A medical visitor from another part of the world asks me recently, have I encountered much misogyny in my twenty years of working with doctors. 

Images immediately crowd my mind. Men in suits, ignoring me. A meeting room. Late night calls. Being screamed at down the phone. 

I am not a clinician but am an equally highly qualified professional. I have spent as long as most doctors in developing my skills, knowledge and acquiring  many qualifications. My role is an integral one in developing and sustaining medical education and practice. The question is pertinent – it comes the week that a report finds misogyny is endemic  at the British Medical Association. I am sure that other medical organisations, such as Royal Colleges, are suffering from ‘there but for the grace of god’ relief that they were not similarly exposed. 

It was a difficult question to answer. 

Yes and no, I say.

It depends how you define misogyny. 

Yes as a woman of thirty years professional working, I have had a number of sexist comments, the odd shoulder pat, and twice overt physical intimidation, but they bothered me less, as they were easy to call out and prevent from occurring again. Overt small boy behaviour is  easy to deal with – a ticking off in a public place was all they took. 

But what about the deeper, more insidious levels of sexism?

In my twenties I was expected to go out to dinner four times a month with a group of ten surgeons, a role thrust on me that was a combination of geisha girl and academic hostess. After a long day at work it was taxing; increasingly I became uncomfortable with being the only other woman, and the lewd jokes around the table. I put my foot down and stopped going. 

One project I worked on involved teaching a new group of 10 to 15 consultant surgeons, two to three days a week in a range of different hospitals around the country. It was a mandatory programme and their motivation for attending was varied to say the least. As they came into the room, I would greet them, shake hands and welcome them. Most of them thought I was the course organiser, the person from whom they had received information about the venue. At first I tried to disabuse them of that, but eventually learned that it could work in my favour. So whilst I would still introduce myself I would also perhaps pour some coffee, ask about their journey, where they worked, and then if I knew the department, ask after one of their colleagues. By the time we came to start the course, I had some prior albeit not classified information about them and had broken the invisible barrier between us. I could make reference to their department or colleague, demonstrating that contrary to their unconscious biases, I was part of their world. 

But there’s worse than that, I tell my visitor. I could cope with that, although it was a little annoying – I never really knew if I was initially dismissed on those occasions because I was female or because I was non clinical.  In a world of predominantly men, back then, in surgical specialties, I was the minority in the room. 

What is worse, I say, is being subjected to  institutional misogyny – being treated differently by organisations because of my gender. Perhaps the worst example of that was when two senior colleagues invited me to a meeting, due to my  email communications about a lack of support and resourcing for a large, profit making project I was heading. They were afraid I was burning out. How many male colleagues have been summoned to a meeting having asked for better support for a high profile project, only to be asked if they are burning out? 

But worse even than that, the worst misogyny I have suffered was female enacted. I don’t know if we have a word for females using sexist discrimination, intimidation and fear to achieve power over other female colleagues, but until we do, I can only refer to it as female enacted misogyny (FEM.) A quick look on the internet and I see that the term “internalised misogyny” may relate to my experiences. Internalised misogyny – or internalised sexism, is when an individual enacts sexist actions and attitudes towards themselves and people of their own sex. On a larger scale, internalised sexism falls under the broader topic of internalised oppression, which “consists of oppressive practices that continue to make the rounds even when members of the oppressor group are not present” (Bearman et al, 2009).  Women who behave in this misogynistic way are women who have  experienced and  internalised misogyny themselves and  may express it through minimising the value of women, mistrusting women, and believing gender bias in favour of men according to Szymanski et al (2009).   

My female oppressors were  products of a deeply male dominated culture all their working lives, and have learned to play highly manipulative games, just to compete. But as neither a competitor nor a man, I struggled to see why I was such a threat. By then, I suspect the culture of “them and us” was so ingrained it would have been very difficult for them to stop it. I have had more than one female enacted misogynistic oppressor, all high flyers, all long time NHS clinicians, and I can only assume that it is learned behaviour. The higher they go professionally, the worse the FEM seems to be. 

Is it due to the historic patriarchy in medicine? I don’t know. 

Have I encountered hatred, contempt, exclusion, hostility and  discrimination at work? 

Yes, a little. But sadly far more of it was from other female colleagues than from males. 

And I have no real idea why. 

Bearman, Steve, Neill Korobov, and Avril Thorne. “The fabric of internalized sexism.” Journal of Integrated Social Sciences 1, no. 1 (2009): 10-47.

Szymanski, Gupta, and Carr. 2009. “Internalized Misogyny as a Moderator of the Link between Sexist Events and Women’s Psychological Distress.” Sex Roles 16, no. 1-2: 101–109.