Over the past few decades, women have entered the vocation of paramedicine in increasingly greater numbers. In BC, female practitioners currently compose approximately 39% of the 4300 paramedics working for the provincial EHS service(1). Our paramedic subculture has evolved to embrace this as normal, and it is no longer the case that women consistently encounter overt opposition to their place in prehospital care. However, women still face an arduous task as we work our way towards true integration and representation in all roles and license levels, with women only comprising 19% and 12% of ACP and CCP/ITT roles in BC respectively. (1) Women are present, but there are subversive ways that sexism still complicates the work they do in the field.
“Second generation sexism,” (2) happens when the overt barriers to success are removed from a workplace, but insidious ones remain that impact women’s career development. Second generation sexism persists within the workplace because of subconscious biases that society has regarding the roles and characteristics of women.
It is difficult to admit that we hold biases, but recognizing that we all have a certain degree of bias is an important first step in raising awareness. Bias is most often a learned behaviour and depends on variables such as an individual’s socioeconomic status, race, ethnicity, gender and education. Additionally, bias is often characterized as stereotypes towards groups of people that are based on an immutable physical characteristic such as gender, ethnicity, sexual orientation or persons with a disability. (3)
Gender bias is a persistent phenomenon that continues to negatively impact women in today’s workforce and especially those in traditionally male-dominated fields like EHS. Whilst there remain fewer instances of the more overt first generation gender discrimination in Canada, an insidious second generation gender bias remains. Second generation gender biases are “work cultures and practices that appear neutral and natural on their face, yet they reflect masculine values and life situations of men who have been dominant in the development of traditional work settings”. (4) According to researchers the benevolent nature of second generation sexism is actually more harmful to women than the outwardly hostile nature of first generation gender bias. In the face of hostile sexism women will reject these attitudes based on their discriminatory nature. When faced with benevolent sexism however, women have a harder time rejecting it, as it feels positive and well-intentioned. (5)
Common Biases Women Face at Work
This type of bias is based on incorrect assumptions about men and women’s inherent abilities as we generally tend to underestimate women’s performance and overestimate men’s. Women are required to work harder and accomplish more in an effort to prove that they are as competent as their male counterparts. (6) This bias also leads to women being hired only on past accomplishments while men are hired based on future potential. (7) Ultimately, performance bias can result in lower performance ratings and missed opportunities for promotions and career progression.
The likability bias is rooted in our implicit assumptions about men, women and leadership. Canadian society still views leadership qualities through a masculine lens, resulting in ambiguity when women take charge.Women in leadership roles experience the likability bias when being assertive as it earns them a reputation for being unlikable (or worse), but being passive renders them ineffective (2). This double bind operates on a largely automatic level of which most of us are unaware . Men do not walk this same tightrope.
Maternal bias is considered to be the gender bias with the heaviest impact. Women who choose to have children are often assumed to be less committed and less competent than their childless colleagues. (8) Family obligations and work-life balance are often viewed negatively and therefore women are not presented with as many challenging assignments or offers for work that requires travel as it is assumed that they will not be interested. (6) Maternal bias is multifaceted and still widely prevalent. It can completely shape a woman’s career trajectory resulting in lack of job offers, poorer career progressions and limited access to workplaces that actually work for women.
Similarity breeds connection and this plays out as affinity bias in the workplace. Individuals in positions to hire and/or mentor others often gravitate towards and therefore treat preferentially those that are similar to themselves. The affinity bias results in people’s networks being homogenous in regards to sociodemographic and behavioral characteristics which has powerful implications for the attitudes they form and the interactions they seek out. (9) With heterosexual white males continuing to hold a large percentage of managerial and clinical leadership roles within EHS services in Canada, affinity bias continues to have a particularly negative effect on visible minorities, LGBTQ and female employees. (6)
Bias that women encounter is not limited to gender as women can also experience biases due to their race, sexual orientation, a disability or other aspects of their identity. When women experience multiple biases this compounded discrimination can be significantly greater than the sum of its parts resulting in further decreased job opportunities, career progression and inclusion within the workplace.(6) Intersectionality, with its multiple levels of inequality and disadvantages, creates obstacles that are not well understood in conventional ways of thinking about race, gender and sexual orientation. (10)
How can we be agents of change?
Agents: Women on the frontline of change
As women, it can be challenging to imagine ourselves taking on career opportunities beyond our current work. The change in how we see ourselves in the workplace is called identity transition. (2) Not considering ourselves candidates is a common barrier to women advancing into new opportunities. Consider yourself a candidate, even for positions you haven’t considered previously, or think you are underqualified for. Seek out new paths, imagining yourself as an EHS educator, manager, flight medic, preceptor, and beyond.This identity transition is required for women to consider themselves candidates for leadership, career advancement, and risk taking.
