Gender Discrimination in the Medical Profession

As I was walking through Target on October 30th, I heard a little girl telling her parents she wanted to be a doctor and wear the white lab coat for Halloween. Her mom looked down at her and said, “Oh no, you should be a nurse and wear cute scrubs for Halloween, that would make more sense.” As I was getting x-rays taken of my broken foot, I watched a woman follow behind a man wearing a white coat, taking orders from him while he sat behind a computer replying to emails.

As I was applying to colleges and choosing a major related to medicine, I saw pictures of men in white coats and women in light pink scrubs sitting behind a desk in the background. The white coat. How could a simple piece of white clothing mean so much in today’s world?

In existing literature, there is a missing gap of the gendered positions in the medical profession. Jess Drinkwater, Patricia Tully, and Tim Dornan assert that female medical students are more likely to compromise their goals for their personal lives and raising a family in “The Effect of Gender on Medical Students’ Aspirations: A Qualitative Study”. By finding that women “…believed it was expected of them” and “…wanted to counterbalance and enhance their professional lives”, they show how society’s expectations for women affect the education of female medical students (2008; 423). By identifying specific parts of a medical education that can prevent women from advancing at the same pace as men, Drinkwater et al. provides a strong sense of discrimination in the medical profession. They, however, lack the explanation of how these gender roles have been formed by society, and these roles have transfused into the medical profession (Drinkwater et al. 2008). Naomi Gerstel’s and Dan Clawson’s “Class Advantage and the Gender Divide: Flexibility on the Job and at Home” touches on varying patterns of flexibility between the home and work provide different advantages to men and women in. By researching four different groups of the health profession, it shows the inequalities of work hours and family life between men and women. Gerstel and Clawson are missing the point of how each category is gendered, with unequal amounts of women compared to men (Clawson and Gerstel 2014).

Clawson and Gerstel along with Drinkwater et al. miss how women are discriminated against in the medical profession in terms of societal values and opinions. Another piece of literature that misses this point is Anne K. Monroe’s “Through a Gender Lens: A View of Gender and Leadership Positions in a Department of Medicine”. Although, it does improve slightly on explaining how these gender roles have risen from society and how they affect women in leadership positions. The gender stereotypes affect a woman’s performance and impact advancement in academic medicine (Monroe 2015). Marci D. Cottingham comes close to showing how societal stereotypes affect the medical profession in “The Missing and Needed Male Nurse: Discursive Hybridization in Professional Nursing Texts”. Nursing is a gendered profession where women are the primary gender that make up the employment. Men are looked at as not masculine if they pursue a career as a nurse. By saying, “the social world is the constantly produced and producing product of action, speech, and text socially exchanged and observed,” Cottingham explains the impact of society being determinative and creating the stereotype of whether working in a specific profession is acceptable or not (2018:199). These sources offer valuable insight into the discrimination of women in the medical profession but miss the specific way of how society has gendered it.

Analyzing how society plays a role in discrimination in the medical profession sheds light on the growing gender inequality through time. In this paper, gender discrimination will be defined as “behaviors, actions, policies, procedures, interactions, etc., that adversely affect a woman’s work due to a disparate treatment, disparate impact, or the creation of a hostile or intimidating work or learning environment” (Council on Ethical and Judicial Affairs 1994:5). For the latter part of the 20th century and now the 21st century, gender has been discriminated against in the medical profession. By examining societal values and opportunities through the eyes of medicine, discrimination is shown by the lack of women in leadership positions, social norms of gender and what is expected of women and men in a familial relationship, inflexibility of opportunities for women, and stereotypes of medical professions and specialties.

