Article Text
Abstract
Women are under-represented in surgery, especially in leadership and academic roles, and face a gender pay gap. There has been little work on the role of implicit biases in women’s under-representation in surgery. Nor has the impact of epistemic injustice, whereby stereotyping influences knowledge or credibility judgements, been explored. This article reports findings of a qualitative in-depth interview study with women surgeons that investigates gender biases in surgery, including subtle types of bias. The study was conducted with 46 women surgeons and trainees of the Royal Australasian College of Surgeons. Maximum variance sampling strategies ensured a comprehensive set of perspectives. Data were analysed using iterative thematic analysis to document and classify forms of gender bias experienced by the participants, including implicit bias and epistemic injustice. It found four types of bias affecting women surgeons: (1) workplace factors such as access to parental leave and role models; (2) epistemic injustices—unfair assessments of women surgeons’ credibility by patients and colleagues; (3) stereotyped expectations that they will carry out more of surgery’s carework, such as meeting the emotional needs of patients and (4) objectification. Implicit biases arose in each category. Given that many of the biases identified in this study are small, are harmless on their own and are not necessarily under anyone’s conscious control, important questions arise regarding how they cause harm and how to address them. I draw on theoretical work on cumulative harm to answer these questions.
- ethics
- health workforce
- surgery
- women
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Footnotes
Contributors KH is the sole author.
Funding The study was funded by a Macquarie University Research Fellowship (MQRF) 'Gender in Surgery: An Exploration of Biases Affecting Surgeons, Trainees and Patients' (2016-2019). MQRF Award ID: 63989874.
Competing interests KH reports non-financial support (travel and conference registration) from the Royal Australasian College of Surgeons (RACS) to present a paper at the RACS Annual Scientific Congress in 2017.
Patient consent for publication Not required.
Ethics approval The study was approved by the Macquarie University Human Research Ethics Committee (Approval # 5201700117).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon request. However, this availability is conditional on the ability to protect participant identity and adherence to conditions of the research ethics approval.
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