Why Do People Harass and Abuse?
Medscape: What are the motivations of the people perpetrating the sexual harassment? Some cases of sexual abuse are actually criminal; others are far less severe.
Strauss: The motivations vary. There have been studies on why men in general (not just in healthcare) harass. The reasons are everything from misogyny to being very aggressive, to just thinking that this is what men do and that talking this way or behaving this way to women is a way to demonstrate masculinity. For some, it's a way to show that they have power.
There are also times when, from the point of view of some harassers, what they said or did wasn't a big deal. They think to themselves, If somebody did that to me, I'd be okay with it, so why is it such a big deal to someone else? However, this is failing to recognize that a harassing physician may have a more powerful position than the others, and that changes the equation of the effect of his actions.
Medscape: With both physicians and nurses, more clinicians said they have witnessed sexual harassment or abuse than experienced it themselves. What's the significance or impact of having witnessed harassment?
Strauss: Research among both children and adults notes that you don't have to be the direct target of the conduct in order to be negatively impacted by it. The first such case to conclude that was Robinson v. Jacksonville Shipyards, Inc., where, in 1991, a federal judge declared that pictures of nude women posted on the wall created an environment of sexual harassment for women.[1] If a person in the OR is telling a dirty joke to another physician, and there are other people in the room hearing the joke, my research shows that other people say they are offended at hearing derogatory comments.
Medscape: A small percentage of male physicians say they were harassed by women. In the general public, some have said that men complaining about sexual harassment is exaggerated, and that many men don't mind it. In reading the respondents' comments, it looks like the men who were harassed felt pretty upset about it. More than one male physician said he was amazed at how upsetting he found the harassment from a woman.
Strauss: I think one of the contributing factors is that when there's abuse or harassment of women by men, there is often the unspoken threat of violence, even if that particular perpetrator would never become violent. Research shows that in society in general, there is much more physical crime committed by men than by women, and this potential is often on women's minds.[2]
As these sexual harassment reports show, women can definitely sexually harass as well. It's not as frequent, and when women are sexually targeted by men, the impact on a woman is usually more severe versus on a male target. But if a woman is partaking in this sexual misconduct, it's just as wrong as if a man did it.
Sometimes a person is just interested in asking someone out or getting romantic, but it flips over into sexual harassment when they don't stop after being told "no." And that can go either way, male or female. But if you have asked and someone says no, you must stop pursuing. If you don't, it crosses a boundary and demonstrates disrespect toward another individual, and potentially is sexual harassment. That's not okay, no matter which sex is doing it.
Medscape: One finding I thought was sad was that so many people who were sexually harassed did not speak up to the perpetrator: 55% said nothing to the perpetrator; they didn't ask him/her to stop and didn't tell him/her how they felt about the harasser's actions. And 60% of those who were harassed or abused did not report it. Why do so many keep silent about harassment?
Strauss: I'm not surprised by those percentages at all. Many feel that it's not safe to speak out. There is fear of retaliation against them that could damage their career. They're afraid they won't be taken seriously. They may feel like nothing will be done, or that they might be labeled a prude. Many people feel that they can get a sense from the organizational climate that this behavior will get tacit approval to occur.
They also may have witnessed previous harassing behavior where people in the group or organization said, "That's just the way he is," or "You can't do anything; he's the chairman of the department" or "It won't do any good; no one will believe you." And sometimes they might have even seen pushback, as in, "You're overreacting."
Many physicians and other clinicians don't trust the system—that management will do anything, or that there are processes in place for this to be important enough to be responded to.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Leslie Kane, Susan Strauss. Sexual Harassment in Healthcare: Doctors and Nurses - Medscape - Jun 27, 2018.
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