I

t’s 2018. We’re in the wake of the #MeToo moment. Increased reporting is exposing rampant sexism in medicine, media, and beyond. Women are now more empowered than ever to speak up in response to bias and harassment. One could think we’ve come a long way.

And yet, for all our expressed outrage at widespread sexual harassment and our newfound “wokeness” about gender equity, we still find ourselves confronting sexism in what we perceive to be the most progressive, sophisticated spaces.

That was driven home at the Aspen Ideas Festival, where two of us (E.M. and N.N.) were honored to be part of a panel discussing the growing epidemic of clinician burnout in the United States. Needless to say, the room was occupied with accomplished, highly educated individuals.

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Which is why, when a question from a member of the audience — an experienced female emergency pediatrician — elicited a comment from moderator and NBC correspondent Dr. John Torres, also an emergency room physician, about her being “good-looking” — jokingly referring to E.R. doctors as attractive — we laughed it off. She continued with her question and the session moved on. And there we sat, in a room infused with well-worn complicity. No one said a thing about the comment.

It was both ironic and fitting that in a session dedicated to the issue of burnout and the drivers of clinician dissatisfaction, Torres’ casual sexism did more to illustrate why so many health care providers — particularly women — feel isolated to the point of depression and suicide. Sexism, power, and a culture of silence is precisely part of the problem. Unbeknownst to him, Torres had hit the nail on the head with his comment.

Later, we raised our concern privately in a phone conversation with Torres, who welcomed what could have been a hostile exchange with both humility and interest. And as we spoke about his time in the media, military, and health care, and how those male-dominated cultures affected him, we also spoke about his daughter, now a medical school student, and how a culture of misogyny in medicine affects her. It was the conversation we should have had in Aspen — that we all need to have when confronted with sexism.

A landmark report published this month by the National Academies of Sciences, Engineering, and Medicine paints a damning picture of sexual harassment faced by women physician trainees and faculty. The 300-page report reveals that the academic workplace has the second-highest rate of sexual harassment (58 percent) when compared with private sector and other workplace environments.

Of the many disturbing quotes from respondents to the National Academies survey, several underscored the systemic and perpetuating nature of the issue, like this one by a young resident: “I still don’t think that the prospect of being sexually assaulted was as bad as watching the next generation of sexual harassers being formed. I think that was the worst part for me.”

In addition to their exposure to sexually harassing behavior as a training and occupational hazard, according to a Medscape report, female physicians have significantly lower wages than their male counterparts. Equally staggering is the minuscule percentage of women who have advanced to leadership positions within medicine compared to men. Similar discrepancies affect people of color and LGBTQ communities. So it seems that even in a field such as health care, which prides itself on evidence, science, and progress, we still miss the mark when it comes to gender issues, cultural diversity, and human equity.

As women, people of color, and members of the LGBTQ community, we’ve learned to silently swallow micro- and macro-aggressions in professional areas dominated by straight, cisgender, white men. We’ve done this despite being aware that for all of these groups, discrimination in the workplace still afflicts approximately 40 percent of individuals. We bite our tongues — not only because we know that a flash of passionate conflict could jeopardize our physical and emotional safety and our professional reputations, but at the end of the day it just feels futile when our calls for action are ignored, buried, or dismissed.

With the fear of being labeled as the woman, the minority, or the gay clinician, we “take the high road” by staying silent and pretending we don’t internalize it. As noted by an assistant professor of medicine in the National Academies report, we don’t want to be “labeled as the troublemaker.”

After the burnout session at the Aspen Ideas Festival, a few folks in the crowd approached us to apologize for their silence. We, too, apologized. The collective silence had hurt us all.

During the closing ceremony, a moderator again brought gender into the dialogue in his interview with Sen. Cory Booker. We had spent the prior 30 minutes listening to filmmaker Ava DuVernay and activist Ai-jen Poo celebrate the powerful role of women as catalysts for social change. After a question about Booker’s opinion of White House press secretary Sarah Huckabee Sanders, the moderator quipped that perhaps Sanders had “a crush” on Booker.

Again, we all laughed. No one seemed to bat an eye at the inappropriateness of the remark.

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Make no mistake about the antagonist here. This isn’t the fault of a host or a white man or a conference. Indeed, we’d be well-served with more Aspen Ideas Festivals.

But these remarks and microaggressions are proxy measures of the power and discriminatory culture permeating personal and professional spaces. What we need is for people to listen, to initiate conversations, to be OK with discomfort, to be honest when they mess up, and to challenge each other to do better and do differently.

At the Aspen Ideas Festival, we didn’t quite get there.

We did, however, learn something about ourselves that we hope we all take home.

To the physician who raised your hand during our session on burnout, we apologize for our silence and thank you for your contributions to the field of medicine. And to Dr. Torres, thank you for your willingness to engage with us as we developed this article. We’re all in this space together, and grateful that when mistakes are made, we have an opportunity to learn from and with each other.

Together, let’s break some more glass ceilings — and break the silence.

Elizabeth Métraux is director of external affairs for Primary Care Progress. Nicolas Nguyen, M.D., is director of physician experience at Beth Israel Deaconess Health Care. Kelsey Priest is a fifth year M.D./Ph.D. student at Oregon Health and Science University.

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  • Good Morning Casey,
    Sorry, but you are associating a comment about attractiveness with sexual harassment; this is a dramatic overstatement. As a scientist, you might want to measure the thickness of your Epidermis…

  • Most of the women if not all behind #Me to movement would like to be called attractive, good looking women. It has nothing to do with harassment!!!!

