Sexual Harassment in Training, Practice Reported by Two-Thirds of Gynecologic Oncologists

Marina Stasenko, MD

Results from a survey conducted by the Society of Gynecologic Oncology (SGO) found that 70% of female and more than half of male gynecologic oncologists in the United States were victims of sexual harassment in either training or practice; and of those, only 10% said they reported their experiences.

In delivering the results at the 2019 ASCO Annual Meeting, lead study author Marina Stasenko, MD, a clinical fellow in gynecologic oncology at Memorial Sloan Kettering Cancer Center, said the topic of sexual harassment has drawn attention in sports and entertainment, but the problem has not been extensively studied in the medical field.

“Our study sheds a light on sexual harassment and gender disparities,” she added. “Future work should focus on interventions that address these issues.”

Stasenko and her colleagues sent an anonymous survey to all 1566 US-based physicians who are SGO members. A total of 402 (26%) responded, 255 women and 147 men. Female respondents tended to be younger, more diverse (28% nonwhite vs 13%), unmarried (16% vs 3%), and less experienced than male respondents. The survey did not include questions about physician/patient interactions.

Overall, 64% of respondents said they experienced some form of harassment during training or practice, 71% of women and 51% of men.¹Stasenko said the high rate of men experiencing harassment could be the result of selection bias among respondents.

“Folks who wanted to report, who had something to say, were the ones who responded,” she said. She added that awareness of sexual harassment is higher than it’s ever been and that could play a role. “With the Me Too movement, with Time's Up, this is a conversation people are willing to have more often. Perhaps men are just more willing to discuss it now than they were 5 or 10 years ago.”

Women were slightly more likely to report harassment (17% vs 10%), but the difference is not statistically significant (P = 0.21) Forty percent of respondents did not report the incident or incidents to officials because it did not seem important enough, 37% felt that nothing would be done, and 34% said they feared retaliation. Stasenko said that more than 20% of respondents didn't know how to report harassment or who should receive that report.

“Certainly, improving the pipeline of how to report/to whom to report is very important,” she said. “One of our findings was that more than 90% of respondents knew there was a [sexual harassment] policy at their institution, but only about 60% knew what the policy was and how to use the reporting techniques.”

Fifty-one percent of women said they had been subjected to sexist remarks while in practice and 58% said they had been subjected to sexist remarks while in training, the most common form of harassment for women. The most common form of harassment among men was being the subject of unwanted sexual advances (28% in training and 24% in practice). Thirty percent of female respondents said they had been subject to unwanted sexual advances in training and 23% said the same while in practice.

In both training and practice, 4% of women and 2% of men reported being asked for sexual favors in return for academic positions.

Female physicians feel the weight of harassment more than their male colleagues. They were more likely to say that gender affected career advancement (34% vs 10%; P ≤ 0.001) and played a role in setting salary (20% vs 4%; P ≤ 0.001). Moreover, women were more likely to say they received lower evaluations or academic positions due to harassment (31% vs 14%).

Fifty-seven percent of female respondents perceived a gender pay gap compared with just 9% of men. Forty-two percent of women feel their income is lower than their colleagues compared with 6% of men. Eighty-one percent of men believe that gender played no role in determining their salary compared with 36% of women. Further, 20% of women believe gender played a direct role in determining salary and 44% believe gender may have played a role compared with 4% and 15% of men, respectively.

Seventy percent of male respondents said there were no obstacles to their career advancement compared with 34% of women.

Sexual harassment has long been a problem in medicine. Results from a 2016 study led by Reshma Jagsi, MD, deputy chair of radiation oncology and Newman Family Professor of Radiation Oncology at the University of Michigan, found that 41.3% of women who worked as academic medical faculty had experienced unwanted sexual advances and 92% reported experiencing sexist remarks and behavior.²

A report from the National Academies of Sciences, Engineering, and Medicine published in June 2018 found that 40% of female medical students had experienced sexual harassment from faculty or staff.³Furthermore, the report’s authors found “no evidence” that current policies and procedures had resulted in a significant reduction in sexual harassment. The authors called for a systemwide culture change to prevent and respond to sexual harassment.

ASCO Expert Merry-Jennifer Markham, MD, interim chief of the division of hematology and oncology and an associate professor in the department of medicine at the University of Florida, said that sexual harassment is a widespread societal issue. She noted that the Time's Up Healthcare movement is designed to raise awareness of this issue specifically as it pertains to sexual harassment and gender disparity affecting women working in medicine.

“It's important that we're having these conversations. The only way we're going to move forward is to continue to have discussions about the facts,” Markham said. “Dr Stasenko’s study is very important in that it's just more data to show us where the problems are. The ultimate goal should be gender equality—equality in the workplace, regardless of gender. We need to do all that we can to eliminate disparities and to eliminate as much as possible this issue of sexual harassment that clearly affects both genders, but primarily women.”

References:

1. Stasenko M, Tarney CM, Veith M, et al. Survey of sexual harassment and gender disparities among gynecologic oncologists.J Clin Oncol. 37, 2019 (suppl; abstr LBA10502).
2. Jagsi R, Griffith KA, Jones R, et al. Sexual harassment and discrimination experiences of academic medical facultyJAMA. 2016;315(19):2120-2121. doi:10.1001/jama.2016.2188.
3. Benya FF, Widnall SE, Johnson PA, et al. Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine. National Academies of Sciences, Engineering, and Medicine. ncbi.nlm.nih.gov/books/NBK507206/. Published June 2018. Accessed June 1, 2019.