K. L. Barnes1, L. McGuire3, G. Dunivan1, A. Sussman4, R. McKee2 1University Of New Mexico HSC,FPMRS/Obstetrics And Gynecology,Albuquerque, NM, USA 2University Of New Mexico HSC,Colorectal Surgery/General Surgery,Albuquerque, NM, USA 3University Of New Mexico HSC,School Of Medicine,Albuquerque, NM, USA 4University Of New Mexico HSC,Family And Community Medicine,Albuquerque, NM, USA
Introduction: The number of female surgeons continues to rise, however reports of sexism and stigmatization in the clinical setting continue. Although, overt sexism is becoming increasingly rare, underlying prejudices held against women are frequently expressed as microaggressions- subtle discriminatory or insulting actions that communicate demeaning or hostile messages at the interpersonal level. We sought to assess the frequency and severity of gender-based microaggressions experienced by female surgeons.
Methods: This mixed methods approach utilized both focus groups and questionnaires to explore female surgeons’ experiences of gender bias in the form of microaggressions. The Sexist Microaggression Experiences and Stress Scale (Sexist MESS), a validated, 44-item questionnaire, was used to quantify the frequency and psychologic impact of gender-based microaggressions. This questionnaire consists of six domains, with higher scores indicating more frequent or severe microaggression impact. We conducted focus groups with female surgeons to explore their unique experiences of workplace gender bias and developed 15 additional questions. These questions were added to the survey and sent to all female resident, fellow and attending surgeons at a single academic institution.
Results: Four focus groups including 23 female trainee and attending surgeons were conducted revealing four emerging themes: Exclusion, Adaptation, Increased Effort, and Resilience. The survey response rate was 64.3% (65/101 surgeons). Survey data showed that the frequency and severity of microaggressions was higher in 5 of 6 domains for trainees compared to attending surgeons (Table 1), with the exception of “Inferiority”. When Obstetrician Gynecologists (OB/GYN) were compared to all other surgeons, rates of reported microaggressions were similar in all domains except “Leaving Gender at the Door”. Non-OB/GYN surgeons reported more pressure to downplay, hide or avoid characteristics and behaviors associated with femininity in order to succeed. The variables of non-white race, currently providing childcare, and number of years in practice after training did not demonstrate statistical significance.
Conclusion: The extent and psychological impact of microaggressions experienced by female surgeons varies based on level of training, with higher rates reported by trainees compared to attending surgeons. The type of surgical specialty practiced made little difference, with OB/GYN and non-OB/GYN surgeons describing similar experiences. Higher frequency and severity scores for the domain “Leaving Gender at the Door” reported by non-OB/GYN surgeons may be explained by the lower proportion of women in these fields compared to OB/GYN.
