The little brown woman

In American medicine, research has consistently shown disparities between the health experiences of non-Hispanic whites and minority groups; but the practice of racial discrimination within the medical profession is less well acknowledged. Unlike other professions, medicine is a person-oriented field, where Indian physicians are susceptible to facing discrimination on a daily basis. Likewise, with the effects of discrimination being greater for men than for women, the existing gender inequalities in American medicine have differential impacts on the workplace experiences of Indian men vis-à-vis women. However, much of the production of gender and racial inequalities in organizations and particularly in medicine, have focused on one or another of these categories, seldom attempting to study them as complex, mutually reinforcing or contradicting processes. My research strives to make this dimension a crucial part of the analysis.

As a system of social practices that places people into two significantly different categories, men or women, gender relies on a set of social arrangements of inequality, based on these constructed categories. Organizational roles in medicine often still carry stereotypic images of the kinds of people that should occupy these positions. Organizational practices in turn, reinforce the segregation of work by gender, widening status and income disparities between men and women, and replicating cultural stereotypes of gender. Research shows that widely disseminated gender beliefs and stereotypes are still prevalent in the United States, although organizations differ in the severity and the extent to which these inequalities exist and are endorsed. Gender stereotypes portray women as less competent, and better at less valued communal tasks when compared to men who are viewed as status worthy, instrumental and agentic. Studies show how in our society the role of a manager has been culturally associated with men. In professional fields that have been culturally perceived as masculine, like management, defense, or medicine, evaluations are biased towards men. Therefore, when women perform comparably to men, men are still regarded as being more capable at a given task than women  who may have to accomplish more than men to be rated equally. Unlike men, women are also deprived of their due recognition at the workplace and are underrepresented in positions of management and leadership.

Gender and racial discrimination act as a double bind for minority women in medicine, who consistently report significantly more impact from discrimination than men. However the interlinked impact of gender and race in shaping the career trajectories of Asian-American women has largely remained unexamined. Especially regarding the conditions of new racially different immigrant groups, the interconnected complexity of gender and racial inequalities requires further analysis. Focusing on either one category ignores the internal divisions of races along gender lines, and precludes an understanding of how the two categories have a complex, mutually reinforcing or contradicting interaction.

Drawing on 121 in-depth interviews with first- and second-generation women and men physicians of Indian origin in the U.S. Southwest, I examine the incidence and nature of gender based discrimination in American medicine. I focus on two aspects: (1) gender discrimination by employers and colleagues against women physicians of Indian origin, and (2) how gender discrimination interacts with race and manifests itself in the professional lives of first- and second-generation physicians. U.S. healthcare has become increasingly dependent on immigrants, in particular women physicians, from the developing world. I document the significant impact gender and race can have in molding the professional trajectories of Indian women physicians. The experiences of these physicians help clarify the interaction of skilled migrant workers with racial/ethnic and gender relations in U.S. workplaces.

By Wasudha Bhatt on her article, “The little brown woman: Gender discrimination in American medicine,” published in the October 2013 issue of Gender & Society.

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