Medical sexism: how to be an ally

“You should probably shadow me, as I can’t teach her because of my restraining order on young girls”

Regardless of who made this “joke”, this is not okay.

Does it matter that it was a male consultant? A senior doctor with a wife and kids? Someone entrusted to teach medical students? Someone who continued to make sexist comments in front of my female colleague, despite us both being clearly uncomfortable?

When I’ve recounted this story to female medics, the general response has been disgust, disbelief and the infinitely-loud eye roll of “this is nothing new” (which is a tragedy in itself). When I’ve told other male medics, most have responded in the same way. But not all.

“Not all men”

Some of the usual excuses have been brought up when I’ve told other men this story:

  • “It was just a joke, that’s just how he is”
  • “Since when did you become so sensitive?”
  • He’s just part of a different era, it was normal for them”
  • Or my least favourite: “you’re lucky, he clearly liked you enough to crack banter”

So yes, not all men are sexist. Not all men will commit acts of violence against females. But also not all men will discourage this behaviour when discussing it behind closed doors, or consider the impact of their words or actions.

Which brings me to the main part of this: the consultant above was clearly wrong. The approach to tackling ingrained sexism in a senior doctor is perhaps a different conversation (although one we need to have, given the disproportionate health outcomes for females). But I want to focus on myself.

Innocent bystander?

I wanted to reflect on what I did (and didn’t) do during this situation, as I think that’s probably the first step to allyship. I’ll reserve how “good” or “effective” my actions were for female commenters, because that’s ultimately the only way I’ll know.

  • The first thing I did was check the response of my female colleague; in my head this was to assess the “severity” of the situation. On reflection, this shouldn’t really matter because it shouldn’t be up to the victim to be “resilient” or accept it as a joke, if it’s clearly beyond that.
  • The second thing I did, which on reflection is probably not that good, was to physically put myself between the two and volunteer to shadow this consultant. Now, he had already “picked” me so this was somewhat superfluous, but in my head I was removing the power from him and giving it to us, the medical students, whilst also forming a physical barrier between them. This treads that delicate balance between using privilege and not wanting to patronise, and I’ll leave it up to you to whether I did this well or not.
  • Thirdly, after shadowing this consultant (he wasn’t a very good teacher, surprisingly), he continued to make sexist comments. The female colleague and I made comments to refute his statements, and I felt slightly less useless being able to support her in this, but because the consultant wasn’t being “called out” as such, it may have seemed like we were just joining in the “banter”. (Still, she managed to get some good burns in)
  • Finally, after we left the department, I asked her how she felt and what she would have wanted me to do. I think this was probably the best thing I could have done at the time, because to be honest I was quite lost. Ultimately, she understood the difficulty of being a bottom-rung medical student and having to negotiate inappropriate behaviour, and hence why I couldn’t (or rather, didn’t) take a stand against the consultant.

I think the issue of calling out far superior colleagues is a difficult one. At the time, I had only been in clinical medicine for a few months so certainly didn’t feel the “authority” to confront the consultant about his comments. Now, embittered by the ravages of time and coffee, I might think about it.

From this experience and several others, and talking to female colleagues in healthcare disciplines, I have come up with a few key points that men in healthcare should think about. Ultimately, whether you’re aware of it or not, sexism occurs throughout healthcare (and beyond) and we have a responsibility to protect patients and professionals alike.

Remember the EQUAL framework:

  1. Education: for me the best way to do this is to look at the problem as a whole (the Romney report, BMJ articles etc.) and also speak to individuals. You’ll quickly see how almost EVERY female colleague has at least one story
  2. Question yourself: we all hold biases, whether we’re aware or not. The important thing is to employ introspection and try to become aware of them. Have you ever seen sexist behaviour in healthcare? Have you ever been a part of it? Have you ever asked a patient or colleague how they felt about their treatment?
  3. Understand the issues: again, the best way here is to talk to female colleagues. There may be issues that haven’t even crossed your mind, or whose severity you’ve underplayed.
  4. Ask and act: if you have a situation where sexism may be playing a part, ask the involved colleagues about it. This requires the previous steps to work because you may not realise it is happening without understanding how these issues may manifest.
  5. Lead: show other males (especially younger ones) how to act and discuss these issues with them. It’s completely possible to have “banter” but still call out sexist behaviour/comments amongst friendship groups (trust me, I’ve done it).

This is merely scratching the surface of a deep issue (much like my blog post on racism in the NHS), but I think it’s always good to reflect. At the very least, I’ve found this to be a useful exercise.

It’s also important for me to say that I am, of course, still a student of this framework and am by no means above reproach. As a tall, straight male I can sometimes be pigeonholed into a “lads” group in the clinical setting, and have probably unwittingly excluded female colleagues.

But I’m working on it, and you should too.

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