Q&A: ‘Brave conversations’ key to combatting microaggressions against women

A 2020 McKinsey survey showed 84% of respondents have experienced workplace microaggressions, with additional challenges reported among women, individuals from historically underrepresented groups and members of the LGBTQ+ community.

Additional results from the 2,030 surveyed respondents showed only 50% of women felt a sense of inclusion at work compared with 57% of their male counterparts, and 44% have chosen not to pursue a job because of this perceived lack of inclusion. Separate survey data from 2021 demonstrated a compounding effect among women of color, those in the LGBTQ+ community and, most notably, women with disabilities, who were more likely to have their judgement questioned and be spoken over or interrupted at work.

“According to Derald Wing-Sue, PhD, microaggressions are every day slights rooted in bias,” Sonia K. Narang, an organizational effectiveness consultant and executive coach, told Healio. “They can be subtle, automatic and often unconscious nonverbal or verbal responses. They send the message that you don’t belong or are less than.”

Examples of microaggressions include forgetting or mispronouncing names, confusing two people of color, being excluded from social events, not getting credit for your work or ideas, being asked to speak as the representative of your group or being coached in a way that is not authentic to you. In health care specifically, one of the most common microaggressions women face is being mistaken as a nurse.

According to Narang, microaggressions carry emotional and behavioral adverse impacts on feeling engaged and productive at work.

“The impact of microaggressions is rather harmful,” she said. “According to a Ted Talk by Tiffany Alvoid, microaggressions are like paper cuts. One or two are not a big deal but, when you experience them repeatedly on your hand, they add up significantly to where you can’t use your hand.

“With constant exposure, you can internalize them and it changes our worldview of ourselves.”

In a Healio exclusive interview, Narang outlined how microaggressions differ from other biases and harassment, tips for combatting these transgressions and the power of working “as a collective” to spark change.

Healio: How do microaggressions differ from other biases or harassment in the workplace?

Narang: Biases are thoughts, we all have them. We pick them up from our family, media and everyday interactions. When you act on your bias, you then have microaggression at play.

According to the U.S. government, harassment happens when an employer treats an employee or job applicant unfairly because of their race, color, religion, sex, national origin, age (40 years or older), disability or genetic information. It is really important to put your biases in check so they don’t spill out as bias, discrimination or harassment.

Biases can quickly turn from thoughts to actions and spiral from the micro to the macro causing harm.

Healio: How might women be uniquely affected by microaggressions? More so, women of color, with disability or members of the LGBTQ+ community?

Narang: According to a study conducted by McKinsey, minority groups are much more likely to experience microaggressions, which have an adverse impact on them both emotionally and behaviorally in terms of feeling engaged and being productive.

In every subgroup, by gender, gender identity, minority status or sexual orientation, more than eight in 10 respondents reported these indignities, and more than a quarter said they needed to correct others’ assumptions about their personal lives. That’s why they are also called microinequities: They lead to inequality.

Women, minority and LGBTQ+ respondents faced additional challenges: Women and ethnic- or racial-minority respondents were likelier than others to say their careers have advanced more slowly than their peers. These respondents, as well as LGBTQ+ respondents, also reported experiencing more microaggressions at work than other respondents.

For example, respondents in each of these demographic categories were much more likely than others to say they have been excluded from social events and have heard derogatory comments or jokes about people like them.

Healio: Are there any regulations that protect against microaggressions in the workplace?

Narang: Title VII of the Civil Rights Act of 1964 prohibits employee discrimination based on certain characteristics such as race, color, religion, sex, pregnancy, childbirth, sexual orientation and gender identity. Organizations also have policies around microaggressions at work and will encourage you to reach out to your supervisor and human resources team.

If you aren’t in immediate danger, I advocate for my clients to deal with microaggressions or unwelcome behavior by asking a question. We teach this in my class, “Brave Conversations.”

For example, if someone asks me, “Why do you speak English so well?” I will respond by repeating the question, “Why do I speak English so well?” They respond and I ask, “What do you mean by that?”

By asking questions repeatedly I am trying to sort out if the person asking the question is a clumsy communicator or engaging in microaggression. If they are a clumsy communicator, I can invite them to have a conversation with me and provide feedback on their behavior change. If it is microaggression with intent to harm, I can help to the appropriate channels at work.

Healio: How can women combat these transgressions against themselves and their fellow colleagues?

Narang: We are not trained to deal with microaggressions: We instead go back to our level of training with conflict that has been influenced by our upbringings, family, relationships, etc.

But, we can train for them. If you have a simple two choice decision, it takes you 0.5 seconds to respond, a learned response takes about 5 seconds to recall and an unlearned response can take up to 10 seconds. We freeze and fumble as a result. When I am faced with microaggression or unwelcome behavior, I freeze. I can’t run and usually I don’t fight because there is a power imbalance or the stakes are high, particularly at work.

Don’t berate yourself even if you don’t say anything. During unwelcome behavior we freeze, nod or sometimes even giggle: Don’t engage in self-recrimination. Frequently, clients will tell me, “I should have said something” or “I can’t believe I didn’t say something.” That is not helpful and results in a vicious cycle.

Women, my plea to you is if a woman comes to you with a microaggression or experience of prejudice, racism or discrimination, please don’t tell them that they are being too sensitive. Actively listen. Do not ask questions like “If it was that bad, then why didn’t you say something in the moment?”

If you see a microaggression in action towards another women, interrupt it. If someone says an inappropriate joke, respond with, “I don’t find this funny.” If another woman is having a tough time in a meeting, engage in microaffirmations, agree with them or amplify their voices.

Healio: How would you advise women begin addressing these issues with their superiors and what might prevent women from doing so?

Narang: It depends on their level of psychological safety. These conversations are tough and invoke a great deal of feeling in individuals. I would reach out to your HR team for counsel and find a good friend to walk through a plan on how to deal with it. If you are in immediate harm, please reach out to someone senior on your team or within HR sooner.

We aren’t trained as a society in how to deal with microaggressions. Fear is probably the most cited example in my practice. Clients don’t want to make a big deal out of it or be labeled as difficult.

Healio: What advice would you give to a woman in GI, a field predominantly represented by men, for combatting microaggressions?

Narang: Corporate America has a lot of systems in place to capture microaggressions. Bonuses, promotions and evaluations are all impacted.

Based on my observations, medicine is woefully behind. There are not enough systems in place to help women in GI. My deepest desire is that all women can empower themselves with some training like “Brave Conversations.” You can learn and practice a response in such situations.

I also want women to help each other out. We have to co-conspire and help each other like my male clients do. I yearn for women to have each other’s back, particularly when you see a micro- or macroaggression at play.

Healio: What else should our readers know about this topic?

Narang: There is hope. The only way we are going to overcome this is by sticking together with fellow women. Ask what you all can start doing for each other as a collective and do what you can to spark change from within.

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