Latina/o Physicians and Gender Discrimination in American Medicine

“I have never taken care of more Spanish speakers, undocumented patients, Latinx patients…than I have during the pandemic” exclaimed Dr. Susan López, a Latina internal medicine physician working in a Chicago hospital late last year.

These words echo the results of my recent research on gender and racial/ethnic inequality among Latina/o physicians in the state of California who, for the most part, work in minority and Latino immigrant communities.

In our work with Latina/o physicians, Maricela Bañuelos and I examine how ethnicity (such as language use) and gender intersect in American medicine. We examine the distinct experiences that men and women have in the U.S. medical workforce when performing their daily job tasks. We draw on interviews 48 Latina/o physicians (26 women, 22 men) mostly in the Southern California area. The doctors included in the study identified as Mexican, Central American, South American and Puerto Rican, with varying degrees of Spanish language ability. We coupled the interviews with observations in their places of work and medical galas/events to offer a behind the scenes look at interpersonal relations between these men and women with co-workers, nurses, staff and patients. 

FINDINGS

We find that bilingual and bicultural Latina doctors were expected to perform Spanish/English translating work at all times, and when they said “no” or explained that it wasn’t their job, they were more likely to experience hostility or were accused to being difficult to work with by their co-workers, pushing them to manage their appearance and behaviors.

It was more readily acceptable, on the other hand, for Latino doctors to say “no” or not do Spanish/English translations when they were asked. Often nurses or staff members would find someone else, or were ready to jump in and perform this translating and other work for them.

Bilingual Latina Doctors Pay a Tax

Both Latina/o physicians described their Spanish/English bilingual and bicultural abilities as an asset in their jobs. But, they also felt burdened by translation demands–with women having to do the lion’s share of this work. Latina/o physicians noted that Spanish/English bilingualism often meant they performed tasks outside of the bounds of their job description. For instance, specialists and doctors from other facilities failed to provide translations and often relied on the referring bilingual doctor to their work. Bilingual Latina physicians were often pulled in to perform this labor, especially for women patients, and coupled with being the “lonely only” bore the brunt of this work.

Latina/o doctors described instances in which they were not readily accepted as doctors and in which patients assumed they were not the attending doctor because they looked “too young.” Latina doctors stated that it was more common that patients mistook them for holding a lower occupational position. Moreover, only women reported unwanted comments about their appearance and racially-based sexual harassment from patients.

Latino Doctors’ Advantages

Our analysis underscores that Latino physicians held a gender advantage over Latina physicians when it came to demonstrations of respect in interactions from nurses and staff, regardless of racial/ethnic background. Men physicians noted that nurses would often “jump in” and perform simple tasks for them like drawing a patient’s blood. Women physicians noted that nurses would take “forever” to complete simple tasks while performing it quicker when the request was made by Latinos. This resulted in Latina physicians modifying their behavior so their coworkers would follow through on their task, but on most occasions they performed the tasks of others themselves to get the work done.

Both Latina/o physicians modified their self-presentation to fit a profession that favors medical providers who conform with the conventional white male norm of high-status occupations.  Unlike Latinas, however, men said they tried to overcome the ageism colleagues and patients subjected them to by “proving themselves” or subtly modifying their physical appearance.

MAJOR TAKEAWAYS

Bilingual Latina physicians often find themselves performing Spanish/English translations at all levels of the medical hierarchy– in their own specialty, for nurses and staff, and for medical personnel in entirely different facilities. Even though Latino doctors faced marginalization because of race, they also benefited from the sexism that Latina physicians experienced daily. We find that everyone—from physicians to nurses and staff to patients—is complicit in maintaining this inequality across the medical education pipeline and into their jobs.

Even when wearing the white coat—the traditional garb doctors wear—and their name badges, both Latina/o doctors were regularly mistaken for not being the attending physician, confused as housekeeping staff at times. While men said they could simply grow out a beard to look older, Latina doctors were encouraged to take greater measures to fit in.

We must pay attention to how racism and gender discrimination manifest for physicians and also recognize that bilingualism and biculturalism are assets in the job in order to renumerate physicians that possess those skills appropriately.

Glenda M. Flores is an associate professor of Chicano/Latino Studies at UC, Irvine. Her book Latina Teachers: Creating Careers and Guarding Culture and new research on Latina/o/x physicians focuses on gender, race and class inequality in white-collar occupations.

Maricela Bañuelos is a doctoral student in the Department of Sociology at UC, Irvine. Her research focuses on Latinas/os/xs in higher education and educational equity.

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