Bias Interventions Aren’t Enough To Advance Women In STEM

with Keren Meital Kinner, MSEd, and Dana Hiniker

In three separate conversations over the course of a week, three women from three different academic medical institutions shared feedback from recent evaluations. In every case, the women had been labeled “too confident.”

“So I stopped speaking up,” one noted. “I qualified every statement with, ‘I may be wrong, but…’ or ‘I’m just junior faculty, so…’” Another woman shared that her supervisor suggested she “lower the pitch of your voice so we can better understand you.” And still another manager offered this gem of unsolicited advice, “At this stage of your career, you’ll be more effective at making friends if you let the experienced people at the table speak. Try not to say too much.” (Worth noting that the “more experienced” colleagues were all men.)

It’s 2019. Why are we still dealing with this?

There’s no question that healthcare is woefully underrepresented by women at the top. A recent report in Harvard Business Review offers the latest numbers: in the U.S., women make up just 18% of hospital CEOs, 16% of deans and department chairs, and only one in five full professors at academic medical schools. This, despite women outnumbering men in both enrollment in and graduation from those same institutions.

And for the small percentage of women who have been successful breaking into leadership roles, their advancement hasn’t come without a fight — or a comment they ignored, a touch they tolerated, or a joke they laughed off. Talk to any group of women across STEM, and you’d be hard pressed to find individuals spared remarks about their appearance or their affect — remarks rarely leveled toward men with the kind of condescension that women regularly endure. It’s these remarks and biases that compel many women to leave the workforce altogether, with exodus for women in science and medicine peaking just ten years into their careers. Further, these biases exacerbate already epidemic levels of burnout, which is higher among women than men.

Earlier this month, the journal Nature covered a study analyzing the representation of women recipients of biomedical awards over five decades, finding that not only are “top prizes in science heavily biased towards men,” but for the highest-value awards across 628 prizes, less than 15% of recipients were women. What’s more, those women received an average of less than 65 cents of the prize money for every dollar a man received.

The article also noted that “women are disproportionately less likely to be first authors of research articles, and papers with women in prominent authorship positions attract fewer citations than do those with prominent male authors.” The HBR report backs this up, noting that women are in the minority when it comes to senior authorship (10%) and Editors-In-Chief (7%) at prestigious medical journals. In some publications, including the New England Journal of Medicine, women’s authorship has actually gone down in the last decade.

It’s not that medicine hasn’t made some attempt to address these inequities. In the wake of #MeToo and a number of high profile allegations of sexism and sexual harassment in STEM, a range of promising initiatives launched in institutions across the country to provide non-conscious or implicit bias training, for example, and bolster structures for women to report sexual harassment and discrimination.

But the truth is, these efforts aren’t enough.

While institutions are well-intentioned in focusing on the upstream problem of sexism and bias, their interventions — like implicit bias testing (IAT) — continue to keep the focus on men, thus reinforcing the gender asymmetry. Meanwhile, the downstream victims — women — still aren’t getting the tangible, actionable support needed to advance their careers and amplify their voices to secure positions of authority that enable them to enact real change developed for and by those most impacted by sexism.

Lest we totally throw bias interventions under bus, there is some efficacy. In 2015, research in CBE Life Sciences Education examined interventions held at the National Academies Summer Institute for Undergraduate Education designed to reduce gender biases. They found that in the two weeks following participation in the workshop, participants were “more aware of gender bias, expressed less gender bias, and were more willing to engage in actions to reduce gender bias.”

That’s laudable, to be sure, but reducing gender bias hasn’t led to a meaningful dismantling of the systems and barriers that keep women from advancing. Moreover, bias against women isn’t a woman’s problem — any more than racism is a problem of people of color. So why, then, are women placed in a position of having to wait for men to catch up before we can move ahead?

Institutions need to begin investing real resources into real solutions now. While much investment is being made in rehabilitating the male workforce, we should insist that (at least) equal investment is made into women’s mentorship and coaching programs. That women are granted protected time for publication and research. That women’s research is funded at the same levels as male colleagues. We should demand first authorship, equal representation at conferences, and the same compensation for awards and honoraria.

In a piece in The Atlantic, psychologist Glenn Adams, in response to questions about the impact of bias interventions to reduce sexism in the workplace, calls for a shift “from the task of changing individual hearts and minds to changing the sociocultural worlds in which those hearts and minds are immersed.”

What better time for women to take action to shake up that sociocultural world than right now, with a national climate increasingly ripe for change. Just look at the rapid rise of young women leaders like Alexandria Ocasio-Cortez and Ayanna Pressley who rejected the sexist scripts we’ve been conditioned to automatically, blindly, and silently accept. They didn’t wait for the long arc of history to bend toward justice; they went ahead and bent it — effectively and unapologetically, inspiring generations of women in the process.

So rather than offering IAT as a solution to women’s underrepresentation, maybe it’s time to embrace some #AOC. And in doing so, celebrate, advance, and cultivate more “too confident” women in medicine.