  • Holy s—, imagine going through life and dwelling over the smallest, most insignificant things. When you attempt to ascribe motivation to actions that may have none, it is very difficult to not see every action as racist, sexist, ageist, etc. Live and let live.

  • I was as insensitive as any man about this until marrying a strong and beautiful woman who helped me understand why comments that she “was as smart as she was pretty” were belittling. Men have chosen not to see the sexism in focusing on women’s appearance, instead of their abilities. Comments below, trying to shame women into accepting an objectified view of themselves are misguided and offensive.

    • It’s good your wife cured you of your bad habit. Alas, you now have the reform bug. I was a member of the National Organization for women in 1977 when you were doing what?

      Have you enlightened your wife about the much higher suicide rates of men, the fact that almost exclusively men have been killed as soldiers, or that almost all job-related fatalities are male? Your virtue signaling is admirable, but I know of no evidence that high-achieving women are less appearance-conscious than other woman. Men who encounter obstacles are expected to overcome them; while women are now supposed to clutch pearls. It is your comment that shames women, not others in this discussion. Your view of women is Victorian.

      About 15 years ago I received an endoscopy in Puerto Rico administered by a female doctor whose skirt was, generously estimated, micro. She apparently didn’t think that it harmed her career (working in a prominent group practice), or shamed her. Nor did she apparently feel the need to minimize her femininity to effectively practice medicine. Shame on her!

    • You are an “MD”? And you think an endoscopy is rectal?

      The only Dr. Ronald Cann I find via Google is a psychiatrist. That could explain your confusion about a common medical procedure. No profession has done more harm to women over recent centuries than psychiatry. It has been the source of savagely appalling sexism.

    • You looked me up? I’m flattered. Yes, I couldn’t help but resort to that old joke: “ Your proctologist called, they found your head!” Don’t really understand why you don’t want to acknowledge that comments about women’s physical appearance are significantly different than acknowledging their abilities. And in reality, I haven’t been practicing for the past century. Freud never asked me about his theories of infant sexuality.

    • Another old joke: The neurotic builds castles in the air. The psychotic lives in them. And the psychiatrist collects the rent.

      Your deflection of the fact that you didn’t know what an endoscopy is was quite deft, doctor.

      I’ve said twice that I didn’t think the comment was appropriate in a professional setting, but that is a trivial matter.

      It’s unfortunate that you have not chosen to read extensively about the brutal history of psychiatry — and especially about its mistreatment of women. Instead you choose to make a joke about it. How inappropriate.

  • The main point of the article is the following. A woman’s looks should not be commented on in a highly professional setting such as a conference panel discussion. It’s demeaning and detracts from the conversation. If you disagree then you most likely have not had it happen to you before.

    • It wasn’t appropriate; but it isn’t an indicator of discrimination against women in science. All people overcome obstacles to reach their goals, and men have plenty of obstacles that are not chic to discuss.

      In my 30s I was employed by a married female PHD geneticist who had left UCLA to become an entrepreneur. We spoke freely on many issues and disagreed often and cordially, if firmly. One evening she hosted a party at her house and naturally had a few drinks. When she encountered me alone she told me, “I find it sexually stimulating when you argue with me.” I was neither flattered nor offended; I was indifferent, though I’m sure it impacted my work environment in both positive and negative ways. That men are less likely to trip over little problems is an advantage: nature or nurture?

  • Have we reached the point where “Me too” is simply another form of mindless political correctness? Have we reached the point where political correctness does not allow us to say complimentary things to one another?
    What are we doing with our language, and our minds?

    • Too late. Grievance feminism controls the hearts and minds of the intelligentsia. We are directed to be outraged that a woman is called attractive, but not that all of the top 20 most lethal occupations have death rates over 85 percent male. Men are life unworthy of life.

    • We’ve reached the point where men who obstinately refuse to stop being apologists for and enablers of a toxic chauvinist “Mad Men” culture, which should have died out decades ago, need to catch up to some basic facts. Sexual harassment is never complimentary. Ever. If you cannot communicate with a woman – whether she is a stranger, a colleague, a friend, or a family member – without bringing up her looks or speaking about her in sexual or romantic terms, then it’s time for you to grow up and expand your mind…and possibly refrain from speaking to women for more than five seconds at a time until you’ve achieved the former. You might then learn that women overwhelmingly prefer not to be spoken to or spoken about by men in such demeaning, dehumanizing ways. It’s quite easy for most women to keep their sexual thoughts to themselves. How baffling that so many men find it difficult.

    • Casey, why have we not reached the point when women are willing to do their “fair share” of the dirty and dangerous jobs that men do to keep the country moving? By almost any measure, from suicide to job-related deaths, life is worse for men in Western countries than for women. Men do not gripe about being the victims of over 90 percent of workplace deaths, but women gripe about being called attractive.

      For years now, a substantial majority of college students have been female in the US. Females are obtaining more undergrad and advanced degrees than men. (Granted, they still tend toward majors that lead to lower paying or no degree-related jobs.) The idea that present day females are victims is belied by the pettiness of their complaints.

  • I agree with my fellow panelists about this incident and indeed i was quite uncomfortable when I heard the comment. I am so glad that Elizabeth, Nic and Kelsey followed up. Ironically Paula Johnson and I discussed the National Academies’ report on Sexual Harrasmnet at an earlier panel at the Aspen event. Together, all of us must do all we can to change the culture and climate especially in the medical profession. Thank you Elizabeth, Kelsey and Nic.

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