I’ve been privileged to speak at three events in the last month about being a woman in medicine and a woman in surgery, but the one that changed my perspective completely was called “Women at the Intersections: the invisible barriers we face in Medicine and Healthcare”, organised by Jessie Lu, a medical student at Monash University, as part of their Diversity and Inclusion Week.
Although I call myself an intersectional feminist, this drove home the importance of this concept, and made me think that perhaps we don’t go far enough to address power imbalance with ‘Women in [Industry]’ events.
My personal intersection is that of race and gender, but a long list of other characteristics including, but not limited to, disability, gender diversity, age, body size, education, socioeconomic status, and sexual orientation, also lead to multiple complex intersections of disadvantage for other individuals.
Our difference is individual and unique, but intersectionality, as a concept, should unite us with fundamentally common experiences of disadvantage and goals for equality.
Intersectionalism as a term was coined by Kimberle Crenshaw. But she acknowledges that the concept predated her first use of the term in 1989 to describe the specific discrimination faced by black women within General Motors, a company which hired equal proportions of both women and African-Americans, except divided neatly as white female secretaries and black male factory workers. These black women had no legal recourse as neither gender or race based discrimination laws protected them. This was, of course, decades after black women were disenfranchised from the suffragette campaigns to get (white) women the vote, and from the early feminist movement itself.
As a child, my race loomed large as a source of social disadvantage. I grew up in an ethnically homogenous part of the United States, where my racial difference was constantly highlighted by my peers in a derogatory way. As a teenager, we moved to Australia, which I found to be far more multicultural and welcoming – but perhaps that was because, coming from the USA, my ethnicity was regarded as ‘American’, which was ‘cool’, rather than ‘Indian’, which was not. Coincident with this move, I first became aware, like many women do as teenagers, of the disadvantage afforded by my gender.
Gender inequity has been clear and present through my career journey in a male dominated profession, and ultimately led me to understand feminism and the need to address ongoing issues around unconscious bias due to gender. But it was not until I was a qualified surgeon that I started to appreciate again that ethnic difference continues to be associated with unconscious bias. International medical graduates in Australia – be they from China and India, or Anglo-Saxons from the UK – face uphill battles in obtaining registration, qualifications and training positions in this country. Medicine is not alone in treating highly skilled migrants in this way.
I agonised over whether I should state that I was ‘Australian-trained’ on my website, knowing that my patients would value this, but also feeling that I was letting down my amazing internationally trained colleagues by highlighting this as a point of advantage.
I tally both how many times a day I am asked if I am the nurse, but also the number of times I am asked where I am from; I am still occasionally asked for a cup of tea or to change the sheets.
My secretaries and referring doctors are asked both if I am really a female surgeon, and also if I speak English ‘properly.’
And when a group of young women of colour asked me recently whether I have been discriminated against in a professional capacity because of my race, after I spoke about intersectionality at a ‘Women in Surgery’ event, I wasn’t sure that I could answer accurately that I don’t think I have, because what feminism has taught me is that just because people aren’t aware of discrimination and disadvantage doesn’t mean that it doesn’t exist or isn’t happening.
Part of the reason I can’t answer that question is because we don’t have any data on multiple disadvantage in medicine or surgery. The Royal Australasian College of Surgeons and other professional medical entities collect data on the gender of their members (in a binary way), but there is no data on race or ethnicity, whether members are disabled or how they identify their sexual orientation, where they went to school or how much their parents earned. I am not suggesting that it is necessary or indicated for professional bodies or workplaces to collect or keep all these data points – but, as we say in medicine, you can’t find a fever if you don’t take a temperature. And right now, although we know that Australia, as a nation, has issues with race and sexuality and disability and body size and poverty, we have no real data to even start to understand how these complex factors interplay to cause disadvantage to any given person, or in any given industry.
I concede from the outset that my experience of both racism and gender bias is far less than what many people in this country experience, and that I have a host of privileges that provide cushioning to the prickles of disadvantage. This is the beauty and tyranny of intersectionality – it should not be about inane conversations where we consider disadvantage as a hierarchy, and debate whether a white female with a disability is more or less disadvantaged than a Chinese male who is gay – it is about the extraordinarily complex ways in which established power structures impact on our day to day lives and make life and the pursuit of needs, goals and happiness easier or more difficult.
