Mental Health Psychology / Psychiatry Women's Health / Gynecology

In neurosurgery, how widespread is sexual harassment?

Responses to an online survey of 622 neurosurgeons reveal that the majority have either encountered sexual assault or undergone it.

neurosurgery
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When the Me Too movement gained worldwide visibility in 2017, the prevalence of sexual harassment across industries and socioeconomic environments became very clear.

The campaign also illustrates workplace harassment where power imbalances occur. In 2018, the Pew Research Center released a study that showed that sexual assault in or out of the workplace was faced by 59 percent of women and 27 percent of men.

More than half the women (55%) indicated that there was sexual abuse in the workplace.

To build a healthy workplace, knowing how much such abuse occurs is important. To that end, on behalf of the One Neurosurgery Summit, which brings together seven neurosurgery organizations, boards, and academies, Dr. Deborah L. Benzil, a neurosurgeon at the Cleveland Clinic in Cleveland, OH, conducted a survey on the incidence of sexual abuse in the neurosurgery sector.

The survey results appear in the Neurosurgery Journal. The survey found that some form of sexual harassment at work was reportedly encountered by a high percentage of females and males working in neurosurgery.

Survey design and implementation 

According to the journal, the goals of the survey were to:

  1. Assess perceived attitudes toward systemic issues that might be permissive of sexual harassment.
  2. Measure the reported prevalence and severity of sexual harassment.
  3. Determine the populations at highest risk and those most likely to perpetrate sexual harassment.

In the study, Dr. Benzil included a number of questions, including asking about the gender of respondents, information about the community where the abuse occurred, and the neurosurgery culture. The survey also questioned where, such as at a hospital or private practice, the abuse took place.

The research examines how many people in the workplace endured sexual assault and how many observed it as well.

SurveyMonkey was used by Dr. Benzil to send the survey to all members of the Society of Neurological Surgeons and Neurological Surgeons’ Congress.

Dr. Benzil sent out 5,166 surveys and collected a response from 12% (622) of individuals, 20% of whom were identified as women.

This is more than we would predict, according to the study report, given that women in the U.S. make up just 8% of neurosurgeons that practice and 19% of specialty residents.

Survey results

“This research shows that neurosurgeons experience severe sexual abuse in all ages and practice environments,” according to the results.

Any type of bullying or sexual harassment in neurosurgery has been encountered by sixty-two percent of all respondents (85 percent of women and 56 percent of men). Furthermore, 88 percent of women and 44 percent of men reported having faced such abuse.

The survey asked the respondents to identify their worst sexual harassment encounter.

“The following experience is documented in one such example: “One of my professors becomes flirtatious. I’m not involved, I point out. He started picking me up and tearing my blouse… [I] calmed him down… “He said, “Remember, we are a small community and you can easily lose your credibility. There are ways we can fail you, and no one’s ever going to know ‘.

Dr. Benzil writes that “Given social patterns and the high proportion of male neurosurgeons, it is not shocking that in reports of sexual assault, men were disproportionately named as the perpetrators.”

“Responses suggest that in the neurosurgical culture, variables correlated with the likelihood of sexual assault – male domination, a hierarchical setting, and a permissive environment – remain prevalent,” she concludes in the study.

The research took into account the ages of the survey takers who experienced abuse. To see if people around the board notice sexual assault or if one community sees it happening more than others, it is important to look at how reactions differ by age. The survey included sections for respondents of the following ages: 40 and under, 41–50, 51–60 years, and over 60.

Sixty-seven percent of women and men reported being harassed in the under 40″ age group. This is greater than any other bracket of age.

The survey found that 63% of respondents aged 41-50, 60% of individuals aged 51-60, and 56% of those over 60 experienced violence.

Sexual assault circumstances often come at the hand of someone in a position of power over the person they harasss. The survey indicates that this related to the field of neurosurgery as well.

Survey takers described colleagues in positions of authority as participants in the majority of harassment cases across all age groups.

For example, in the 41-50 age bracket, 94 percent of respondents said a superior was responsible for the harassing behavior.

Implication of findings

Only 31% of respondents said they reported the harassment. If they published a study, the majority of neurosurgeons feared retribution.

The findings of the survey should help departments of neurosurgery decide what steps to take to establish a healthy workplace in the future.

In the study, Dr. Benzil notes that:

“For more than a decade, organized neurosurgery has been committed to attracting and retaining more women to reach the best and brightest for our specialty. The persistent and pervasive presence of sexual harassment, and the environment that permits it, will continue to undermine these crucial endeavors.”

Response to survey findings

On behalf of the One Neurosurgery Summit and the Neurosurgery Professionalism Taskforce, Dr. Douglas Kondziolka and Dr. Linda Liau, both senior neurosurgeons, commented on the findings in an editorial.

The editorial states that for practice surveys, the response rate of 12 percent was usual. Through highlighting sexual assault allegations that individuals identified in confidential feedback from oral board assessments in neurosurgery, the authors also corroborate the ongoing nature of the issue.

They stress that the workplace should have zero tolerance for sexual harassment.

The survey also brought some good news, the senior neurosurgeons say, considering the high recorded rate of harassment events.

“Most of those surveyed felt that people they worked with were respectful and civil,” they write.

They also comment that the proportion of female neurosurgeons is now higher than ever: “Only about 5 percent of neurosurgery residents were women when we began training.” Now in 2020, 19 percent of neurosurgery residents are women.

Still, they warn that the field of neurosurgery should make way for more diversity in the workplace and reconsider its approach to hierarchical authority, considering these changes.

“[O]ur own hierarchy should have levels where open discussion can occur, and fear of reprisal is mitigated,” they write.

In education and practice, hierarchy has been the norm for decades, but it need not be unchanged. Since so much is at risk, neurosurgery depends on hierarchy. But without developing an uncomfortable or threatening work experience, neurosurgery as a profession is difficult enough. As the authors discuss, the danger is burnout, they underline.