Women’s professional groups must include all women and forgo the family planning pitfall
Co-written by Britt D.K. Gratreak and Alicia Sandoval
Published on Medium
Reproductive organs: regardless of whether someone has them or wants to use them, they should feel welcome in women’s professional groups. (Image by Alicia Sandoval)
Equity cannot be achieved until we support the inclusion of all women and gender minorities.
Many organizations devoted to furthering women in science and medicine were created to address challenges that women face in these fields and to otherwise support their members at local and national levels. These organizations are certainly improving equity on many fronts: they confront gender bias and sexual harassment, create leadership opportunities, and actively empower their members to advocate for their best interests. Although these intentions are both necessary and inspirational, an extraordinary proportion of events and lectures by these groups commonly focus on one topic more than others — childbearing. It is no surprise that not all women feel welcome in these spaces, despite the fact that these organizations focus on promoting their success, because some women cannot or choose not to have children.
Traditionally, women are expected to contribute far more time and energy to caring for their families and this disparity is complicated by the fact that residency programs don’t have a uniform parental leave policy. Indeed, studies have shown that general surgery program directors tend to perceive female residents as having worsened productivity compared to male residents after becoming a parent. Parenthood is a consistent part of complex sexism faced as a woman, but there are many other issues at play that we need to focus on, too. While female-identifying applicants now make up 51% of incoming MD and 44% of incoming DO medical students, only 36% of practicing physicians (MDs and DOs) are female. There are many reasons why women are leaving academic medicine that include a lack of work-life balance related to family planning, but also includes being perceived as less competent than male colleagues, a lack of mentorship, and hostile work cultures unrelated to parenthood. This is a reality intensified for women of color who face an onslaught of racism, empty diversity efforts, and exclusion in addition to complete lack of support starting early on in their medical education.
Is womanhood still inherently defined by reproduction, even among women fighting for equity?
Many professional organizations offer Q&A style panels that help students and early career professionals direct their efforts and get the most out of their education. Across institutions, professionals on these interactive panels inevitably answer questions about work-life balance. Almost without fail, the conversation then leads to having children, family planning, and finding a husband while in the throes of medical school or graduate school. While these conversations are useful for many, they can be awkward and excessive to some. For women who prefer women, women who have no interest in having children, and women who do not have child-bearing reproductive organs, the conversation that follows can be isolating if it consumes the rest of the conversation. While this conversation should happen, if it is too drawn-out it prevents other topics from being discussed. What about balancing hobbies, advocacy, or creative projects? How about negotiating contracts after a job offer? How do successful women navigate service opportunity offers that they are expected to pursue on the sole basis of their gender without professional compensation? How should we deal with racial bias as recipients and allies? Is womanhood still inherently defined by reproduction, even among women fighting for equity?
Focusing primarily on family planning at these events makes a portion of women invisible. It is often presented as the highest priority barrier faced by women, making it seem as though it is expected to be faced by every woman. Society by default already identifies women as the primary source of care within family structures and judges women harshly for focusing on anything but motherhood. Systemically, medicine perpetuates a culture in which women face many barriers in even having a choice about their own reproductive health as patients. This stereotype does not need to be further emboldened by professional groups, especially when doing so runs the risk of alienating women from participating and steering them away from abundant resources of invaluable networking and career-building lessons that cannot be found elsewhere. It is important to keep in mind that our fight for gender equity and justice includes fighting for non-binary people, who are commonly excluded from gender bias and harassment study categories, and whose experiences are often left by the wayside in these organizations.
Despite evolving modern understanding of women’s place in the workforce and in the medical specialties they choose, women’s associations still seem to default to traditional ideas regarding the role of women in relation to their family and direct a significant amount of resources and focus on how to reconcile the two. While parenthood is an important topic to many women that are engaged with these events and organizations, it should not be the only focus of the conversation because students and trainees need advice on all fronts.
Leaders in fervent, well-intentioned organizations such as the American Women’s Medical Association (AMWA), Association of Women Surgeons (AWS), and Association for Women in Science (AWIS) can stop perpetuating this disparity by taking a few direct, simple steps to include all women.
We must frame the topic of parenthood as a possible aspect of being a woman, rather than the default reality expected of anyone identifying as one.
Leaders in these organizations should be aware of women they may be ostracizing in their audience and among their membership. These organizations can make an effort to ensure that family planning does not become the central theme of their events (unless of course it is explicitly stated as the focus of the event). When work-life balance questions are raised, the conversation should be redirected after some time to allow some answers related to aspects of professional life beyond motherhood. We must frame the topic of parenthood as a possible aspect of being a woman, rather than the default reality expected of anyone identifying as one. During women in medicine or women in science panels, moderators should allocate an equal amount of time to discussing multiple topics including family planning, advocacy, and professional identity to accomplish this end.
These are simple ways to honor both women who are interested in having children and those who are not by mindfully creating more balanced events and redirecting conversations to be more inclusive. In our endeavors to make space for women and gender minorities in historically hostile environments, we must not forget that we are making space for all women — not only those who represent traditional understandings of femininity.
This article was co-written by Britt D.K. Gratreak and Alicia R. Sandoval who are first-year M.D. students at the University of Arizona College of Medicine — Tucson.
REFERENCES & STORIES CITED
Murphy, B. (2019, April 22). Family time: How much parental leave do medical residents get? American Medical Association. https://www.ama-assn.org/residents-students/resident-student-health/family-time-how-much-parental-leave-do-medical-residents.
Sandler, B.J., Tackett, J.J., Longo, W.E., & Yoo, P.S. (2016). Pregnancy and parenthood among surgery residents: results of the first nationwide survey of general surgery residency program directors. Journal of the American College of Surgeons, 222(6), 1090–1096. https://doi.org/10.1016/j.jamcollsurg.2015.12.004
Humphries, L.S., Lyon,S., Garza, R., Butz, D.R., Lemelman, B., & Park, J.E. (2017). Parental leave policies in graduate medical education: a systematic review. The American Journal of Surgery, 214(4), 634–639. https://doi.org/10.1016/j.amjsurg.2017.06.023
Heiser, S. (2019, December 9). The majority of U.S. medical students are women, new data show. Association of American Medical Colleges. https://www.aamc.org/news-insights/press-releases/majority-us-medical-students-are-women-new-data-show
Kaiser Family Foundation. (2018). Distribution of osteopathic medical school graduates by gender. https://www.kff.org/other/state-indicator/distribution-of-osteopathic-medical-school-graduates/
Kaiser Family Foundation. (2019, March). Professionally active physicians by gender. https://www.kff.org/other/state-indicator/distribution-of-osteopathic-medical-school-graduates/
Levine, R.B., Lin, F., Kern, D.E., Wright, S.M., & Carrese, J. (2011). Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution. Academic Medicine, 86(6), 752–758. https://www.ncbi.nlm.nih.gov/pubmed/21512363
Blackstock, U. (2020, January 16). Why Black doctors like me are leaving faculty positions in academic medical centers. STAT. https://www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/
Misra, J., Lundquist, J.H., Holmes, E., & Agiomavritis, S. (2011, January-February). The ivory ceiling of service work. American Association of University Professors. https://www.aaup.org/article/ivory-ceiling-service-work
Weissman, A. (2017, November 30). How doctors fail women who don’t want children. The New York Times. https://www.nytimes.com/2017/11/30/sunday-review/women-sterilization-children-doctors.html