On Being A Woman in A Woman’s World

The genetic counseling profession is overwhelmingly female. Like about 90-95%, pretty much worldwide. Always has been, and, not seeing any imminent factors that are likely to change that percentage, I am guessing that it will continue to be a “female” profession for the foreseeable future. I am not exactly sure why this is so, though its historical roots provide a partial explanation. The founding parents of the profession and the original students were female, and the first training program was established at Sarah Lawrence College in 1969, an educational institution that until 1968 matriculated only females. Heck, I first learned about the profession when I read an article in Working Woman magazine nearly 40 years ago. Being female, if you will, is in the profession’s DNA.

Given the predominance of females in genetic counseling, I am often asked “What is it like being a male in a ‘female’ profession?” I don’t have a very articulate or insightful answer, and I usually respond with a mix of glibness (“Well, there are shorter lines at the restrooms during annual conferences, now that women no longer take over the men’s restrooms like they used to when conference centers had fewer women’s restrooms.”) and thoughtful gravitas (“As a student and novice, it was difficult finding a male role model or mentor.”). Mostly, though, I just go to work each day and try to do my job as well as I can, and I usually don’t spend much time thinking about the impact of my gender on my interactions with patients or colleagues unless a particular set of circumstances warrants it.

The recent celebration of International Women’s Day got me to thinking about the obverse question – “What is it like being a woman in a woman’s world? What are the pros and cons?” No doubt there is significant variability among work settings, but based on years of observation of the profession and informal discussions with colleagues, I think that some of the potential benefits for women working with predominantly female colleagues and supervisors might be:

• An abundance of smart, compassionate, assertive, and wise females to serve as role models.
• More female clinical bosses, program directors, and – especially in the laboratory sector – mid- and upper level managers, implicitly communicating the message that you can rise up the power pyramid (though unfortunately there are still plenty of roadblocks in the upper echelons).
• Greater support for pregnancy leave, dealing with family issues, and part-time employment.
• With respect to genetic counseling colleagues and immediate supervisors, sexual harassment is probably much less likely to occur than when working in a male-dominant profession.
• A historical record of tackling clinical, ethical, professional, and employment challenges that has resulted in the incredible expansion of job opportunities and scope of practice, tacitly suggesting that young genetic counselors can – and are expected – to continue this tradition.

There are also downsides to working in a pre-dominantly female environment. Until relatively recently, salaries could be shockingly low because women everywhere have always gotten the raw end of that deal. Another significant problem is that when men have power over women, it not uncommonly manifests in inappropriate sexual language and crude behaviors. Even if all of your genetic counseling colleagues are female, there are still plenty of male health professionals and administrators that you interact with. This environment can foster both subtle and blatant sexual harassment. The blinkers fell from my eyes about this issue when I was looking for a job right after graduation school. At one interview, I met with several male non-genetic providers who I would be interacting with. One of them looked at me and announced to the group “Well, this counselor’s breasts are a lot smaller than the counselor he would be replacing.” I was stunned by the statement, though I am ashamed to admit that I was too young and insecure to call him out on it. But it made me acutely aware of the pressures and tensions that women face when trying to deal with men on a professional level. As the Tom Waits song goes, there just ain’t enough raised right men.

Although women have made great strides in genetic counseling in gaining acceptance by patients and health professionals, there is still a glaring gap in the respect afforded to women based on their gender. In my clinical practice, patients and even providers very commonly refer to me as Dr. Resta, no matter how hard I try to disabuse them of that notion. This even after the patient has just signed an insurance coverage agreement form that specifically states that I am not a physician and I just handed them my business card that has no mention of an MD degree. Yet my female genetic counselor colleagues – even those a few decades closer to my age – are only occasionally referred to as “Doctor.” There may be several reasons for this but undoubtedly my gender triggers a near autonomic reflex to refer to me as Doctor.

I recognize that my observations are limited by the implicit biases inherent in being an upper-middle class white male. I am usually unblissfully unaware of the ways that my world view is filtered by my gender, heterosexuality, and socioeconomic status. So please tolerate and/or point out any of the blind spots in my speculation. But mostly I want to hear from the Good Readers of The DNA Exchange about their personal experiences – What is it like working in a predominantly female profession?

And while I am thinking about it, it would be equally interesting to hear about the professional views of genetic counselors who are ethnic minorities, are other than strictly heterosexual, have disabilities, or are otherwise under-represented. I encourage you to consider writing a piece for The DNA Exchange about the good, bad, or whatever experiences you have had in working in a profession where you are not quite like everyone else.