In the medical profession, there is a lack of women in leadership positions. There is no mentorship or sponsors to be guided along with. Just like in other professions, doctors and surgeons follow a fellow doctor with more experience to learn more about the correct ways of practicing medicine. An electrician will be an apprentice before going on house calls alone, or even a magician will have an apprentice to teach his or her wisdom to. With women not having an equal opportunity to have a mentor or be a mentor in this specific profession, they are discouraged from moving up to leadership positions. The Council on Ethical and Judicial Affairs states, “Mentors can have significant impact on one’s professional advancement, and some physicians believe success ‘is impossible without a sponsor who will promote, protect, and in other ways enhance one’s professional fortunes’” (1994). With only a few female mentors and role models for women to look up to and follow, women physicians feel they have to independently find their way to the top leadership positions. Having to face medical school and then finding a high-position job on one’s own is almost impossible alone. While men are applying for promotions, women are haven’t obtained a permanent position which delays the time for promotion (Arrizabalaga et al. 2014; 366). Anne K. Monroe conducted a survey of the leadership positions at the Johns Hopkins Medical School of Medicine. The results concluded that for division directors, 88% of positions were held by men and for fellowship directors, 73% were held by men. These two directive jobs are the highest-ranking and have a majority of men holding power. There was a significant percentage of women holding leadership positions, but very few were high status positions with resources. Without having women to look up to as mentors for girls in medical school, the opportunity is very unequal for men and women to attain top leadership positions (Monroe et al. 2015).

Without having a leadership position, women aren’t granted an equal amount of institutional research funding. The glass ceiling is preventing the advancement of women in the profession. If women do not work in top leadership positions, they’ll lack the status, influence, and resources to break the glass ceiling (Monroe et al. 2015:842). It was found that 49.5% of men versus 37.4% of women were promoted after applying (Arrizabalaga 2014:365). With the lack of funding, there is no opportunity to be promoted to higher levels of the profession and no way to establish a presence in the medical community. People hire people who look like them. The people in charge of allocating research funding and labs for clinical work are men. The tendency for men to higher other men for bias reasons hurts the opportunity for women to attain funding, even with equal qualifications.

A common threat that has been facing women for a long period of time is the unequal pay. Not just in the medical profession, but in both male-dominated and female-dominated professions. Butter et al. points out the bureaucratic and non-bureaucratic divisions of health occupations in “Gender Hierarchies in the Health Labor Force”. The nonbureaucratic division is “private, independent, self-employed practice” where the bureaucratic division includes the dominant work context in which most of the under-paid positions are, such as nursing, health aides, therapists, and the majority of healthcare providers (Butter et al. 1987: 138). With being paid lower amounts, women are discriminated against. This bureaucratic division of labor that affects the medical profession furtherly affects females in a more negative way. Institutional policies that have been set in place for years are outdated. Women have gained more power and are increasing in number in being physicians and surgeons. With these sexist rules in power, how will the discrimination end?

Some may say that the wage gap is closing (Butter et al. 1987). Although it may be improving, there is still a long way until women have the chance to be looked at as equals in the workplace, specifically the medical profession. Men have more autonomy in what they are doing while working. Charlotta Magnusson, a researcher from the Swedish Institute for Social Research, studied the gender wage gap in the medical profession. Despite a high number of women entering the medical field, the gender wage gap still exists in Western societies and Sweden. She found that “the size of the gender wage gap was significantly larger among married/cohabiting parents (approximately 8.3%) compared with single men and women (approximately 5.2%)” (2015:50). With women marrying more and more often, the gender wage gap will only get larger (2015). Gender discrimination is occurring all over the world.

Aside from women missing in leadership positions, society has determined gender norms and what is expected of women and men in a familial relationship, which has restricted women from pursuing careers in medicine. The gender norm of men working the jobs that earn more money discourages women from attempting to enter highly professional fields like medicine and law. It is very hard for women to defy the gender norms placed upon them by society. Historically, it’s been the women who have to stay home and take care of the children, putting work and her career second. The world patriarchy prevents women from furthering themselves past the gender norm. For example, in Ayesha Masood’s analysis on the workplace experiences of Pakistani women doctors, she describes the impact of the hijab and its important role in the understanding of Muslim women’s work experiences. Although the hijab is a woman’s way of asserting their unique and religious identities, the historical patriarchal interpretations of religious doctrines of the hijab represents that women are “supposed to either perform ‘women’s work’ by exclusively taking care of women’s needs or to work in feminine professions” (Masood 2018:216). In countries outside of the US like Pakistan, religion plays a very large role in how society looks at the medical profession. Female physicians in Pakistan are defying the stereotype of what is expected in the familial relationship (Masood 2018). The oppression of women outside of the profession influences the discrimination inside of the workplace. If the management is affected by the gender norms determined by society, women will never have an equal chance to advance their medical careers.

