American Association for Physician Leadership

Workplace Gender Bias

Grace E. Terrell, MD, MMM, CPE, FACP, FACPE


July 8, 2023


Physician Leadership Journal


Volume 10, Issue 4, Pages 55-57


https://doi.org/10.55834/plj.5354739590


Abstract

Workplace gender bias typically takes one of two forms. First, women who act according to certain characteristics ascribed to women, such as warm, caring deferential, often are overlooked for leadership positions because they are perceived as not tough enough. On the other hand, women who are perceived as aggressive often are penalized. Recognizing these biases can do much to overcome them in today’s workplace.




Workplace gender bias takes one of two forms. Descriptive bias ascribes certain characteristics to women. They are supposed to be caring, warm, deferential, emotional, sensitive. Women who demonstrate these traits are often said to have “lack of fit” for a leadership position. Prescriptive bias describes what happens to women who break through and claim a traditionally male position.

Eric Jaffe says:

Here the empirical evidence is also overwhelming. Studies have found that women who succeed in male domains (violating incompetence) are disliked, women who promote themselves (violating modesty) are less hirable, women who negotiate for higher pay (violating passivity) are penalized, and women who express anger (violating warmth) are given lower status.(1)

In several experiments, successful female managers were perceived negatively in ratings of liability, interpersonal hostility, and boss desirability, unless they were perceived of having communality, such as being a mother.(2) The experiment involved a memorandum about a company’s female vice president, attesting to her “outstanding effectiveness, competence, and aggressive achievement focus.” Subjects in the study rated a male vice president described in identical terms consistently higher.

When the descriptive paragraph was appended with the language stating “although Andrea’s co-workers agree that she demands a lot from her employees, they have also described her as an involved manager who is caring and sensitive to their needs. She emphasizes the importance of having a supportive work environment and has been commended for her efforts to promote a positive community,” the ratings equalized.

Additional experiments show that gender differences in the propensity to initiate negotiations may be explained by differential treatment of men and women during negotiations. Male evaluators penalized female candidates more often than male candidates for initiating negotiations, with perceptions of niceness and demandingness explaining the resistance to female negotiators.(3)

Men who expressed anger in a professional context have been found in research to confer higher status than female professionals. This was the case regardless of the actual occupational rank of the target, whether the person was a female trainee or a female CEO. Also, whereas women’s emotional reactions were attributed to internal characteristics, men’s emotional reactions were attributed to external circumstances.(4)

Other data tell us that male and female leaders are liked equally when behaving participatively and including subordinates in decision making. But when they are acting authoritatively, women leaders are disliked much more than men leaders.(5)

Violating Stereotypes

Women are not always disliked when they are successful, but they often are penalized when they behave in ways that violate gender stereotypes. If women are expected to be warm, nurturing, nice, and friendly, a women leader pushing her team to higher performance can be seen as assertive, aggressive, or abrasive. She may be perceived as “too masculine,” an Ice Queen, Ballbuster, Bitch, Witch.

Consider the former executive director of the New York Times, Jill Abramson. Publisher Arthur Sulzberger Jr., replaced her in that role in 2014, several weeks after she challenged the publisher over what she perceived was unequal pay and benefits relative to the male editor, Bill Keller, whom she had replaced. Abramson previously had been publicly profiled as overly aggressive and strong-willed. Her staff described her as “impossible to work with,” and “not approachable” in a Politico article just a few days after the paper won four Pulitzer Prizes, the third highest number ever received by the newspaper.

Dean Baquet, who replaced Abramson at the Times, has been seen to burst out of Abramson’s office, slam his hand against a wall, and storm out of the newsroom. Yet it was Abramson, not Baquet, who was accused of being overly emotional, with an anonymous staffer sharing, “Every editor has a story about how she’s blown up in a meeting.” Baquet, himself, dismissed the stereotype but interestingly used the “B word” to do so: “I think there’s a really easy caricature that some people have bought into, of the bitchy women character and the guy who is sort of calmer. That, I think, is a little bit of an unfair caricature.”(6)

Shortly after she was named as the first women to appear at the top of the New York Times masthead in its 160-year history, Abramson was profiled in the New Yorker. The second paragraph was spent describing her “white dress and black cardigan with white flowers and red trim” as well as her “pale complexion” and “deep dark lines under her eyes,” Her voice was described in paragraph nine as “the equivalent of a nasal car honk.” Further down in the article, she has “an abrupt manner” then “too rough with underlings.” Yet, she had previously received criticism for publishing a book about her dog, The Puppy Diaries: Raising a Dog Named Scout. “Being executive editor is a full-time job, you shouldn’t be writing a book, especially one called The Puppy Diaries,” said one editor.

