Women in oncology are held to different standards than men and face gender-based harassment and a series of unconscious biases that affect how they are perceived and how they perceive themselves.
However, these adversities can be overcome with mentorship and support, and by open discussion in a workplace culture that allows people to speak out.
These were the messages from a session on “Women in Oncology” held recently during the virtual World Congress on Gastrointestinal Cancer.
The session was chaired by Erika Ruiz-Garcia, MD, chief of the Translational Medicine Laboratory, alchohol and caffeine on atkins diet Instituto Nacional de Cancerologia, Mexico City, Mexico.
Are achievements of female oncologists “evaluated with the same parameters as those applied to men?” she asked the panel of speakers.
The parameters used to measure success are both “subjective and objective,” argued Sharlene Gill, MD, professor of medicine at the BC Cancer Agency, University of British Columbia, Vancouver, Canada.
She does not believe that there is a “gender differential in the objective expectations,” but she pointed out that the reality is that women do not achieve professorships or podium presentations in proportion to their numbers within the profession.
Support and mentorship are crucial, she said, acknowledging how much it helped her with her career, as it allowed her to “not limit my expectations of myself.”
Advice to Young Women
Gill also commented that in conversations with young women in her training program, she has found “oftentimes women are very thoughtful about family and expectations and sometimes don’t allow themselves to ‘lean in’ to career ambition.”
“We need to allow ourselves to think that we can do all of these things,” she said.
Another speaker agreed. Georgia Demetriou, MD, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa, said her advice to younger female colleagues is that they should “make peace” with the guilt of not being able to “give 100%” at home.
“Once you realize you cannot be all things to all people, you will be all things to yourself,” she commented.
“At that point, you will do the best you can in every sphere,” she added. “You don’t have to be perfect…you just have to strive for excellence.”
Demetriou talked about her experiences of “gender-related adversity.”
Such adversity is “sometimes very subtle,” and women are not necessarily always aware of it “until you take a step back and realize you’ve been held up to a different standard [to] your male colleagues.”
She underlined that there are “unconscious” biases that women experience in their “everyday work life.”
This can be when “a woman who is maybe a little bit more assertive, maybe who puts herself out there in terms of career goals, is seen as pushy as opposed to just ambitious.”
“It’s those preordained kind of biases that we have in our culture and our community that put the adversity” in the way, Demetriou continued.
“We are expected to have different characteristics, maybe to be a little bit softer, a little bit more empathetic,” she added.
“That does bring something to patient care in the clinic but when it comes to leadership and managerial positions, being a little bit more aggressive, as it would be perceived, is not seen as a leadership quality [in women], but is rather frowned upon,” she said.
Demetriou believes that it is certain “adjectives” — used by both men and women to define a woman — that are “in a sense what does us a disservice.”
Workplace Sexual Harassment
Workplace sexual harassment was discussed at the meeting by Deborah Mukherji, MD, associate professor of clinical medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Mukherji said harassment is “universal” and, referring to the #MeToo movement, added that it “has been drawn into very sharp focus recently.”
“In all aspects of professional life, there are many incidents that go unnoted, with women particularly being very concerned about speaking out,” she said.
These incidents range from micro-aggressions, through macro-aggressions, to “incidents of frank sexual harassment.”
To deal with these disrespectful incidents will require a cultural shift, she said.
“We need to educate our colleagues and our trainees to speak out when they feel uncomfortable,” Mukherji said, and be safe in the knowledge that there will be “no comeback…no adverse effect of speaking out.”
Gill added said that talking about harassment is “timely,” as a survey presented at ASCO 2021 revealed that gender harassment during the last year was reported by 79% of women and 55% of men working in oncology.
She agreed that “we need to create a culture in which people feel that they can work free of sexual harassment and feel comfortable calling out that behavior,” whether or not they are the victim.
This again emphasizes the importance of support and mentorship, said Pia Österlund, MD, PhD, a consultant in the Department of Oncology, Tampere University Hospital, Tampere, Finland.
Beyond harassment, appropriate mentorship could help ensure that women have the “same outcome” from performing the same tasks as men, and receive the “same salary, which is not the case in any country in the world.”
“We need to take more responsibility,” as female leaders in oncology, Österlund said, emphasizing the need to help junior colleagues progress.
Mukherji agreed, saying there is “some responsibility on both us as program directors and leaders to make sure that our departments and our societies have gender and equality policies in place.”
“If there is no gender policy or there is no harassment policy in your institution, you need to find out and make that change,” she said.
“Speak up, speak out, and get everyone on your side in a very nonthreatening but positive way and we can definitely improve our research, improve our care, and improve diversity,” Mukherji emphasized.
The oncologists quoted in this story have disclosed no relevant financial relationships.
ESMO World Congress on Gastrointestinal Cancer 2021: Woman for Oncology: The Construction of the Majority Minority. Presented July 3, 2021.
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