Still far from equal: reflections on Women’s inequality in America – Dr. Nasim Ahmadiyeh M.D., Ph.D
She was only five, but she spoke in a metered and matter-of-fact tone, stating plainly that she no longer wanted to play with boys because she had observed that boys on the playground were rough and used harsh words and tone. Bias or astute observation? By age six, she shared that it appeared that girls were valued less than boys by society, and by age seven she proclaims she would like to move to a country with a female leader because she feels life during a pandemic would be better there, as women make better leaders. You might think my daughter was fed these thoughts, that I sit to brainwash my child, or get into lengthy political commentary with her – but I don’t – I truly don’t, although I have lied to her on one occasion, but more on that later. The scientist in me was fascinated that to a young child growing up in the Midwestern United States, gendered stereotypes and the implications of gender inequalities were already clear and causing concern.
We know that children learn in the context of communities and that socialization plays an important role in learning how to be a human being. Since socialization is the very process by which children are integrated into the norms of society, what is the environmental milieu into which children today in the United States are being raised and what is the scene playing out before them?
Studies have shown repeatedly that teachers engage boys and girls differently in the classroom in ways that are detrimental to both girls’ and boys’ full intellectual and social development (1). Did you know that girls score as well as boys in math in middle and high school, and women earn not only more bachelor’s degrees but also more doctoral degrees than men in the United States (2)? Despite this, a recent study published in March of this year in Proceedings from the National Academy of Sciences which examined change in multiple indicators of gender inequality from 1970-2018 concluded that the progress women have made in this country in relation to education and integration into society has slowed and stalled (3). Specifically, with regard to entering fields of study that have traditionally been male-dominated or ‘segregated’, we have made no progress toward integration for over 20 years and in fact have slightly moved toward more segregation, and with regard to integration into traditional male-dominated fields of employment, progress has significantly slowed (3).
This problem is compounded when we look at women in academics – the training ground for the next generation – because women are less likely to go into male-dominated fields without female mentors (4). In 2017, 23% of doctoral degrees in engineering in the United States were earned by women but only 11% of full professors in engineering departments were women. Interestingly, in Canada 55% of doctoral degrees in engineering were earned by women that same year, but still only 11% of full professors in engineering were women (5). In general surgery, 40% of residents (trainees) are women but only 8% of full professors in academic surgery departments are women. At the current rate of progress, it is projected that academic surgery may achieve gender parity by 2096 (6). This is made all the more thorny by a large study showing that patients operated on by female surgeons actually had lower postoperative mortality than those operated on by male surgeons (7), which few seem to want to talk about (though you can imagine the attention the study would have garnered if the opposite were found). A previous study had also shown that female internal medicine physicians had better outcomes than men (8). We should care that women are more equally represented in all fields of study and work, because it is not only women who lose out when fields are segregated, but all of humanity loses the chance to benefit from their contributions.
Another trend worth mentioning – not lost on women living this reality – is that as women have been increasingly pursuing higher education and entering the workforce in greater numbers, there has not been a reciprocal increase in the contributions of men at home (3). Both within the context of the family and the contexts of school and work, then, boys and girls, men and women, are surrounded by and immersed in a normative culture of inequality. Coupled with the gender biases prevalent in children’s literature, textbooks, and media, it becomes quite challenging not to be influenced by, operate by, or perpetuate gender-stereotyped norms. Normalized oppression is the most dangerous kind of oppression, for it tends to evoke acceptance by all involved instead of an imperative for change. Gender inequality has been norm for so long – just how things have been – that it is sometimes hard to even see its dynamics at play.
Indeed, many in our society see nothing wrong with the lack of representation of women in all fields of society, and in fact blame the destabilization of family life on the advancement of women, rather than work toward increasing men’s contribution to a thriving and successful family life. But ensuring that women participate fully and equally in all aspects of the life of society – in all fields – is actually a matter of justice. And justice is impossible without universal participation. A just society, then, necessitates the full participation of women in all fields, and would imply that it also requires the full participation of men in all facets of society including the family and community.
For my part, I have tried to counteract the inevitable effect that I predict society’s biases against women will have on my daughter by overcompensating in her earliest years. My daughter’s only pediatricians and dentists have intentionally been women. I have gone out of my way to introduce my female friends who are physicians to her, so that until very recently my daughter thought that all doctors were women and still refers to doctors as “she”. In a drastic attempt at infusing her young mind with possibility, from the time she was about 18 months old and throughout her childhood, when we would take flights and the flight attendant’s voice would direct us to fasten our seatbelts or prepare for landing, I would tell her that it was the pilot speaking. (Did you know that 95% of pilots are men!) I figured I had a few tender years with which to surround her in a world where women were all around and could do everything, where there were no barriers, before the world would set her straight.
But are we captive to this cycle of the adoption and perpetuation of biases against women’s full equality? Is there a way to fast-track and break free of these assumptions and act in accordance with insight as opposed to mere imitation of the past? What would it take to fundamentally change our perceptions and actions, our structures, policies, and patterns of life to more easily allow for the full participation of women and men in all facets of society? If we seek a just society, where all can thrive, we might start with checking our own biases almost continuously and commit ourselves to change. We don’t even need to leave our homes to start.
References:
https://www2.ed.gov/about/offices/list/ocr/docs/gender-equity-in-education.pdf
Paula England, Andrew Levine, and Emma Mishel. Progress toward gender equality in the United States has slowed and stalled. Proceedings of the National Academy of Sciences March 2020, 117(13): 6990-6997
Leigh Neumayer, Susan Kaiser, Kimberly Anderson, et.al. Perceptions of women medical students and their influence on career choice. The American Journal of Surgery 183(2): 146-150.
Elizabeth Stephens, Christine Heisler, Sarah Temkin, et. al. The current status of women in surgery: How to affect the future. JAMA Surgery 2020; 155(9): 876-885.
Christopher Wallis, Bheeshma Ravi, Natalie Coburn et. al. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ 2017; 359:j4366
Yusuke Tsugawa, Anupam Jena, Jose Figueroa, et. al. Comparison of hospital mortality and readmission rates for medicare patients treated by male vs female physicians. JAMA Internal Medicine 2017; 177(2): 206-213.
About the Author
Nasim Ahmadiyeh M.D., Ph.D. is assistant professor of surgery at University of Missouri-Kansas City School of Medicine, breast surgical oncologist and Medical Director of the Comprehensive Breast Care Program at Truman Medical Centers, the primary safety-net/essential hospital in the Kansas City, Missouri, metro area. Her recent research focuses on cancer health disparities among the safety-net population.