The perils of intersectionality: racial and sexual harassment in medicine

Abstract

It was early evening in the fall of 1994 as I began my long call. I met the daughter of the next patient I was admitting while she was waiting for her mother to return from interventional radiology. I recall that evening like it was yesterday. I was adorned in a clean, short white coat over a green blouse and navy blue slacks. My stethoscope was in one pocket and my medicine manual in the other. After being informed that my patient had returned, I went to her room. Before I could introduce myself as Dr. Hill, she said, 'Oh, thank goodness you are here. Are you the TV lady? I have been waiting for someone to come up here to collect the money so I can get my TV turned on!' While I was frozen in place trying to process what I had just heard, her daughter, exasperated and embarrassed, exclaimed, 'Heavens Mother! That is your doctor!' That occasion would, unfortunately, not be the last time during my intern year that I would be mistaken for the TV lady, dietary staff, or other non-physician support staff. Each time it occurred, I felt degraded and demoralized. I never shared these feelings with anyone because it seemed too sensitive and painful to articulate. My turmoil was further heightened by the high regard and respect I had for the important role of our support staff in caring for our patients. I was afraid that disclosing my frustration and pain at being assumed to be non-physician staff would alienate me from the individuals who were part of my strongest support system on the wards during my internship. I also could not sort out whether these experiences were occurring due to my race or to my sex.A 2018 National Academies of Science, Engineering, and Medicine consensus study uncovered the alarming frequency of gender harassment, unwanted sexual attention, and sexual coercion in academic

Trends in Internal Medicine Faculty by Sex and Race/Ethnicity, 1980-2018

“…According to current literature, these challenges are associated with a lack of parity in compensation, 23 , 24 promotion, leadership opportunities, 25 and, at their worst, frank discrimination and harassment. 26 , 27 , 28 , 29 Equally concerning are the increased levels of isolation, burnout, and attrition in academic medicine. 30 …”

Seven decades of chemotherapy clinical trials: a pan-cancer social network analysis

“…The most common venues for publication were high-impact clinical journals: the Journal of Clinical Oncology (n = 1595, 28.5%), the Lancet family (n = 710, 12.7%), the New England Journal of Medicine (n = 495, 8.8%), and the Blood family (n = 495, 8.8%). Co-authorship has changed in a non-linear fashion over time: the median number of authors per publication increased from n = 6 in 1946 to n = 20 (IQR [16][17][18][19][20][21][22][23][24][25] in 2018 ( Figure S2). Across subspecialties, the median number of co-authors per publication varied somewhat, from a low of n = 10 (IQR 7-15) in gynecologic oncology to a high of n = 16 (IQR 11-22) in dermatologic oncology.…”

“…This could contribute to a widening disparity between authors with early access to resources through personal networks and authors in more socially disadvantageous positions, e.g., those who come from low-income backgrounds or were the first in their family to attend college 21,22 . These groups are more likely to include underrepresented minorities, e.g., women of color, who face a number of discriminatory barriers in pursuing careers in medicine and medical research 11,23,24 .…”

Women in Academic Psychiatry: Inequities, Barriers, and Promising Solutions

“…Women academic physicians of all identities are known to experience discrimination, gender-based harassment, unwanted sexual attention, and sexual coercion at an alarming frequency, even more so for BIPOC and LGBTQIA+ women [27,28]. A study of 5782 physician mothers found that 2/3 reported gender-based discrimination and 1/3 reported maternal discrimination, defined as discrimination due to pregnancy, maternity leave, or breastfeeding [29].…”