Mentoring is an important aspect of career development (11) and happens when senior, experienced paramedics see potential or strengths in junior employees and encourage career paths that build on these strengths. Research shows that “women receive less of the high quality mentorship that accelerates careers–and they are less likely to have a mentor who advocates and opens doors for them.” (11) In male dominated professions like EHS, women in leadership roles are scarce, and as such can have a big impact on the identity transition and skills development of the women around them. Positively reinforce the women around you, and encourage their strengths and aspirations.
Advocate for management and organizations to take effective action. Point out when women are underrepresented in certain EHS roles, and educate people on the talent lost when women are passed over. Address systems that inherently disadvantage women, including long hours, lack of scheduling flexibility, or equipment designed for the male body (12). Advocate for better representation in your organization’s media, and in its leadership.
Allies: Supporting Female Colleagues
Our greatest allies in the journey towards an egalitarian workplace are the men we work with. We need your help to close the gap. To this end, evaluate whether bias is at play for the women around you. What is holding them at a disadvantage? When it comes to likeability, ask yourself and others, “would you feel that way if this paramedic was male?” Consider why women are required to ‘be nice’ on top of other leadership qualities. Evaluate whether bias is at play when a woman leader doesn’t generate your respect, and challenge yourself to see beyond the biases we have all internalized.
Mentor women and offer equal access
Women are less likely to be considered strong candidates for leadership, since stereotypical “leadership qualities” tend to be heavily masculine. Research shows that true leadership qualities don’t rely on stereotypically masculine characteristics, but rather involve the ability to focus a group’s industries around a common purpose or goal (2). The ability to see the larger picture and execute a successful plan is not unique to men, but is evenly distributed across the gender spectrum.
In light of this, as an ally for women in the workforce, cheer your female colleagues on. Positively reinforce their careers, and seek out mentees that look different from you. Respect leadership styles that don’t rely on masculine stereotypes, and allow the time and space for female mentees to develop their strengths against the tide of implicit bias. Since most EHS leadership positions are currently held by men, those with experience have a responsibility to mentor and develop the potential in women who show talent for the job and its possible career paths themselves.
Challenge stereotypes, challenge sexist jokes or remarks, challenge biases. Consider ‘women’s issues’ as human issues, which disadvantage a subsection of your workforce. Advocate for working conditions that are sustainable long term, since work-life balance is often particularly challenging for women with families (11). Advocate for women speaking up for themselves; research shows women are interrupted and their ideas discredited more often than men (11). As an ally simply saying “I don’t believe she was finished speaking” can help a woman’s voice and ideas be heard. Ask us what we think, and be willing to speak up for us when needed. All of us are needed to push back against biases that disadvantage some of us.
We all benefit when women’s talents are allowed to be fully realized in the workforce. We have made great strides as a profession towards the inclusion of women in all roles and we celebrate those. At the same time, it’s important to work together to dismantle the subtle biases that continue to make work more challenging for women, and to develop and champion the talents of people of all genders.
- British Columbia Emergency Health Services (CA) 2021
- Ibarra H., Ely R., Kolb B. Women Rising, the Unseen Barriers. Harv Bus Rev [Internet]. 2013 Sept. Available from: https://hbr.org/2013/09/women-rising-the-unseen-barriers#
- Psychology Today, Bias [Internet]. 2021. Available from: https://www.psychologytoday.com/ca/basics/bias
- Bourg Carter S. The Invisible Barrier: Second Generation Gender Discrimination. The New Face of Gender Bias and How We Can Stop It. [Internet] 2011. Available from: https://www.psychologytoday.com/ca/blog/high-octane-women/201105/the-invisible-barrier-second-generation-gender-discrimination?amp=
- Dixit J. The Science of How ‘Benevolent Sexism’ Undermines Women: A Summit Q&A with Peter Glick [Internet] 2018. Available from: https://neuroleadership.com/your-brain-at-work/peter-glick-on-how-benevolent-sexism-undermines-women/
- Lean In. For Women. Challenge Gender Bias Video Series [Internet] 2021. Available from: https://leanin.org/education#challenging-gender-bias
- Williams JC, Dempsey R. What Works for Women at Work: Four Patterns Working Women Need to Know. New York: NYU Press; 2014.
- Correl SJ, Benard S, Paik I. Getting a Job: Is there a Motherhood Penalty? AJS. 2007 Mar; 112: 1297-1338 DOI: https://doi.org/10.1086/511799
- McPherson M, Smith-Lovin L, Cook JM. Birds of a Feather: Homophily in Social Networks. Annu Rev Sociol. 2001 Aug; 27: 415-444 DOI: https://doi.org/10.1146/annurev.soc.27.1.415
- Crenshaw K. Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color. Stanford Law Rev. 1991 Jul; 43: 1241-1299 DOI: https://doi.org/10.2307/1229039
- Lean In. For Men. 7 Tips for Men Who Want to Support Equality [Internet] 2021. Available from: https://leanin.org/tips/mvp
- Criado Perez, C. Invisible Women: Exposing Data Bias in a World Designed for Men. New York: Abrams Press, 2019.