Society has constructed a norm that women are in charge of taking care of the house and children while the men go to work, forcing women to view the medical profession as unattainable. Highly prestigious jobs that require lots of education and earn the highest wages all require it to be the center of one’s life. Since society has engrained in women’s brains that they can’t have both a successful career and family, women give up on trying to get these jobs. Drinkwater et al. found in her study of the effect of gender on medical students that “women were prepared to sacrifice high professional aspirations to the realities of parenthood, whereas men held to their high aspirations by tacitly assuming their partner, as mother, would care for their children” (2008:424). The expectation by society that women are supposed to take care of the children, female medical students are discriminated against because they have that weight on their shoulders. It isn’t expected of men to take a lot of time off of education and work to raise their children. Even if women do attain a degree and work in the medical field, it is looked down upon if they take time off to raise their family. It is harder to come back to work after having children and to still have the same level of respect.

Society is changing, and women are able to afford more child care and offices are offering day care to their employees’ families. This can be helpful for women, but the common worker still faces resistant institutions, and in a relationship, parents may disagree on how they want their children to be raised. Gender norms may discourage women from putting their children in day care. Workplace policies that support employees’ families are typically only available to high-come, dual-earner families. Women being paid less and not able to advance in the profession keeps the policies unattainable to them (Clawson et al. 2014).

With these gender norms determined by society, discrimination also occurs due to the inflexibility of opportunities in both the home and workplace. People in the less-prestigious jobs in the medical profession have inflexibility in determining their schedules. Clawson’s and Gerson’s main argument is that “women in particular need flexible workplaces in order to meet the inflexible demands that families place on them” (2014:396). The study was focused on physicians, registered nurses, EMTs, and nursing assistants. For physicians, they found the flexibility to put in the long hours on the job typically depends on having wives who take care of family matters. Flexibility is defined in various ways and unequally distributed through the jobs within the medical profession and between men and women. Disadvantaged occupations, such as male EMTs and female nursing assistants, have little flexibility to shape their work schedules or pay (Clawson et al. 2014). With these inequalities between occupations within the profession, the discrimination will only grow due to the gap between specialties. Surgeons will continue to make more and more money while lower-status positions will continue to have the same low wages.

Resistant institutions make it difficult for women to work and take care of a family. A resistant institution is an obstacle to egalitarian gender relationships. With career success tied to full-time work in the 21st century, the inflexibility of women being able to work and raise kids makes it difficult to balance each aspect. Privatized child care is very expensive and is debated on whether parents want the raising of their children to be primarily by day care workers instead of themselves or other family workers. Looking at the intersectionality of how gender and class affect the inflexibility and discrimination, examine how “…gender is both a resource and constraint” (Clawson et al. 2014: 398). It is a resource for men, primarily white men who got an education. Gender is a constraint for women, either if they have an education or whatever race they are. For higher classes, the ability to afford privatized child care allows for men and women to advance in their careers. For the lower classes, this is not an option. Institutional practices are shaped by resource and constraint which helped produce and maintain gendered workers. Class also determines where one lives. It was found that “wage differences between various fields of medicine may be caused by certain specialties, especially in rural areas, being in more demand…a scarcity of doctors in certain specialties that served to inflate the wage level” (Magnusson 2015:49). Doctors will go places where they will get paid the most money. For some rural places where the primary occupation is low-paying, they may not get the same medical treatment as someone would in a big city.

The inflexibility of opportunities for women arises from the stereotypes of women and men in the medical profession, which prevent individuals from considering entering a specific field due to fear of social exclusion. The stereotype of nursing being a strictly feminine profession discourages men from nursing, even though there is a shortage of nurses currently. Men have faced difficulties in trying to enter this female-dominated profession. Marci Cottingham highlights how “men in nursing is equivalent to women in traditionally male occupations with little attention to the ways in which US men, particularly white and heterosexual men, are advantaged currently and historically” (2018:197). Since society has stereotyped nursing as something only women would pursue, men are looked at as exceptions to this. Just like a woman being a lawyer or an engineer, a man being a nurse defies society. This is where the fear of social exclusion occurs, due to the judgement that occurs from family, friends, and even patients that are being treated (Cottingham 2018).

