October 24, 2020

CP Online Health

Eat Well, Life Well

This time last week I had this mad idea to share some of my thoughts about “exercise” – not thinking that post would create such a stir! Is it really so radical to recognise that not everyone likes That Word? And that for some, the benefits of exercise aren’t as valued as other important parts of life? And that movements, like people, come in all shapes and sizes so what YOU like might not be something I like?

In New Zealand we’ve also had a new emergence of Covid19 in the community, after 102 days without any community-based cases. This has been very scary for some of us, a real frustration for others, and an economic blow for many others. It’s brought out the worst in our electioneering politicians (National, I’m looking at you), and in turn led to bad behaviour on the interwebs.

Bad behaviour, too, between clinicians on the interwebs. Behaviour unbecoming of senior white male clinicians, mainly. Not that this kind of unsocial behaviour is surprising to me: among some of our rehabilitation professionals there is a culture of “calling out” people who don’t hold similar beliefs, culminating in atrocious behaviour that serves no-one well. (ever heard of motivational interviewing and rolling with resistance?)

In case you hadn’t worked out, I’m a woman. Furthermore I’m a middle-aged woman – at the age where I suddenly become invisible. Those micro-aggressive behaviours of opening doors for me, lustful glances as I walk by, offers to buy me a drink… they’ve vanished. I’m like a piece of wallpaper. Because, as all women find, so much of my influence over the years has been based on my appearance.

Feminism has been part of my life since forever. I can’t recall when I first started resenting the ideologies that meant I wasn’t allowed to consider metalwork or wooodwork but had to study sewing and “home economics”. Or that I was advised I could be a nurse or a teacher, but never, despite having good marks in English, chemistry, biology, and physics (yeah I was that A-grade student) encouraged to consider a career in science or medicine.

These were overtly anti-female actions.

Then there have always been the slightly (but not always so minimal) “obligations” to watch how I dress, where I walk, how I sit, how I express an opinion (did you know I have a “strong personality”?!!). The time a senior male asked the two of us in an office “would one of you girls do this photocopying” – when both “girls” were over 50 years old?! Ask yourself who organises the coffee at your meetings – and who tidies up afterwards…

I look at the academics in my department: six women. Two are young and involved in the CREATE group, lab science developing bio-engineering solutions for cartilage degenerations. The other four have all had at least 15 years clinical career before completing a PhD, then maintaining that clinical career while also carrying out research. The men? Not so much.

When we begin to look at systematic disadvantages surrounding female participation in research, the strengths women bring into our applied clinical research programmes are often overlooked, particularly in career progression in academia. For example, we’re well-connected. We’ve had experience in clinical work so we can ask those awkward questions – and we often do. These questions are often complex because they’ve arisen from our daily clinical experiences. This means the questions lend themselves to mixed methods research, or intensive repeated measures research (single subject experimental designs, ecological momentary assessment designs), action research, qualitative methods. This kind of research doesn’t get published in Nature or Science.

And then we come to collaborations – where people meet in person (pre-Covid) it’s common to find women’s voices are not as loud, noticed or solicited. This practice begins at school (Wieselmann, 2019), and is evident most clearly in male-dominated work (Wright, 2016). While gender sensitivity training is available, it’s not possible to establish whether outcomes are improved, and many of these studies are about LGBT populations (Lindsay, Resai, Kolne & Osten, 2019). Intersectionality (where people are disadvantaged in many ways – eg sexual orientation, age, disability AND gender and ethnicity) means people in these groups are often stigmatised or invisible, excluded simply because they don’t fit with the established (ie male) norms. We have so much to do.

There have been superb examples of women researchers making themselves visible on social media. I’ve been fortunate to be included in some of these endeavours – raising my personal profile, but more importantly, helping me and others find each other!

My point in writing this post is that while many men are wonderful examples of compassionate, generous, kind and strong masculinity, there are others who are oblivious to their privilege. In their fear (although they would deny that they are afraid) they lash out at women who will not obey the rules this group of men cling to. We can call this fragility. A state where it’s perfectly fine to say that a defender of female under-representation is considered to have “allodynia of emotional pain”, arguing that “if you are this sensitive you might reconsider engaging in the Twitterverse.” Not only unprepared to acknowledge one woman’s response to his behaviour, but arguing for normalisation of this behaviour, along with exclusion for those who don’t agree.

I am calling for actively promoting the work of female commentators, researchers, clinicians and educators. Our voices are as valid as the currently dominating male ones.

I’m not calling for men like the one I’ve quoted above to be silent (though it’s hard to HEAR if you’re always doing the TALKING). I am calling for men who are recipients of privilege just by being male and because our society has held male norms as more valuable than female norms to be the change our societies need. Especially in healthcare where the attitudes I have seen demonstrated on Twitter suggest little sensitivity towards those with different experiences. I do wonder about the interactions with patients by those who have recently revealed their privilege and limited sensitivity on Twitter.

We can do better. Be positive and kind and compassionate and strong. We’ve got this, women.

Lindsay, S., Rezai, M., Kolne, K., & Osten, V. (2019). Outcomes of gender-sensitivity educational interventions for healthcare providers: A systematic review. Health Education Journal, 78(8), 958–976. https://doi.org/10.1177/0017896919859908

Wieselmann, Jeanna. (2019). Student Participation in Small Group, Integrated STEM Activities: An Investigation of Gender Differences. Retrieved from the University of Minnesota Digital Conservancy, http://hdl.handle.net/11299/209027.

Wright, T. (2016) Women’s Experience of Workplace Interactions in Male‐Dominated Work: The Intersections of Gender, Sexuality and Occupational Group. Gender, Work and Organization, 23: 348– 362. doi: 10.1111/gwao.12074.