In a survey of 250 female gynecologic oncologists, more than half reported experiencing instances of bullying, gender discrimination, or microaggressions. They also reported that having a female department chair provided no buffer against these forms of gender harassment or discrimination in the workplace, according to a report presented at the Society of Gynecologic Oncology (SGO) 2021 Virtual Annual Meeting on Women’s Cancer by Sarah M. Temkin, MD, Director of Gynecologic Oncology at Anne Arundel Medical Center in Annapolis, Maryland (Abstract ID: 10910).
The study’s first author was Linda J. Hong, MD, of Loma Linda, California.
Need to Study the Issue
“These experiences impacted the careers of women. Over one-third (36.1%) had been excluded from leadership because of gender. ‘Being written up for speaking up’ was [commonly] reported (32.9%). Significant numbers of women (18.3%) had changed jobs due to bullying and harassment, and some (9.6%) had been the subject of a sham peer review,” said Dr. Temkin.
Sarah M. Temkin, MD
“No association between these [occurrences] and leadership or practice environment were identified…Given the lack of association between women in leadership positions, organized responses and cultural changes beyond simply putting women into leadership are required,” she added.
Gender harassment within the medical profession is by no means uncommon, Dr. Temkin pointed out. In obstetrics and gynecology, female physicians comprise roughly 60% of the workforce, but have a disproportionately lower share of academic and managerial positions. What is less clear is whether there are associations between these observations and the “leadership gender and practice infrastructure,” according to Dr. Temkin.
Study Population
Dr. Temkin and colleagues, therefore, examined whether characteristics of leadership and departmental infrastructure impact the work environment for women gynecologic oncologists by conducting a 1-month, Internet-based survey of 472 members of the “Women of Gynecologic Oncology” Facebook group. In addition to capturing demographics and practice infrastructure, the questionnaire revealed personal experience with workplace bullying, gender discrimination, and microaggressions based on the validated Sexist MESS [Microaggressions, Experience, and Stress] survey.
The survey was returned by 250 (53%) members of the group. Most respondents were < 50 years old (93.6%), White (82.2%), and non-Hispanic (94.3%). In addition, most were married (84.7%) and had children (75.2%).
Their practice environments included academic centers (61.0%), private practices (12.4%), and hospitals (22.9%). Most (89.9%) supervised trainees, and most reported within the department of obstetrics and gynecology (77.5%), followed by surgery (35.7%). For most respondents (60%), the department chair or division chief was male.
Survey Results
The most common experiences reported by the 249 survey respondents included:
- Any microaggression (83.0%)
- Gender discrimination (57.0%)
- Have hidden personal life or changed personality to adapt to work environment (56.6%)
- Bullying (52.8%)
- Pretended to be interested in activity and/or sport to feel included (41.9%)
- Told to smile more (30.9%).
Both bullying and gender discrimination were more likely to have occurred during training than in practice, she noted. Respondents were unlikely to share these experiences with others: only 24% reported bullying, and only 19% reported gender discrimination.
Other Interesting Findings
Interestingly, the perpetrators of these acts were “multiple and varied,” she continued. Most commonly, bullying, gender discrimination, and microaggressions came from colleagues in authority, but a significant number of women pointed to peers, administrators, staff (including nurses), trainees, and patients.
“Fewer than half of bullying cases were seen as arising solely from male perpetrators. A significant number of respondents endorsed bullying and harassment from women, and a third of responders said that women had impeded their advancing into leadership positions,” she said. “Few felt their male colleagues were similarly negatively impacted by their gender.”
Despite these large numbers of women practicing gynecologic oncology, the endorsement of bullying and discrimination from this survey was remarkably similar to those reported in other specialties.... How can we do better?— Sarah M. Temkin, MD
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Need to ‘Do Better’
Dr. Temkin applauded the efforts of a number of other surgical societies in bringing awareness to the problem and creating an environment with more equity. But, she added, “The gynecologic oncology workforce differs from those of other specialties that are surgical and remain predominantly male.” She noted that more than 50% of gynecologic oncologists are female.
“Despite these large numbers of women practicing gynecologic oncology, the endorsement of bullying and discrimination from this survey was remarkably similar to those reported in other specialties,” she said, adding that the most important question is, “How can we do better?”
Disclosure: Dr. Temkin has served on the advisory board of Clovis and has received honoraria as a cancer expert.
