Sexual Harassment Reported by 64% of Gynecologic Oncologists

Roxanne Nelson, RN, BSN

June 03, 2019

CHICAGO – A survey of members of the Society of Gynecologic Oncology based in the United States found that nearly two thirds (64%) of respondents reported experiencing some type of sexual harassment during training or practice.

Among women the rate was 71%, and in men, 51%, and most incidents went unreported.

Women were also more likely than men to respond that gender affected career advancement (34% vs 10%) and played a role in setting their salary (42% vs 6%).

"Sexual harassment is a form of discrimination that includes gender harassment, unwanted sexual attention, and sexual coercion," said lead study author Marina Stasenko, MD, a fellow in gynecologic oncology at Memorial Sloan Kettering Cancer Center, New York City.

The study was presented (abstract LBA10502) here at the American Society of Clinical Oncology (ASCO) Annual Meeting.

"More than half of American women have experienced unwanted and inappropriate sexual advances", she said. "Sexual harassment experienced in the workplace can have many negative consequences, including a decline in job satisfaction, productivity, or performance."

Until recently, much of the conversation about sexual harassment in the workplace was behind closed doors, explained Stasenko. "However, the #MeToo and #TimesUp movements have shone a spotlight on sexual harassment in the business world, the media, and now in science and healthcare."

"Through our study we hope to increase awareness and acknowledgment of sexual harassment and gender inequalities within gynecologic oncology, hopefully leading to future interventions to address these disparities," she said.

Sexual Harassment Pervasive in Medicine

Sexual harassment is a problem in the workplace and a third of US women have reported experiencing unwanted sexual advances in their careers. A high prevalence of sexual harassment in academic medicine persists according to the results of several surveys.

A 2014 meta-analysis of 35 studies, for example, found that a third of medical students and residents reported experiencing sexual harassment. Twelve percent of female physicians and 4% of male physicians reported they had personally experienced sexual abuse, harassment, or misconduct in the past 3 years, according to Medscape's Sexual Harassment of Physicians: Report 2018.  

In addition, gender disparities continue to persist in medicine, even though women comprise half of all US physicians under age 44. 

The current study was conducted to evaluate perceived gender biases, prevalence of sexual harassment, and how these affect physician growth and advancement in gynecologic oncology. Stasenko explained she focused on gynecologic oncology in the survey because it is her field of specialty.

More Prevalent Among Women

The anonymous survey was sent to all 1566 US-based physician members of the Society of Gynecologic Oncology, and of those queried, 402 (26%) replied; 255 replies were from women and 147 were from men.

Female respondents tended to be younger and more ethnically diverse than men (28% vs 11%), unmarried (16% vs 3% ), and had fewer years in practice (each P ≤ .001).

The most frequent form of sexual harassment reported by women and men was being subjected to sexist remarks (51% vs 24%). This was followed by being denied opportunities for training (33% vs 19%), unwanted sexual advances (23% vs 28%), and being asked to exchange sexual favors for academic positions (4% vs 2%, equally in training and practice).

The survey also found that 31% of women and 14% of men received lower evaluations or academic positions as a result of harassment, 34% of women reported that their gender had affected their career advancement (compared with 10% of men), 42% of women stated that gender played a role in their salary compared with 6% of men, and more than half of women (57%) stated they perceived a gender pay gap versus 9% of men.

Despite sexual harassment being so widespread, only 10% of respondents said they had reported the incident(s) to officials (17% of women and 10% of men). The reasons for not reporting these incidents included not feeling it was important enough (40%), that no action would be taken (37%), and fear of retaliation (34%).

Some of the respondents said they didn't know how to report sexual harassment at their institution or who to report it to, Stasenko noted. "Improving knowledge of how to report it and increasing awareness of who to report it to and what the institution's policies are can all be improved upon."

"Our study sheds light on experiences of sexual harassment and gender disparities, and future work should focus on interventions that address these issues."

Commenting on the study, Eloise Chapman, MD, gynecologic oncologist at Weill Cornell Medicine and New York-Presbyterian noted the issue is not new. "This has been reported since the 1970s, and one of the reasons for creating the Equal Employment Opportunity Commission is to protect against workplace discrimination," she said. "Movements like #Metoo have helped revitalize the issue and brought it back into the light."

Chapman noted that the split between men and women was interesting, but it wasn't clear in this survey what the definition of sexual harassment was. It also wasn't clear whether the reported harassment took place during training, practice, or both. "It would be interesting to see if this was more of a problem during training, because we see this more among women than men," she said. "Or is it happening early in practice versus being in practice for a long time? This is important as previous studies have looked at this. If we are going to address these issues, we need to know where and when this is happening."

It is also important to know what the respondents perceived as sexual harassment. "While the high percentage of males responding is surprising, we need to know what the people answering this survey perceived as sexual harassment," Chapman explained. "We don't know at what timepoint the men were in their careers when they experienced sexual harassment."

The study overall offers a lot of questions and not just answers. "This is a sensitive topic and is giving more significance as to what is happening in the healthcare industry — and I think that's very important," she noted. "This will highlight the need for the healthcare industry to prioritize the physical and mental health of all physicians and to think about the culture of medicine itself."

This study was funded by the Memorial Sloan Kettering Cancer Center. Co-author Yovanni Casablanca reports stock and other ownership interests (immediate family member) in Celsion. Stasenko and Chapman have reported no relevant financial relationships

ASCO 2019. Presented June 3, 2019. Abstract LBA10502.

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