I have been diagnosed with several chronic illnesses. Over the past four years, I have lived in doctor’s offices and hospitals. Rather than bemoan my bad luck, I’ve tried to use the experience for my own behalf and my own enlightenment. In particular, I’ve sought to observe the behavior and attitudes of medical professionals in a therapeutic setting. This is something of a sociological experiment for me, and a way to turn lemons into lemonade.
Half of my doctors are male, but the other half are female. Quite by accident, I’ve had the opportunity to observe the gender confidence gap for myself.
Despite an ongoing, glaring lack of equality for women in culture and in policy, Katty Kay and Claire Shipman's new book, The Confidence Code, argues that what's truly holding women back is their own self-doubt. In fact, Kay and Shipman dismiss the importance of institutional barriers upfront, writing in the introduction that, while there's truth behind concerns about sexism, the "more profound" issue is women's "lack of self-belief".
It's true that there's a gendered disparity in confidence – American men overestimate their abilities and skills while women underestimate them. In fact, we've known this for some time: "imposter syndrome" – a phenomenon in which high-achieving women believe "they are really not bright and have fooled anyone who thinks otherwise" – was first written about in 1978.
My urologist is a shining star in the field. She’s been interviewed for the Discovery Channel as an on-camera expert. She projects complete confidence, a command of her discipline, and total professionalism. But even high achievers like her have weaknesses and vulnerabilities. In March of last year, she flawlessly performed a surgical procedure meant to address my troublesome bladder. A month later, we followed up to see how I had healed.
“I want to thank you for doing such a great job,” I said. Instead of the expected “Thank you”, her facial expression changed to a pained look. I wasn’t expecting it, so I reinforced what I had already said.
“Take the compliment, doctor.”
That gesture did not produce the desired effect. She did not smile with satisfaction, instead deflecting the question and quickly changed the subject. I know now how difficult it is for many women to accept praise, even heartfelt, sincere praise like my own. This was an unexpectedly visible sign, and since then I have wondered what latent insecurities exist within other female doctors. Even so, anecdotal evidence has its limitations. If I wasn’t sure what signs to look for, I might feel that no problem existed.
I’ve learned slowly how to peer underneath the surface for clues. The example I have noted, that of an unexpectedly strong showing of insecurity, has been a minority view. A female neurologist I consulted recently had an excellent bedside manner, one that was reassuring and sympathetic. I saw no problem there. I only viewed a young doctor not far out of med school working hard, seeking to be present and available to her patients.
My cardiologist is a crusty, energetic soul who doesn’t mince words. She has the stamina of a woman twice her age, tumbling out of patient rooms, bouncing around like a pinball. Once a nurse, she got tired of bureaucracy and went back to school in order to call her own shots. I’m not dismissing the problem because it might appear to be a minority view. Each of us have our own tender points and I may never be privy to anyone’s internal dialogue. As a man, I recognize I don’t always know what to observe, and these are the times I know to listen rather than react.
While encouraging women to have more self-esteem is not a bad idea generally, there's no evidence that being more assertive will change the way women are perceived in the workplace. Confident women at work are still labeled "bossy" and "bitchy", to their own detriment – unless they can "turn it off". And despite all the gains women have made, most Americans – men and women – would still prefer a male boss. While Kay and Shipman give a nod to ambitious women who are judged more harshly than their male peers, they seem to have no solution – other than putting the onus on women to change.
I may be unusual. Due to my own baggage, I prefer women to treat me. I have made appointments with female doctors with great purpose. At the same time, the male providers assigned to my care have never given me direct evidence of the flip side of this problem. I wonder how many Americans prefer a male doctor over a female one, and even more importantly, how many women believe that their own gender is somehow intrinsically inferior.
Without clear cut evidence, we have to connect the dots to make our argument. Confounding a new crop of feminists is the widely held perception that women’s emancipation has arrived and that no additional work needs to be done. Like with racism and homophobia, evidence of discrimination has gone undercover, but it remains. The best thing we can do is diagnosis the problem with surgical precision, in ways that are compelling but also difficult to refute. Otherwise, the issues will be consigned to the shadows, and little progress will be made.
The problem has a name, at long last, but simple knowledge of it is unhelpful. I return to the concept of privilege. Those with the odds in their favor have no compelling societal or cultural reason to examine their status. A few believe enough in equality to acknowledge that they benefit at the expense of others. To mobilize the masses, it takes a huge, glaringly obvious injustice. Until that day, we speak to ourselves and our small circle of confidantes more than we speak to others, but not for lack of trying.