At the Intersection of Race, Gender, and Surgery

12 Dec 2019

By Valeria S.M. Valbuena

In 1989, American Civil Rights Lawyer Kimberlé Williams Crenshaw published her now essential critical race theory piece entitled “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics.” In this paper, Crenshaw elegantly dissected the institutions of race and gender as individual pillars upon which part of the experience of Black Women in America is constructed. Race and gender, however, could not be effectively used on their own to fully describe or understand what the collective experience of living as a Black Woman is truly like. Nowadays, intersectionality is a household term used to describe the communion of any two identities. Intersectional feminism belongs to Black Women and their unique stories and challenges, and it’s been adopted to aid in the understanding of similar issues for other groups.

In the world of medicine, intersectionality often translates into being a physician member of more than one marginalized group. Minority women and Women of Color (WOC) carry a precarious existence in modern academic surgery. We live in the tenuous area where our powerful, diverse,dominant identity carries the painful tax of fulfilling a job classically held by White men. Success for a minority woman surgeon is defined by the same metrics used for the rest of our colleagues, but getting there is often much more difficult. Key milestones such as college and medical school admissions, residency match, early career awards, and high-level sponsorship are deeply influenced by both our identity and the ones of the mentors and friends we lean on to carry our careers forward. Race and gender synchronicity have long been shown to play a key role in productive early mentoring relationships. Without many WOC in surgery leadership, minority women surgeons rarely have the opportunity to benefit from these spontaneous connections. 

Some of the challenges faced by surgeons and trainees who are WOC fall grossly in the realm of gender discrimination. We share the struggle of a profound lack of equal compensation, comprehensive maternity leave policies, rampant sexual harassment, and stunted career advancement. This keeps women of all backgrounds from reaching their full potential.  However, it would be naive to ignore the key role that race brings to the table when it comes to describing lack of access to equitable advancement. There are many opportunities within our field that are more accessible to White women.  A strict feminist take on key issues, such as the pay gap, can often disregard the racial component of the intersectional experience and leave WOC disenfranchised. More importantly, the educational advantage that comes with being a physician often does not translate into a new social status once the white coat comes off. Social pressures, while always inherent to some extent, are very different outside the hospital for women surgeons of different races. I will always be an immigrant Afro-Latina when I interact with the world outside of work, and these interactions change my disposition on a daily basis.

Given these barriers, the question stands: how can we make surgery and surgical training equitable for minority women? I believe advocacy and ally-ship begins with obtaining profound knowledge of each other’s experiences. As a mentor or sponsor of a minority woman surgeon or trainee, maintaining open routes of conversation is key to creating trust. Honest acknowledgement of the unique challenges we face everyday can be particularly helpful for trainees who find ourselves pressed by both the new and escalating expectations of our jobs as surgeons-in-training, while still rising above the historic external pressures of racism and sexism. 

Navigating a world that still displays such a visceral push-back against women leading is difficult, but it is opening avenues for self-discovery for all the members of our surgical community. While we work actively on making the future of women happen, let us remain connected and supportive of each other, being mindful of our differences and biases but also committing ourselves to planting the seeds of lasting change.

Please join @womensurgeons along with our moderators, Dr. Yewande Alimi (@yalimi), Dr. Laurie Punch (@laurie_punch) and Dr. Patricia Martinez Quinones (@PMartinezMD) for this tweetchat on Monday December 16th at 8pm Eastern Time. The questions will be posted directly from the @WomenSurgeons twitter account and you can also find them following the hashtag #AWSchat. If you haven’t participated in a tweetchat with us before, check out this tutorial written by Dr. Heather Yeo (@heatheryeomd) to know more.  

 

The questions we will be discussing are below. Some of the questions are featured from our followers on Twitter about questions they would like to see answered regarding this topic:  

  1. What is intersectional feminism and what are ways to promote those values in daily life?
  2. It used to be much harder to find your “people”. How have you managed to create your “village” of support in this day and age? @leahbackhusmd
  3. How do we retain talent in surgery when so many women feel alienated? @linamacarmona
  4. What kind of support can we provide as peers? Is labeling ourselves as a “minority” perpetuating intersectionality? @civo05
  5. Beyond race and gender – how do we as a surgical society support our LGBTQIA surgeons and trainees of all races/ethnicities?

Dr. Valeria Valbuena is a third year General Surgery resident at the University of Michigan. Originally from Colombia, Valeria completed her undergraduate education starting in her local community college. She obtained a B.A in Biochemistry from the New College of Florida and her medical degree from the University of Illinois at Chicago where she was an active member and leader of the Latino Medical Student Association. Valeria’s research interests include workforce diversity with a focus on medicine and surgery, healthcare disparities, community-based interventions to increase access to safe surgery, and organ donation and transplantation in minority populations. You can find her on twitter at @v_valbuen.

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Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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