at
some time in their careers. The two areas of discrimination that ranked
highest
were lack of mentorship and being treated as invisible both equally
ranked. The
issue of least concern was whether they had been discouraged from
publishing.
These experiences of discrimination occurred more frequently and with
greater
intensity in medical school and residency. Although the overall score for
residency is
slightly lower than medical school, 20 respondents reported severe
discrimination
at the highest level of 5 during residency, versus only 9 in medical
school. Life after
residency was not free of hazards as first position discrimination has a
moderately
high score, with 16 ranking it at 4 and 5.
Looking at current positions (often the only position a woman has
held),
despite 96 women (75%) being fairly satisfied with their present job, 42
women (33%
of all women in the survey) still report some discrimination, most ranking
it level 1
(21) and level 3 (14). These figures support the idea that discrimination
is pervasive
in medical training and employment. Its intensity may diminish as a woman
obtains
employment, but womens commentary suggests that discriminatory behaviors
do
not disappear. Rather, women are more able to ignore them as they are
older, or in
a less vulnerable position.
Harassment Eighty-five (66%) of the 128 who answered the
questionnaire
reported experiencing sexual harassment at some point in their training
and
career. These experiences occurred most frequently during residency with
13
women giving ratings of 5, the most intense level. Medical school was not
that
much less intense with 21 counts of 1, the least intense rating, but still
with 8 counts
of 4 and 10 counts of 5. Total scores drop significantly to first and
current position,
but it is significant that although much lower than harassment scores
during
training, there still are 29 reports of harassment in first position, and
21 in the
current position.
The kinds of behavior that gave rise to these scores covered the
gamut of
harassment. The most common was general hostility, reported by 64 women,
although comments suggest that it occurs more frequently. One woman who
did
not answer the question concerning hostility commented, "never
considered
hostility [as harassment] otherwise would be present at all levels."
Being addressed
in a demeaning way was reported by 62 women, with 40 responses ranked at 3
or
above. Fifty-three women report having inappropriate, lewd, or salacious
remarks
addressed to them with 13 reporting a 5, the most intense level. Fifty
report verbal
abuse and 40 inappropriate touching or fondling. Twenty-eight women report
being propositioned in exchange for some advantage. Most horrifying,
however, is
that 29 women report gross physical contact with 11 reporting scores of 3
and
higher. This is surely rape. Here too there is a suggestion of chronic
underreporting
since 17 women give a score of 1 to "Have you experienced gross
physical contact?"
How can a woman have a low intensity experience with gross physical
contact?
Clearly the question should have been designed to elicit the specific form
of this
contact. But however one interprets the results, the fact remains that 85
women
report sexual harassment at some time in their medical careers and that
34% of
these women report gross physical contact. This is 23% of all 128
respondents.
Emotional problems Fifty-one women reported emotional
problems at some
time with the way in which they were treated, 75 reported no emotional
problems.
One seems to suggest that although she was depressed about what was
happening
to her, since she wasnt hospitalized for depression, it wasnt so bad. The
situations, which these women had to contend, suggest good reason for a
range of
emotional reactions. One woman reported that "after accepting my
first job with
the chairman of my department, his primary competitor accused me in person
and
with many residents with whom he scrubbed of performing oral sex in order
to get
this job." Yet commentary on emotional reactions generally minimized
their level
or significance, even though 40% of all women answering the questionnaire
admitted to having some emotional reaction to how they were treated.
Career problems.Only 19, that is 15% of all 128
respondents, clearly
answered
"yes" to the question of whether they had career problems as a
result of
mistreatment. However, of the 21 women who answered "no" to this
question, but
made some comment, only 2 had something positive to say. An additional 19
women made remarks such as: "I needed to finish my residency."
"But turned down
for a residency I wanted because of gender‹told this during interview by
chairman." "[Ranking] on discriminatory behavior in current job
diminished over
time to 3." "Everybody is a victim sometimes, though victims DO
have a great deal
of power. I prefer to go on with my life than to make an issue of
it." "But didnt get
hired at UCSF because I was a woman‹told this by male mentors."
"Expected to
start work back 1 week post-partum, having delivered 6 weeks
premature."
"Refuse to allow any treatment from deterring/derailing goals: have
therefore
used circuitous methods to deal with problem. Have also accepted less than
comparable male or jr. male colleague. Need to compromise rather than look
for
other job/position."These are all separate comments from different
women. if one
considers the content of their comments, rather than their answers to
yes-or-no
questions about discrimination and harassment, the number of women who
experienced career problems rises to 38, or 30% of all respondents.
Conclusion Discrimination and sexual harassment have
affected
the lives of
most of the women ophthalmologists who responded to this survey. It has
had
significant emotional and career consequences for women who reveal
themselves
to be committed to their careers and work, who are passionate about being
good
doctors, and who have the will and resilience to carry on. This study
makes clear
that these women have experienced pervasive discriminatory practices,
which
attempt to deflect them from their careers, particularly in medical school
and
residency. As it is, the number of women who are currently practicing
ophthalmologists is still very small compared to the number of men in the
field.
How many were deflected? The great cost to the women involved as well as
to the
profession by this pattern of treatment should be addressed. Reform in
medical
schools and teaching hospitals is long overdue. More, it is hoped that
this kind of
study will eventually lead to an improvement in women ophthalmologists
lives
and careers. [For tables and data on which this summary is based, contact
Anne
MacLachlan, 510 652-4054.
-wage@wage.org-