Gender Discrimination in the Medical Workforce: Gender Bias in Medical Specialties and the Male Nurse
By Caitlin Chen and Seerat Chawla
*In this article, we refer to “women,” “female,” “male,” and “men” in reference to either the female/male sex or the general social categorization of women/men as a group. The focus on cis-gendered individuals is not to be exclusive of gender nonconforming, gender non-binary, or transgender people.
Gender discrimination in the medical field is a pervasive systematic issue that has persisted throughout history. The lack of deviation from the cisgender medical model results in gendered expectations such that the men are the practicing physicians and the women are the nurses in a health care setting. Despite being detrimental to the medical profession, these disparities are often unaddressed — allowing negative stereotypes to form that can often act as a social barrier to those interested in pursuing a career, but do not fit the archetypal image of a “male doctor” and “female nurse.”
Discrepancies in Medical Specialties: Orthopedics and OB-GYN
Traditional gender roles have led to men historically dominating the medical field and although women are now gradually outnumbering men in medical schools, gender inequality in medicine is a phenomenon that still affects practicing and future physicians. Physician gender has proved to be a decisive factor in influencing which medical specialities residents end up pursuing following their graduation from medical school. This leads to gender imbalances in the workplace, producing varying levels of power dynamics between male versus female physicians and differing patient expectations for each gender.
According to the Association of American Medical Colleges, medical specialities with the most gender imbalance for male-dominanted specialties include orthopedic surgery, neurological surgery, interventional radiology, thoracic surgery, pain medicine, and radiology. In contrast, female-dominated specialities consist of obstetrics and gynecology (OB-GYN), allergy and immunology, pediatrics, medical genetics and genomics, hospice and palliative medicine, and dermatology.
Of these various specialties, orthopedic surgery has the highest disparity for male-dominated specialties with 84.6% of the workforce made up of male physicians. Orthopedics have the lowest number of female residents compared to all other surgical subspecialties. Various studies examine what may deter a woman from choosing orthopedic surgery, stating the most common reasons include inability to have a good work/life balance and difference in physical strength to their male counterparts. Furthermore, females often face barriers to entering orthopaedics because of lower acceptance by senior faculty in this field and lack of mentorship during medical school. Explanations for decreased female representation often align with traditional beliefs about what a female is capable of doing and allows this sexist system to perpetuate due to lack of role models and opportunities.
On the other hand, OB-GYN residents have the largest disparity for female-dominated specialties with an 83.4% female majority. Gender redistribution in OB-GYN is influenced by patient preference for a female professional. Women have an inherent advantage because of their experience with the menstrual cycle, and patients often feel more comfortable interacting with a doctor that is able to empathize with them. Furthermore, because of societal and cultural norms, women’s reproductive health is sometimes perceived as a taboo subject, resulting in women feeling more comfortable discussing intimate issues with other women. This leads to a decrease in patient practice volume with male physicians compared to their female counterparts. Despite this, female physicians in OB-GYN still face discrimination through compensation and are consistently paid less than male OB-GYN physicians.
The Invisible Male Nurse
As nursing transformed into an acceptable, suitable occupation for Victorian women, men were slowly forced out of the profession believed to be best suited for the natural feminine tendencies. The traditional dichotomy between femininity and masculinity shaped the field, as women were perceived to be better equipped to nurture the sick due to their affectionate and caring nature. This role thus nicely paralleled traditional gender roles in the household. Conversely, men were believed to lack the necessary naturally nurturing traits to succeed in this field. Over time, this gender bias and role stereotype has solidified in the field and skewed the demographic outlook for nursing worldwide.
In the United States today, there is only one male nurse for every nine female nurses. In fact, most patients and healthcare providers alike view nurses as female and only specify the gender when it contradicts this stereotype, creating the title of the “male nurse.” In light of this demographic, the history of men in nursing seems to go completely unnoticed. The first nurses, however, were men. As far back as Ancient Rome, men were caregivers, tending to the sick and dying during plagues and crusades. Yet, most nurse educational facilities and educators are unaware of men’s historical contributions to nursing and thus, unknowingly paint it as primarily a women’s field, furthering gender exclusion within the field.
This feminine image is further perpetuated by the media. Television shows illustrate mostly female nurses that operate within the male physician dominated gender hierarchy in health care. For instance, while Grey’s Anatomy includes female physicians, male nurses seem to be scarce, if any, on the screen. Additionally, the image of the nurse was sexualized through commercials, movies, and shows. Eventually, the association was clear, as nurses must be women in order to be sexual objects.
These images and associations translated into concrete barriers for male nurses entering nursing educational programs and work spaces composed primarily of women. As a visible minority, male nurses report experiences of social isolation and the lack of role models. Many also note feeling scrutinized more so than their female counterparts and being assigned additional tasks such as heavy lifting and transporting patients.
The societal pressure to enter traditional male roles that manifests in the educational space continues to impede recruitment and retention of males in nursing. For those that do enter the workforce, they encounter similar barriers that limit their choice of speciality. The most notable example is male nurses desiring to practice in OB-GYN. While they had been practicing in neonatal intensive care units, they were barred in OB-GYN settings. This was attributed to a fear of men being sexual rather than professional when working with female patients. A common coping mechanism that many male nurses adopted to combat this was to be extra-professional in their approach, an additional barrier to be able to practice in the speciality.
Case studies of the male-dominated versus female-dominated medical specialties and male nurse provide a unique look into the sexualized nature of healthcare work. As these fields seek to become more representative of the populations they serve, there is a need to have a more diverse cohort of professionals as well. Change begins by shifting the narrative in medicine to recognize the historical contributions of all genders in providing care and address the gender biases that create barriers in the workforce. Having a greater appreciation for the role of diversity in medicine will allow for the creation of more inclusive educational programs and work environments that cater to the development and growth of all future providers.
Sources
[1] These medical specialties have the biggest gender imbalances (Brendan Murphy, American Medical Association)
[2] Where Are the Women in Orthopaedic Surgery? (Rohde et al.)
[3] Residents’ Perceptions of Sex Diversity in Orthopaedic Surgery (Hill et al.)
[4] Gender Bias in Obstetrics and Gynecology (Mahmood et al.)
[5] Obstetrician-Gynecologist Perceptions of Patient and Employer Gender Discrimination (Turrentine et al.)
[6] Men in Nursing: History, Stereotypes, and the Gender Pay Gap (Liz Lotts, OnlineFNPPrograms)
[7] Rethinking Gender Stereotypes in Nursing (Minority Nurse)
[8] GENDER DISCRIMINATION AND NURSING: Α LITERATURE REVIEW (Christiana Kouta and Charis P. Kaite)
Caitlin Chen is a second year Human Biology and Society major at UCLA. Seerat Chawla is a third year Molecular, Cell, and Developmental Biology major at UCLA. Caitlin and Seerat are both THINQ 2020–2021 clinical fellows.
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