The healthcare sector in Lebanon is known to be highly feminized, for several of its professions involve caring and helping others–duties assigned to females based on their “natural" qualities and skills as domestic caregivers. The perceived primary role of women as homemakers and mothers thus does not stray far from their role in patient care. As a result of traditional views of females as subordinates, women endure disrespect and discrimination despite the myriad of roles and responsibilities that they have in a hospital setting. Indeed, they get paid less, promoted less often, harassed more, and face constant resentment if their dedication to their career is keeping them from their primary dedication to family responsibilities. One component of implicit gender bias often overlooked as trivial, and unintentional, but can, nevertheless, signal inequalities and highlight a double standard between men and women in the workplace is the language used to address women.
According to the ministry of public health (MOPH), the number of women in the healthcare workforce is increasing; compromising 79% of the public workforce in the healthcare system, and 80.5% in the private sector. The rise has been motivated by the women's expanding educational opportunities and scholarships, coupled with their devotion to overcome the current job shortages caused by young, educated Lebanese males migrating to foreign countries. Moreover, women have been challenging present gender stereotypes by taking on more advanced practice degrees, research, management, and leadership positions. For instance, female physicians are choosing to specialize in new fields such as surgery and orthopedics, which were previously only pursued by men. Therefore, it is clear that Lebanese women have been and will continue to strive relentlessly to shatter various glass ceilings and close the gender gaps they encounter in the workplace by taking on more educational and professional pursuits.
Despite their growing academic and professional status, women in healthcare are [still] less likely to be referred [to] or called out by their professional titles. This phenomenon is not unique to Lebanon as it is also prevalent in various health care institutions around the world. Some examples of gender-stereotyping and patronizing comments from patients in Western countries include calling females “honey," “sweetheart" or “sweetie." In Lebanon, the cultural equivalents of these words include “Habibti," “T2oobreeny" or “Amoura." Such sayings are especially common among young staff or students like myself and my female colleagues. In my experience, I couldn't help but feel somewhat uneasy whenever I was called out by any of these names. I would be standing next to the patient smiling and trying to look pleasant while having a whole internal monologue, wondering if it was about me being thin-skinned, or worse, inadvertently communicating any form of informal signals through my actions. After discussing my experience with my friends, I recognized that I was not alone as we all shared a mutual dislike for the above-mentioned occurrence. It made us feel that we were not viewed as professionals and lacked the trust of our patients in our capabilities.
Furthermore, anecdotes have also shown that such phrases are often followed by asking intrusive personal questions, about the marital status or the presence of children. If a woman is to answer back, declaring that she is not comfortable with the terms used or the question asked, she would get classified as overly sensitive, knowing such forms of endearment are commonly used during conversations in Lebanon. Now, I do acknowledge that the intention behind these messages may be warm or friendly. In fact, typically when asking people why they use this language, they would respond that they want to warm up the interaction, connect personally, and show kindness. However, for many women in healthcare, the terms themselves are not necessarily the central concern. It is rather that their male colleagues do not receive the same type of messages, which proves that women are, indeed, addressed less formally, more than their male equivalent. But why is this an issue of major concern?
While the words themselves may seem innocent, looking closer at the connection between language and social relationships, something becomes apparent. The use of such terms reflects an unconscious bias and delegitimizes a woman's contribution in the workplace. Not only can they infantilize, sexualize, and underestimate women's capabilities, but they can also reaffirm status differences and assert power between gender by placing the status of women lower down in the social hierarchy. Such repeated patterns of gendered language can leave women in health care feeling demoralized and disrespected by both their patients and their male colleagues. Patient safety, in turn, can get impacted because status differentials demotivate and prevent equal collaboration, whether that is of members of the same profession (male doctor and female doctor) or different professions (doctor and nurse). The frequent employment of gendered terminologies additionally perpetuates the belief that women are of lower status or lack the same competence as men. The before-mentioned may lead the male professionals to inhibit the sharing of information with their female counterparts and discourage collaborative decision-making, interprofessional discussion, and planning, all of which are at the heart of patient-centered care and imperative to the safety of the patients.
All things considered, it is evident that gender biases persist in healthcare despite that the female representation is considerably high and expected to continue rising. Placing women in such professional positions alone is thus insufficient for them to be deemed equal to their male counterparts. If gendered language is to persist, its demoralizing impact on women will ultimately affect the health and safety of patients. The formality of the communication that takes place during conversations between female healthcare workers and their patients needs to be respected if we are truly aiming to end the gendered-power hierarchy that exists.