University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada.
The University of British Columbia, Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver, BC, Canada.
J Clin Anesth. 2022 Sep;80:110884. doi: 10.1016/j.jclinane.2022.110884. Epub 2022 May 18.
Discrimination toward sex and gender minority anesthesiologists and anesthesia trainees exists. Potential reasons for this discrimination are unclear and incompletely characterized. This study sought to better understand what discrimination looks like for sex and gender minorities in anesthesiology and the culture within anesthesiology that allows this discrimination to occur.
With institutional research ethics board approval and informed consent, we performed a qualitative analysis of free-text responses from a previously-published internet-based cross-sectional survey distributed to Canadian anesthesiology residents, fellows, and staff. The purpose of this survey was to characterize intersections between respondent gender or sexuality with experiences of discrimination in the workplace. Separate analysis of qualitative and quantitative components of this survey was planned a priori, and the quantitative component was published elsewhere. Free-text responses were independently coded by two researchers and subsequently synthesized into emerging themes using latent projective content analysis sensitized by Butler's theory of performativity.
Out of 490 free-text responses from 171 respondents [140 (81.9%) identifying as heterosexual], two themes emerged: i) fitting in: performativity reinforcing the status quo, and ii) standing out: performativity as a means of disruptive social change. Power structures were observed to favour individuals who "fit in" with the normative performances of gender and/or sexuality.
Our study illuminates how individuals whose performances of gender and sexuality "fit in" with those expected normative performances reinforce a workplace culture that advantages them, whereas individuals whose performances of gender and sexuality "stand out" disproportionately experience discrimination. The dismantling of bias and discrimination in the anesthesiology workplace requires individuals (a) who are empowered within their workplace because they "fit in" with the majority; (b) who recognize discrimination toward communities of their peers and/or colleagues; and (c) who actively choose to "stand out".
性别和性别少数群体的麻醉师和麻醉学员面临歧视。这种歧视的潜在原因尚不清楚，也不完全清楚。本研究旨在更好地了解麻醉学中性别和性别少数群体所面临的歧视，以及允许这种歧视发生的麻醉学文化。
在机构研究伦理委员会的批准和知情同意下，我们对之前发表的一项基于互联网的横断面调查的自由文本回复进行了定性分析，该调查分发给加拿大的麻醉住院医师、研究员和工作人员。这项调查的目的是描述受访者的性别或性取向与工作场所歧视经历之间的交叉点。该调查的定性和定量部分的单独分析是预先计划的，定量部分已在其他地方发表。两名研究人员独立对自由文本回复进行编码，然后使用巴特勒的表演理论敏感化的潜在投射内容分析将其综合为新出现的主题。
在 171 名受访者中的 490 份自由文本回复中[140 名（81.9%）自认为是异性恋]，出现了两个主题：i）适应：表演强化了现状，ii）脱颖而出：表演是一种颠覆性的社会变革手段。权力结构被观察到有利于那些“适应”性别和/或性别的规范表演的个人。
我们的研究阐明了那些性别和性行为表现“适应”于那些预期的规范表现的个人如何强化有利于他们的工作场所文化，而那些性别和性行为表现“突出”的个人则不成比例地经历歧视。要在麻醉学工作场所消除偏见和歧视，需要个体：（a）在工作场所中因为他们“适应”于大多数人而获得权力；（b）认识到对同行和/或同事社区的歧视；（c）积极选择“脱颖而出”。
