Michigan Medicine joins the #MeToo conversation with new study, #MedToo

Monday, November 11, 2019 - 7:53pm

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Design by Kathryn Halverson

The University of Michigan recently conducted an internal investigation into sexual harassment in Michigan Medicine, termed #MedToo, per the recommendations of a 2018 National Academies study.

The National Academies report investigated how women are treated in science, technology, engineering and math fields, now that more women are entering historically male-dominated spaces. The report found that the field of medicine has a higher rate of sexual harassment across academic disciplines, with female medical students experiencing sexual harassment from faculty and staff at a rate 220 percent higher than female students in any non-STEM field. The report concluded by calling on universities to examine the prevelance of sexual harassment within their own health care institutions.

One of the Michigan study’s authors, Dr. Reshma Jagsi, is deputy chair of radiation oncology at Michigan Medicine and also a co-founder of the national movement, Time’s Up Healthcare. In an interview with The Daily, Jagsi recalled initial conversations with the Medical School deans regarding the University’s response to the national study. 

Jagsi explained to the administration the risk of being the first university to collect and publish these results; because no other universities had conducted investigations following the National Academies report, readers may incorrectly assume the issue is specific to Michigan Medicine.

“When I talked to our deans, Marschall Runge and Carol Bradford, they were so incredibly supportive of this,” Jagsi said. “First of all they said, ‘Absolutely you should do this. This is what the national academies is calling for, we have the expertise here, we should lead the way.’”

The researchers surveyed faculty at Michigan Medicine using validated measures adapted from the Sexual Experiences Questionnaire, and examined the experiences of men and women in the field, distinguishing sexual harassment perpetrators between insiders (staff, students and faculty), and patients or patient family members.  

At Michigan Medicine, the study writes, “82.5% of women and 65.1% of men, reported at least one incident of sexual harassment from insiders in the past year.”

Esther Choo, associate professor in emergency medicine at Oregon Health & Science University, is one of the founders of Time’s Up Healthcare. Choo’s greatest concern about the study is its fairly low response rate, which indicates the possibility of participation bias. 

“I would also say that the rates were so high, that even if in the unlikely circumstance that every single person who didn’t respond to the study had never experienced sexual harassment, (the results) would still be significant,” Choo said.

The rates of gender harassment are far more prevalent than sexual coercion at Michigan and nationwide, according to the study. #MedToo states 82.2 percent of women experienced gender harassment from insiders, and 64 percent of women experienced gender harassment from patients or patient families within the past year. On the contrary, only 0.6 percent of women experienced sexual coercion from insiders in the past year. 

“Even though we may think that they’re less consequential than the egregious behaviors that we tend to focus on, the Harvey Weinstein-type aggressors in our society organizational, psychologists have demonstrated that those gender harassment behaviors are actually associated with meaningful impact on any point we care about: physical well-being, psychological well-being and on professional well-being,” Jagsi said.

Kate Brown, a fourth-year Medical student involved with sexual harassment education in the medical school, was not suprised by the overall findings of the study, but explained that this study did provide a new perspective into how the #MeToo era is also empowering men.

“It’s been expected that men just enjoy those things, and that it’s just part of being a man, but I think it’s probably always bothered people,” Brown said. “I think finally in the context of #MeToo, men are being empowered to say, ‘You know, this really is not okay.’”

Although #MedToo examined the impacts of sexual harassment on men in addition to women, it did not examine the impacts on indivuals with intersectional identities.  

“This is the first of many, many papers that will come out of this …” Jagsi said. “There will be separate analyses that will look at the intersection of race and gender, looking at the intersection of sexual orientation and gender, those are coming.”

However, Choo cautions that researchers must consider specific aspects when collecting intersectional data, explaining that despite inclusive intentions, it may end up isolating those who responded. Choo gave the example that if there were only five Black gay women in an institution, reporting on their responses would threaten their anonymity.  

“Those with intersectional experiences in healthcare are in the minority, and so you want to protect the most vulnerable … so sometimes we try to highlight intersectional experiences, and what we’ve done is violate principles of privacy and confidentiality,” Choo said.

In addition to intersectional identities, sexual harassment occurs in spaces where gender inequity is present more generally. At Michigan Medicine, the student body has been more than 40 percent women for the past 25 years, however women are still underrepresented in leadership positions, Jagsi said. Jagsi explains this lack of gender equity is both a cause and effect of gender harassment; when few women are in leadership positions, gender harassment prevails and discourages other women from moving up in the ranks.

Jagsi called for a change in leadership to change the culture of sexual harassment.

“Equity is essential,” Jagsi said. “So we need to hire more women, promote more women, and insure that women are represented at all levels of our organization, and in all positions of authority and influence.”

Fourth-year Medical student Anitha Menon also reflected on the issues of gender inequity in an interview with The Daily.

“I can only imagine that that level of harassment amplifies as you progress up the career ladder and are more and more isolated,” Menon said. “Statistically speaking, there are women, and in particular women of color, really underrepresented in higher levels of the academic ladder, especially in tenured professorships.”

Menon said many medical students have taken it upon themselves to catalyze change in the culture of sexual harassment at Michigan Medicine.

“My real interest has always been to try to educate medical students on the prevalance of sexual harassment and its impacts on medical students — in particular, again, women of color, queer women, trans folks — because I feel like medical students are not — we don’t really recieve that kind of education, and we’re definitely not taught skills of how to intervene in sexual harassment,” Menon said.

Similarly, Brown is involved with addressing sexual harassment in Michigan Medicine through a student organization created by her and her classmates, SafeMD. Originally focused on medical students, the organization has expanded to also teach medical students how to help patients that have experienced sexual harassment or abuse. 

Brown said she believes Michigan Medicine is taking a step in the right direction through conducting this study. But she also believes the toxic environment of sexual harassment needs to be addressed by both students and administrators.

“I think reducing sexual harassment has to come both from the bottom up, where there’s grassroots efforts for people on the ground — whether that’s students or faculty — to demand change and also to step up as bystanders, but I also think it needs to come from the top down,” Brown said. “Institutional leadership needs to say, ‘Harassment is not okay,’ and then needs to take steps to make sure it doesn’t happen, and then make sure that if it does happen, that situation is not tolerated,” Brown said.

Menon said when she spoke with University administrators, they were open to student feedback on how to combat the current environment.

“They want student involvement and student ideas on how to address sexual harassment,” Menon said. “When I presented this to some of the folks who are involved with the curriculum, they were really interested in potentially, potentially, incorporating it into the curriculum."