Gender harassment happens every day in health care organizations, academic medicine, research labs, and other corners of the science, technology, engineering, and math worlds. It’s largely hidden — except to those experiencing it — unlike its more egregious counterpart, sexual harassment, which often makes headlines.
The National Academies of Sciences, Engineering, and Medicine (NASEM) describe gender harassment as “verbal and nonverbal behaviors that convey hostility, objectification, exclusion, or second-class status.” It undermines women, exhausts and demoralizes them, and strips them of their motivation, eventually driving them out of the workforce.
As women physicians working in academic medicine, we know this firsthand.
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With five of our colleagues, we filed a federal lawsuit in 2019 alleging sex, age, and race discrimination by Mount Sinai Health System and four of its male employees, including the dean of the medical school. (Editor’s note: All the documents are public, and the defendants have denied any wrongdoing.)
As our complaint details, we left Mount Sinai emotionally and psychologically scarred after being demeaned by male leadership, denied promotions, underpaid compared to male colleagues, and systematically gaslit by internal reporting structures that were meant to protect us. We were demoted from leadership positions and assigned menial tasks, such as managing a Mailchimp subscription list. Some of us were ignored and frozen out of important work streams, and were forbidden to meet alone with longtime colleagues and mentors. Members of our group were referred to as “bitches” and “cunts” by our colleagues without any repercussions. Those are just a few of the forms of mistreatment we endured at Mount Sinai’s Arnhold Institute for Global Health.
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We believed that our hard work and years of service to the institution would protect us and allow us to be measured on our merits. Instead we struck the “iceberg of sexual harassment,” and it sank our careers.
A 2018 NASEM report on sexual harassment in academic sciences, engineering, and medicine introduced the analogy of an iceberg to describe harassment in these fields. Sexual assault and coercion are the visible and appalling tip of the iceberg. People recognize their severity and the personal damage they wreak, the media often cover these stories, and perpetrators are sometimes held accountable. Gender harassment, in contrast is the huge mass below the surface, largely unseen but nonetheless ruinous.
Women in health care rarely report harassment due to the risk of retaliation. Compounding this, the internal systems that should assist employees all too often make protecting perpetrators and institutional reputations their top priority. Our meetings with Mount Sinai human resources representatives were humiliating and degrading, providing neither safety nor protection, as we recount in our complaint. In one meeting, they referred to a book on “why women think they are being discriminated against when they are not.” Because of these systemic failures, the legal route was our only resort.
Since filing our lawsuit, we are seeing the enormity of the iceberg. Scores of doctors, nurses, staff, and medical students from Mount Sinai and other medical institutions in New York City and across the country have shared their experiences with us. We’ve heard of gaps in pay, lack of promotion, stolen ideas, retaliation for challenging male colleagues, sexualization of learning materials, sexual assault — the list goes on. A common thread is fear of retaliation, which is keeping women silent.
Sexual harassment is pervasive in health care, and gender harassment is the most common type of harassing behavior. It predominantly affects women, with women of color and gender minorities at particular risk. A 2016 study of academic medical faculty reported that 66{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} of women had experienced gender bias during their careers, and NASEM reported that up to 50{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} of female students surveyed during medical school had experienced sexual harassment by faculty or staff.
Mount Sinai’s own data reflect this nationwide problem. In a 2019 survey of its faculty, 25{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} of responding female faculty reported gender-related discrimination and 13{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} reported sexual harassment in the previous 12 months alone — data that, as detailed in our proposed second amended complaint, leadership scrubbed from the initial report that was released to faculty across the institution.
There are some signs of progress across the country. Time’s Up Healthcare, a nonprofit organization, has recruited 62 health care institutions nationwide so far to commit to core principles for equitable and safe workplaces. But signing a pledge is not the same as doing the work. Mount Sinai, which signed on four months after our lawsuit was filed, committed to “preventing sexual harassment and gender inequity and protecting and aiding those who are targets of harassment and discrimination.” Meanwhile, our experiences were being trivialized and discounted while the defendants in the case were allowed to remain in positions of power as the hospital continues to fight us in court. Today, seven of the eight plaintiffs have left the Arnhold Institute, most with careers derailed, while senior leadership publicly stated that our claims are without merit and that Mount Sinai will “vigorously” defend against them.
According to the NASEM report, “an organizational climate that communicates tolerance of sexual harassment” by “failing to take complaints seriously or to sanction perpetrators” is the greatest predictor for high rates of sexual harassment.
Supreme Court Justice Ruth Bader Ginsburg, whose loss we mourn, wrote in 2016 that, despite many advancements, “we have yet to devise effective ways to ward off sexual harassment at work and domestic violence in our homes.”
It is long past time to hold institutions accountable for their actions — or their lack of action. Foundational steps include creating mechanisms for confidential third-party reporting for people experiencing sexual and gender harassment, robust independent data collection on the incidence of harassment, and public reporting of the results.
Mapping out the base of the harassment iceberg may help fewer women be sunk by it. It will also help institutions recognize how big the iceberg really is.
More women in leadership positions will help propel that cultural shift. So will protecting women who speak out about gender harassment. And institutions need to be convinced that it is more expensive to harbor harassers than to change.
Change won’t be easy. It will take numerous strategies, including authentic discussion, public exposure, and, when necessary, using the law Justice Ginsburg did so much to advance.
Holly G. Atkinson is a clinical professor and medical student advisor at CUNY School of Medicine. Anu Anandaraja is a pediatrician, global public health educator, and founding director of Women Together Global Inc. Stella Safo is an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai and a strategic advisor at Premier Inc.
