Women have been gaslighted
Who am I? I am an Indian woman, a British citizen, an Asian Brit, a BME academic, a woman of colour, an immigrant, a mother, wife, a melanin medic….. Oh alas, labels are really not very helpful are they? Like most people, I would like to be recognised as me, an individual. When I was asked to write this blog for the Health Leadership Academy, the suggested topic was “leadership in the NHS for women of colour”. This was not unreasonable because as recently revealed, in the NHS as in other walks of life, i) women continue to be disadvantaged compared to men; ii) racial discrimination persists; and iii) non-white women can suffer double jeopardy. Unsupportive workplace cultures are said to be a major barrier to career progress and women have to be better than men to make the same headway.
Only 7% of very senior NHS managers are non-white, which is less than half their representation in the overall NHS workforce (18%). Among clinical academic professors women comprise 19% and non-whites 17%. Across all NHS staff there is a gender pay gap of 23% (15% for doctors) and 6.5 times as many men compared to women consultants receive a platinum merit award. The Fawcett Society reports that women of most ethnic minority groups experience a gender pay gap when compared with men of the same ethnicity. Indian women have the widest pay gap of 16.1%, compared with Indian men. However the Fawcett Society also reports Black Caribbean women to have a reversed gender pay gap when compared with men of the same ethnicity (-8.8%), a further example that generalised stereotyping is unwise.
I grew up in the US and the UK, and when my father had assuaged his wanderlust and took the family back home in the early 1960s I was unprepared for the culture shock of India. Noise, bustle, crowds, smells, colour, heat, dust, the most complex, tantalising food in the world, and the most wonderful fruit; to this day I will remember the chaos of docking at Mumbai, then still called Bombay, the smell and taste of my first mango and the colour of the myriad marigold wreaths that welcomed us home. There were seemingly endless hordes of relatives, warm, loving, chattering. But my mother now covered her head with her sari in the presence of men; she never referred to my father by name, but as “your father” or when speaking to relatives “your brother”; women and girls ate after men and boys, did not sit with them, and took no part in serious conversation; and the births of baby boys were celebrated and their mothers congratulated, far more effusively than those of baby girls.
I was one of three girls (the doctor’s daughter and the daughters of the school’s maths and science teachers), permitted to attend the local (boys) school, the famous Rajkumar College in Rajkot. I came overall first in my class in my first year there, but another all too vivid memory was my bewilderment as a little girl, when it was not I who walked up to the headmaster before staff, pupils and parents at the annual prize-giving assembly, to receive an enormous silver cup, but a boy; a boy who had come second. I was learning the lessons of life quickly; women and girls took second place to men and boys. Many years later back in the UK, I would be welcomed to the Hammersmith Hospital not as a new consultant and senior lecturer, but as the long awaited new secretary, and when I attended my first appointments panel, the Chair, no less cordially, welcomed me as the admin representative.
These examples are trivial compared to the major injuries, harms and abuses suffered by so many women the world over, but they leave scars nonetheless, that are deepened by repetition. Most women of my generation who have achieved senior positions, will have personal experience of being called aggressive, strident, hard, and scary. They are likely to have been told overtly or by implication, that being ambitious is a dead cert way not to get a husband, a job, or promotion. Reinforcement of the message that their role is not to put themselves forward, that they are in some way not up to the mark of men, that they should be demure and accepting, is everywhere, even among those who love you and mean well, from family to every corner of society, be it the law, politics, government, the arts, the sciences, the corporate world, or the shop-floor. And religious attitudes often add a further nasty layer of opprobrium, by considering women unclean. Then too, there is the guilt that is the inevitable accompaniment of motherhood; did I harm my children by my actions, by pursuing my desires? Is it any wonder that we start to believe that breaking from the mould means we are really bad, really scary, really aggressive, and that we lose faith in ourselves?
What has happened to women over the centuries could be considered a form of gaslighting. The term comes from the 1944 movie, “Gaslight” in which a man gradually persuades his wife she is losing her mind. It is a form of emotional abuse that plants seeds of self-doubt in the victim. Women have been persuaded by society into believing they are inferior or at the very least not as capable as men. This is justified by innumerable reasons that carry no weight in logic, reason, or right. It as manifest in extreme form in some countries, with women barred from the priesthood, or from praying at a temple, standing for high office, or having the right to work, have an abortion, an education, or an opinion. In other countries conscious and unconscious biases and discriminatory laws, can be just as damaging. In the NHS for example, women doctors remain disadvantaged by current employment regulations that favour maternity leave over shared parental leave. Sadly women are often as culpable as men in perpetuating these behaviours, so effectively have we been brainwashed.
So what to do? First, recognise that we do ourselves damage when we accept the premise that we carry the major responsibility for the care of children, the home or elderly parents, or that less than full time working is a women’s issue. These are shared family issues for men no less women. My added take is that we all need to be leaders, whether this is leading ourselves in our personal lives, or in leading in a public role. Most of us will benefit from private reflection to deal with having been so effectively gaslighted. We need to tell ourselves firmly we are not inferior and have the same rights as any man, whether he be father, husband, brother, son, lover, friend, colleague, or employer. Grow a thick skin and stand your ground. Identify your goals, then be persistent. Build your confidence and let adversity make you stronger. Share your experiences and seek the support and comfort of women and men with insight and understanding.
Neena Modi is Professor of Neonatal Medicine at Imperial College London, Past President of the Medical Women’s Federation, Former Chair of Medact, and Immediate Past-President of the Royal College of Paediatrics and Child Health