Many male nursing students encounter discrimination in both Ireland and America. According to Brian Keogh and Chad O’Lynn, male nurses “reported that they were used for physical strength during caring interventions…were more scrutinized, were graded less favorable…” (Keogh and O’Lynn 2007: 257-258). The men stood out from the crowd and were told that they were supposed to expect to have trouble in nursing school. The men were also faced with awkward moments in fields that only treated women, and eventually were told they weren’t allowed to participate in the full range of caring during these treatments, such as obstetrics. Discrimination barriers caused men to either drop out of nursing school or find different schools with a more positive program (Keogh and O’Lynn 2007). Stereotyping medical professions will only hurt society. Nurses are in high demand because of how important they are to a hospital running smoothly.

The stereotype of surgery being an all-male job discourages women from pursuing it. Being a surgeon requires more education and more money to put into schooling, requires more time dedicated to getting a degree and job, and requires work to be the only thing in that person’s life. It takes ten years minimum to become a surgeon, and an endless amount of money for schooling and fellowships. The commitment needed exceeds the commitment needed for other occupations. It makes sense that men dominate the profession since women are restricted by society’s expectations of them. For a woman to become a surgeon, she would have to break through the wall of men in the profession and in medical school. Surgery pays more than most other specialties in medicine, which makes it even more of a goal for medical students. The medical profession is a very competitive place where everything -- class, race, education, and power-- plays a role in how successful one is, like gender, class, race, and education. The stereotypes that have been put in place by society don’t allow women to be competitive in male-dominated specialties in medicine and vice versa for men. They help structure the discrimination in the medical profession.

When people picture hospitals, they’ll picture a man walking into the hospital room and a woman carrying a clipboard and taking the vitals. This stereotype engraves itself into children at a young age. If young girls are learning that they can’t be a doctor because they’re a girl or if young boys are learning that nursing is something only girls can do, there will be no change in the discrimination in the medical profession. As these girls grow up, they are also faced with the threat of sexual harassment. Women physicians are more likely to experience harassment from patients and superiors. Medical students have indicated that sexual harassment is a common experience, being subjected to sexist slurs and sexual advances. Even between classmates, women are discriminated against. The stereotype that women physicians and nurses can be looked at as “candy” for males has caused many women to fear going into the profession (Council on Ethical and Judicial Affairs 1994).

Looking through a sociological perspective in the eyes of medicine, discrimination is shown in the medical profession by the lack of women in leadership positions, social norms of gender and what is expected of women in a relationship, inflexibility of opportunities for women, and stereotypes of specialties in the latter half of the 20th century and the 21st century. When is gender equality in the medical profession going to become the norm instead of the exception? February 3rd is National Women Physicians Day, and also the birthday of Dr. Elisabeth Blackwell. Blackwell was the first female MD in America. The Women’s March on January 20th draws massive crowds and protests the inequality (Mangurian et al. 2018). With days like this and movements like #TimesUp and #MeToo, gender inequality and sexual harassment in the work place are becoming more of a hot topic in everyday conversation. National and international empowerment of women is crucial for the end of discrimination in the medical profession.

A generational transition is happening in the 21st century as more and more females are pursuing a career in medicine. There is hope for the future with the social media movements and protests. Gender discrimination in the medical profession is occurring all around the world. With more opportunity for the empowerment of women, the gap between men and women could hopefully become smaller. If society were to loosen up on their views of gender norms and stereotyping the profession, not only would the discrimination lessen but the health care system would improve. It is better to be treated by a happy and well-paid doctor rather than one in the opposite circumstances. Gendered jobs discourage people from pursuing what they really want to do. Class and race play a role in how these jobs are given. Stereotyping people based off of their social standing won’t help society.

The white lab coat. It protects doctors during laboratory work and while treating patients. It symbolizes the safety of one’s job and family. When patients see the lab coat, they feel as if whatever is wrong with them will be fixed. Once the white lab coat is obtained, the education and sacrifices are worth it to the doctor. With discrimination out of the medical profession, more women will have this coat, and the gender inequality will be lessened.

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