BLOG: Onus should not be on women to ‘fix’ structural sexism in oncology
Click Here to Manage Email Alerts
Structural sexism has long plagued the field of medicine, with a historical hierarchical infrastructure that has led the field to lag behind other industries for decades.
We can certainly learn from others outside of health care and medicine in terms of how to make a more equitable workplace. With the right advocacy, some of these forces can change.
Defining structural sexism
ASCO has focused a significant amount on racial and gender equity issues, especially within the past few years. During this year’s annual meeting, my colleagues and I were asked to present on gender equity, which has been addressed in different ways in the past. We wanted to think about gender equity differently and place an emphasis on structural sexism vs. individual acts of sexism.
Structural sexism is inequity in resources, funding and power on the basis of gender.
There are forces, structures and historical practices throughout academic medicine that have reinforced some of the current practices and behaviors, allowing structural sexism to persist.
Influence on patients, workforce
Structural sexism can have a significant effect on patients. For example, women and gender minorities continue to be under-enrolled in clinical trials. There are also issues with resources and funding. Data suggest that some cancers that primarily affect women are relatively underfunded compared with cancers that primarily affect men.
It is important to understand that sex and gender are different. Sex is a biological set of characteristics, whereas gender is a social construct — and in many ways in oncology, these terms have been conflated. Various published studies have used these terms inaccurately; for example, in clinical trial reporting, the terms are often used interchangeably. There is a need for more accurate reporting to better understand study results. It is also important to use precise terminology and more inclusive language for patients and avoid use of stigmatizing language about gender.
Structural sexism also affects the workforce, which goes hand in hand with more women oncologists going into specialties that are centered on taking care of women and children — and historically, these specialties have been underpaid. For example, breast surgeons and gynecologic oncologists are specialties with a higher proportion of women providers and are underpaid compared with similar specialties within the field of oncology.
Male allies, institutional support
It needs to be made clear that the onus should not be on women to fix themselves when it’s the system that’s broken.
We absolutely need more male allies because in terms of leadership, men continue to make up the majority of leadership roles compared with women and gender minorities that have been historically underrepresented in medicine. We need male allies to create change at the top level to make better workplaces for oncologists and to set up better structures for patients so that there’s increased access to care, regardless of gender or other demographic factors.
It is important for individuals to examine their own biases, but it is also important to acknowledge that some of these resource allocations have to come from the top down — from institutions rather than from individuals. In the wake of the COVID-19 pandemic, policies were created to increase flexible work schedules and better integrate work and home life. Some of the practices that we adopted during that time may work better for our changing workforce. We should all continue to advocate for workplace policies that enhance work-life integration and flexibility for all.
There’s been a lot of focus on women and others who share identities historically underrepresented in medicine climbing the leadership ladder in oncology, which is important so that everyone has access to leadership development and skills. However, we want to also advocate for a workforce environment that works for everyone, so that when given the tools to lead, diverse leaders can succeed.
Editor's note: The opinions expressed in this blog are solely the views of the author and do not reflect those of their employer.
Reference:
Collapse
Read more about
Click Here to Manage Email Alerts