National Academies Calls Out Harassment of Women in Medicine

Bridget M. Kuehn

June 18, 2018

Sexual and gender-based harassment is pervasive in science, engineering, and especially medicine, according to a highly anticipated report from the National Academies of Science, Engineering, and Medicine (NAS) released last week.

The June 12 report calls on institutions and legislators to enact changes that promote a culture of inclusion that protects victims of harassment, increases transparency about how harassment is handled, and establishes clear consequences for harassment.

Work on the 311-page report began in 2015, according to the study's director, Frazier Benya, PhD, a program officer with the Committee on Women in Science, Engineering, and Medicine at the academies, with the goal of assessing the extent and impact of harassment in academia and identifying policies and practices that prevent and address harassment. The project took on greater urgency as the #MeToo movement drew attention to the pervasiveness of harassment of women, noted Benya during a webcast of the public release of the report.

"We didn't know the eyes of the nation would be on this study with all that has transpired since," Benya said.

A 21-person committee of individuals representing science, engineering, and medicine, as well as leaders at universities and scientific institutions and researchers who study sexual harassment, produced the report. It includes a review of the existing literature as well as studies commissioned for the report.

The investigators found high rates of harassment across scientific disciplines. The highest rates were in medicine, with 40% to 50% of medical students reporting harassment by faculty or staff in surveys.

Yet, universities' and other institutions' efforts to combat such harassment have been largely ineffective, the report shows. Too often, these efforts focus very narrowly on compliance with laws such as Title IX and avoiding liability while failing to address institutional culture and hierarchical structures that contribute to harassment, noted Committee Member Billy Williams, MS, vice president for ethics, diversity, and inclusion at the American Geophysical Union and a member of the committee. He said during the webcast that many people do not report harassment because they justifiably fear retaliation.

"The legal system alone is not an adequate mechanism for preventing or reducing harassment," Williams said. "Much of the sex harassment women experience does not meet the legal criteria of discrimination under current law."

"Pushing Women Out of Careers"

Committee Member Lilia Cortina, PhD, professor of psychology, women's studies, and management at the University of Michigan, Ann Arbor, explained that sexual coercion in which a superior explicitly or implicitly insists on sex as a condition of continued education or employment is the rarest form of sexual harassment.

Unwanted sexual advances, such as touching, persistent solicitations for dates, or sexual assaults, are more common. Gender harassment, in which women are targeted for hostility because of their gender, is the most common form. This may include exposure to degrading images of women, sexual slurs, or comments about women not belonging in certain careers.

"Most of the time, sexual harassment is a put down, not a come on," Cortina said. "Gender harassment is about pushing women out of careers."

Cortina noted during the Web briefing that medical students in particular experience more gender harassment than women in other fields. Women of color and those who are lesbian, bisexual, or transgender also are harassed at higher rates, she said.

Harassment has negative effects on the well-being and careers not only of those who are targeted but also of those who witness harassment, Cortina said. Such harassment has a negative impact on science, driving away talent. It is incumbent on leaders at all institutions to promote more healthy and inclusive environments, according to the report.

"The time has come to take action," said Sheila Widnall, PhD, cochair of the committee and institute professor of aeronautics and astronautics at the Massachusetts Institute of Technology, Boston.

Organizational cultures play a large role in promoting or discouraging harassment, according to the report. Harassment is particularly prevalent in male-dominated organizations or places where there is a perception that harassment is tolerated.

"Sexual harassment is primarily a problem of organizational culture," Cortina said. "Academic institutions need to move away from a culture of compliance to a culture of respect."

Recommendations

To promote better work environments, Williams said during the briefing that professional societies and government agencies can adopt codes of conduct, reclassify sexual harassment as a form of research misconduct, and deal with it accordingly. The report also recommends reducing hierarchical power structures that give one person disproportionate power over students and trainees.

For example, it suggests the establishing of mentoring networks and that funding be directed to a department rather than an individual. It recommends establishing support systems for those who report abuse, and policies that lay out consequences for harassment that are proportional to the severity and frequency of the abuse.

The researchers also call for increased transparency on how harassment complaints are handled and for legislation that would prevent confidentiality agreements that stop universities from sharing information about abuse.

Committee Cochair Paula Johnson, MD, MPH, president of Wellesley College, Massachusetts, emphasized that academic institutions need to promote better gender and racial representation at all levels of the organization and promote civil and respectful cultures. These measures should include training students and staff at all levels to intervene if they see inappropriate behavior, Johnson said.

"It is important to make the entire academic community responsible for reducing and preventing sexual harassment," she said.

The NAS itself has faced criticism for not revoking membership from individuals with a history of harassment. Bruce Darling, executive officer at the NAS, responded to questions about the issue during the report's release by saying the academies' councils were considering adopting a code of conduct that would spell out consequences for those who violate them. But he noted that the process could take years and that the organization is considering steps that could be taken in the interim.

"We see we have a responsibility here, too," Darling said.

The authors have disclosed no relevant financial relationships.

NAS. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. National Academies Press, Washington, 2018. Abstract

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