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Inequality: a long fought battle By Marie Louise Sunde

Inequality:  a long fought battle

Marie Louise Sunde

In my work as a senior surgical resident- with a PhD, I am often referred to as a nurse. A few months ago, I introduced myself as the surgeon on call to a female patient, who looked at me and replied: “do you not have any real doctors here?” When I bring a male intern to visit patients, they often direct all the questions to him, despite him repeatedly pointing the patient in my direction. And time and time again, I’ll observe my few superior female colleagues, more often being ignored, having to repeat what they say and having to get angry in order to be heard.

This, is unconscious gender bias. We judge men and women differently without being aware. Each episode is not detrimental but accumulated over time, the effect is real. This is a problem for the individual and society.

According to McKinsey, 28 trillion USD could be added to the global GDP if we completely bridged the gender gap in the workforce. A recent study published in the British Medical Journal, found that patients operated on by female surgeons have a higher survival rate (1). Probably not because women are inherently better surgeons, but because the bar for women in surgery – and all other male-dominated areas, is higher.

Knowing this, why do we still have a gender gap in the workplace? I will argue that unconscious gender bias plays a significant role.

One of the most common forms of unconscious gender bias is the undermining of women. Numerous studies show how we unconsciously think women are just a little less qualified compared to male peers. For instance, a study from Norway in 2017 found that when students were presented to the same leader but with different gender, they rated the man as more competent than the woman (2). It is also interesting to note that both men and women have a tendency to undermine women.

We see this undermining of women in medicine, experienced by both doctors and patients. In 2015, The Brain Tumor Charity, based in the UK analysed British patients contact with the NHS leading up to a brain cancer diagnosis (3). They found that it was more likely for women to see the doctor multiple times before the right diagnosis was made. Female patients were more likely to be told that their symptoms were a result of stress or attention-seeking. The undermining of female patients can have severe consequences. According to John Hopkins University, 40-80 thousand patients die every year in America due to misdiagnosis, most of them as a result of doctor’s delay (4).

Although we tend to undermine women unconsciously, we often do not like to admit it. In our conscious mind, equality has a very high stand. As a result, we often rationalise and downplay episodes if we are presented with what might be considered unequal treatment. ‘It was just a misunderstanding’, ‘It was just a joke’, ‘Don’t take it so seriously’, ‘Don’t be so sensitive’.

These explanations are plausible if you consider each episode in isolation. But when it repeatedly happens in a disproportional ratio, these explanations become less likely.

In addition to being unconsciously undermined, women in male-dominated fields often also experienced ridicule, jokes and sexualised behaviour, which we have been made more aware of since the #MeToo movement. As a young woman in surgery, I have had my fair share of situations we now know as #MeToo, where I have faced ridicule and sexualised jokes. I have had consultants who “accidentally” make my breast area unsterile during surgery, and with surgical precision cover my boobs with new sterile clothing. After having spoken about gender equality in the media, a consultant came up to me and said, “Now you have practically asked us to touch your boobs every time we see you.”

In male-dominated fields, this behaviour is often normalised, which makes it even harder to address. Nevertheless, it is problematic for more than the obvious reasons. As a result, it can cause women to avoid certain situations, which means they will lose out on opportunities.

Unfortunately, this unconscious gender bias means that we still have uneven playing fields. Yet, this is often under recognised. As a result, we misunderstand cause and effect. We create explanations for the differences we see based on stereotypes and outdated beliefs – a consequence of conformational bias. I often hear that ‘women opt out of surgery because they do not like night shifts or high-pressure situations.’ This is odd, as there are plenty of other medical fields with high pressure and night shifts, which are majority women. Another explanation may well be that, the accumulated effect of the unconscious gender bias – the undermining, ridicule, sexualised jokes, rationalisation, downplaying and normalisation, result in women saying ‘enough is enough’.

The first step towards equality is to raise awareness. It is only when we look for it that we will see it. So, I encourage all to look for it, and to address it when you see it. On behalf of yourself, but most importantly on behalf of others. Together we will change mindsets.


As a Surgeon, with a PhD in Surgery, Marie Louise is well acquainted with the challenges women meet in male dominated workplaces.  She has been engaged in gender issues and diversity for a long time.   After Emma Watson finished he iconic speech in UN Women in 2014 with ”If not now  – when? If not me – then who?”, Marie was inspired to found #ShesGotThis – an organisation addressing unconscious discrimination by including men an women, using humour and without blaming.  After two successful campaigns in Norway, both reaching 1 million individuals through social media, Marie has spoken at the UN and was invited to Michele Obama´s ”United State of Women Conference in the White House.

ShesGotThis has been launched internationally in a number of countries.  Last year, Sunde founded a company focusing on building technology solutions that will help improve understanding of causality, change attitudes, and improve gender balance in the business community.  For this work, ShesGotThis partners with academia as well as leading Norwegian companies.



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