Three years later, Abrahamson was out as executive editor, with the Atlantic speculating that “If it’s true that Sulzberger and others were perturbed by Abramson’s ‘aggressive’ style, their dynamic is representative of a series of findings from management psychology, which show that female leaders are disproportionately disliked for behaving forcefully.”(7)

Abramson may have felt trapped by the limited patterns of conduct deemed favorable for women in leadership positions. There is a narrower band of acceptable behaviors for female than male leaders in the workforce. Women have made strides in recent years as being considered more effective leaders than in the past, but only so long as they do so by manifesting perceived “feminine” leadership styles of behavior.

A woman might be accepted as a leader provided the organization’s or group’s performance is stellar. Nonetheless, she may still be seen as deviant.

Gender and Medical Communication

The narrow band of acceptable female behavior is a survival strategy. Women’s “pathological politeness as described as an everlasting ploy of the patriarchy” is a result of girls and women being socialized to be polite as a learned behavior. “Girls are taught to prioritize other individuals’ comfort and emotions over their own,” according to Dr. Leela Magavi, regional medical director for Community Psychiatry in California. Politeness in women becomes a problem. When they do speak their minds and demand to be heard, they’re often labeled difficult or nasty.(8)

A 2002 meta-analysis of physician gender effects in medical communication found that female physicians engage in significantly more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk than their male counterparts, with no differences in the amount, quality, social conversation, or manner of biomedical information giving.

The analysis concluded that women physicians disclose more information about themselves in conversation, have a warmer and more engaged style of nonverbal communication, encourage, and facilitate others to talk to them more freely and in a warmer and more intimate way. They take greater pains to downplay their own status in an attempt to equalize status with a partner, in contrast with men’s tendency to assert status differences.(9)

In other words, most female physicians use normative female patterns of communication in their communication with patients. This pattern of communication has been linked to a variety of positive outcomes, including higher levels of adherence to therapeutic recommendations, but it is not necessarily conducive to promotion into leadership positions in healthcare organizations.

Men getting promoted faster and being paid more than women has been described as due to a “confidence gap” that women have, with concerns this leads to perfectionism and action paralysis in women. Perhaps this female reticence is conditioned from the fear of being assigned to the role of the bitch. If we do not perform perfectly, we will likely be harmed.

References

  1. Jaffe E. The New Subtle Sexism Toward Women in the Workplace. Fast Company. June 2, 2014. www.fastcompany.com/3031101/the-new-subtle-sexism-toward-women-in-the-workplace

  2. Heilman ME, Okimoto TG. Why Are Women Penalized for Success at Male Tasks?: The Implied Communality Deficit. J Appl Psychol. 2007;92(1):81–92. https://doi.org/10.1037/0021-9010.92.1.81 .

  3. Bowles HR, Babcock L, Lai L. Social Incentives for Gender Differences in the Propensity to Initiate Negotiations: Sometimes It Does Hurt To Ask. Organizational Behavior and Human Decision Processes. 2007;103(1):84–103. https://doi.org/10.1016/j.obhdp.2006.09.001 .

  4. Brescoll VL, Uhlmann EL. Can an Angry Woman Get Ahead? Status Conferral, Gender, and Expression of Emotion in the Workplace. Psychol Sci. 2008;19(3):268–275. https://doi.org/10.1111/j.1467-9280.2008.02079.x .

  5. Cooper M. For Women Leaders, Likability and Success Hardly Go Hand-in-Hand. Harvard Business Review. April 30, 2013. https://hbr.org/2013/04/for-women-leaders-likability-a

  6. Auletta K. Changing Times: Jill Abramson Takes Charge of the Gray Lady. The New Yorker. October 17, 2011.

  7. Khazan O. Are People Becoming More Open to Female Leaders? The Atlantic. May 2, 2014. https://www.theatlantic.com/business/archive/2014/05/the-myth-of-the-ineffective-female-leader/361559/

  8. Prooker B. It’s Time for Women To Break Up with Politeness. Elle. April 14, 2021. www.elle.com/culture/a35854625/no-more-politeness-2021 .

  9. Roter DL, Hall JA, Aoki Y. Physician Gender Effects in Medical Communication: A Mata-analytic Review. JAMA. 2002;288(6):756–764. https://doi.org/10.1001/jama.288.6.756 .

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Grace E. Terrell, MD, MMM, CPE, FACP, FACPE

Grace E. Terrell, MD, MMM, CPE, FACP, FACPE, is a national thought leader in healthcare innovation and delivery system reform, and a serial entrepreneur in population health outcomes driven through patient care model design, clinical and information integration, and value-based payment models. She is also a practicing general internist.

She currently is executive in residence at Duke University School of Medicine’s Master in Management of Clinical Informatics Program and a senior advisor for Oliver Wyman management consulting firm.

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