The numbers and power in feminism alone
Feminism, for those who believe in gender-based discrimination and the need for a movement that addresses this, can be a great collectiviser. When it is 50% of the population which faces a uniting form of disadvantage, then the numbers game works favourably to find strong voices and activists who advocate for change.
But feminism has a dark history of deliberately silencing some voices so that the movement is not seen to be diluted – but in silencing those voices, it did exactly what patriarchy does and allows some people to leverage other people’s disadvantage in their own favour.
So feminism, on its own, has great numbers and great power, but it draws on a diverse and multiply disadvantaged base from which to derive part of that power. Feminism which is not intersectional relies on those who face multiple disadvantage to participate in the heavy lifting – but elevates those with less intersectional disadvantage proportionately more.
It is thus imperative on those of us with more power to not only lift up others who face other forms of disadvantage, but also to ensure that we don’t inadvertently tear others down.
At this event I attended last week, women were asked to share stories about themselves that went past their experiences of just being a woman. We heard about non-binary gender identity and disability and migration and family violence and racism and gender discrimination from women who have achieved incredible things despite the challenges in their lives.
These talks made me realise that even at a basic level, “Women in [Industry]” events and awards automatically disenfranchise those who identify in gender diverse ways. And that, more generally, having ovaries in common does not automatically unite our experiences. So if, as feminists, we truly believe that we can’t be what we can’t see, then we need to create space for diverse women speaking about diverse experiences.
In surgery, we would call talks like this ‘level 4 evidence’. Anecdotal experience from someone that we trust enough to give a public voice at a conference. In the absence of hard data, level 4 evidence is not only all we have, but is recognised to have genuine value.
The reality is that we already have diverse champions within feminism and industry. At “Women in [Industry]” events, these women are already there, and often they are already speaking. We need to specifically invite them to speak about their intersectional experiences, and create space at events that are not specifically about race or disability or sexual orientation or gender identity to hear of those sorts of disadvantage as well.
More importantly, we need to listen to those stories, and champion causes that might not directly affect us. We need to stop demanding that women who face multiple disadvantage choose between either mainstream feminism or their own specific cause, just because their stories of multiple disadvantage make us feel guilty, or culpable, or lucky. Because if we don’t, we are asking multiply disadvantaged women to either lift up feminism without giving anything back, or abandon feminism in order to advocate for another specific form of disadvantage.
We also need to ensure that we are not borrowing other peoples disadvantage in order to promote our own personal or feminist goals.
It is not uncommon to hear an amazing and successful woman pitch herself as the opposite of a cis-gendered heterosexual able bodied white middle aged male – but unless she is a young gender-diverse disabled lesbian woman of colour, some of those extra labels don’t apply, and undermine the experience of those to whom they do legitimately apply. ‘White-middle-aged-man’ is not a single word, it actually describes three distinct forms of privilege. But, the white middle-aged male may also be a genuine female ally, or may be disadvantaged in other intersectional ways.
We need to be careful to speak for ourselves and not for others, and to not borrow disadvantage that does not belong to us.
We need to find those who speak for people and communities that we don’t normally hear from and give them a voice – because as we know as feminists, a voice once given is a gift not commonly lost.
Many women are turning from intersectional feminism because they feel that the rewards of their advocacy flow only to others. No more is this seen right now than in the United States where black women started off disenfranchised from suffrage and feminism, and continue to feel as if intersectionality is just a concept without genuine action. I understand that movement, but I am not ready to give up on intersectionalism in this country.
In the last year I have met innumerable incredible women, and men, who truly understand what intersectionalism is, and want to be champions of change.
I have gone from being too scared to talk about my intersections to feeling empowered enough to deliver these thoughts by speech and on paper, acknowledging the enormous privileges that have allowed me to do so.
I’ve been inspired by other women who have done the same. This gives me hope that there are enough people who are genuine intersectional allies, and that we will slowly create a world that is tolerant of diversity and genuinely inclusive of all people. “Women in [Industry]” events are a great place to start.
Neela is a panellist at the Women’s Agenda Leadership Awards lunch on the 5th October.