Even though sexual harassment policies and procedures are required within the medical field, surveys reveal that unwanted sexual and gender harassment is prevalent in healthcare workplaces. In the healthcare community, sexual harassment remains an issue for worker wellness and productivity, as well as the optimal delivery of patient care. Sexual harassment is a risk factor for various mental health conditions and can result in qualified personnel leaving the workplace. Efficient training and preventive measures improve recognition of potential sexually offensive behaviors and help to establish an inclusive and respectful workplace. Acknowledging the problem is the first step, and prevention is the cornerstone of an effective anti-harassment strategy. Changes in institutional and organizational approaches can prevent sexual harassment and covert retaliation. Helpful initiatives include enhanced senior faculty member training and encouragement of bystander complaints when they witness prohibited behaviors. All medical fields can benefit from reflecting on workplace culture, focusing on prevention, reviewing policies and strategies, and committing to change.  Sexual harassment continues to be prevalent in medical training, a pressing concern for leadership. The adverse effects detract from the professional workforce. According to the Equal Employment Opportunity Commission (EEOC), unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when submission to or rejection of this conduct explicitly or implicitly affects an individual’s employment; unreasonably interferes with an individual’s work performance; or creates an intimidating, hostile or offensive work environment. [See 29 CFR PART 1604] This unethical practice exploits inequalities in status and power, abuses the rights and trust of those affected, may influence or be perceived to influence professional advancement, harm working relationships, and is likely to jeopardize patient care. [See AMA Code of Medical Ethics Opinion 9.1.3]  The United States EEOC enforces Title VII of the Civil Rights Act of 1964, which not only prohibits sexual discrimination, including pregnancy, sexual orientation, and gender identity, but also makes sexual harassment or retaliation illegal. Sexual harassment in the workplace is a form of sex discrimination that violates Title VII. Since Title VII, cultural and legal changes include decreased tolerance for harassment, increased legal responsibility assigned to institutions, and a significant increase in women choosing careers in medicine.  Unwelcome sexual behavior occurs when the victim does not invite the behavior or when the victim regards the conduct as undesirable or offensive. If behavior starts as welcome behavior and then crosses over to unwelcome behavior, consent can be revoked at any time. The individual should announce that the behavior needs to stop. The harasser cannot use a defense that the other person started the behavior or initially gave consent after the alleged victim announces that welcome behavior is now unwelcome behavior. The work environment or the workplace is not limited to the assigned physical location of the employee. The work environment includes all locations where work is performed, and work-related business is conducted. Medical conferences and training sessions, satellite clinics, business travel, work-related social activities, and work-related communications are all considered part of the work environment or workplace. Ahostile work environment occurs when the harasser creates an uncomfortable or harsh atmosphere for the person subjected to unwelcome behavior.  The harassment can be verbal, nonverbal, or physical and is sexual or based on someone's gender. Physical forms of sexual harassment may include intentionally touching, massaging, leaning over or cornering a person, caressing, pinching, kissing, and hugging, as well as sexual assault or rape. Verbal forms of sexual harassment include socially and culturally inappropriate and unwelcome comments or jokes with sexual overtones, persistent proposals, asking about sexual fantasies/preferences/history, spreading rumors or fabricating lies about one's personal sex life, inappropriate remarks about a woman's physical appearance, and unwelcome requests or persistent invitations to go out on a date. Referring to a woman by inappropriate names, such as doll, babe, honey, or similar, is unacceptable. Nonverbal forms of sexual harassment include unwelcome gestures, suggestive body language, indecent exposure, repeated winks, sexual gestures, whistling at someone, and unwelcome display of pornographic materials. Sending letters, phone calls, texts, emails, social media comments, blog posts, or other communications of a sexual nature may constitute harassment. In healthcare, verbal harassment is the most common form, primarily sexually suggestive statements or jokes, followed by meddling questions about one's intimate life or physical appearance. Occasional compliments that are socially and culturally appropriate and acceptable are not considered sexual harassment. Any consensual adult interaction of a sexual nature that is welcomed or reciprocated is also not harassment. The law does not prohibit simple teasing, offhand comments, or isolated incidents that are not serious. The behavior is illegal when it is more than a single incident and creates a hostile or offensive work environment, or when an individual’s employment is negatively affected. According to the EEOC, the two main types of sexual harassment claims are (1) quid pro quo and (2) hostile work environments. Quid pro quo, or “this for that,” sexual harassment implies that if “you do something for me, I’ll do something for you.” Quid pro quo sexual harassment involves demands for sexual favors in exchange for some benefit or to avoid some detriment in the workplace. This type of behavior occurs when an individual in an organization attempts to influence the process of recruitment, promotion, training, discipline, dismissal, pay increases, or other benefits of an employee or job applicant in exchange for sexual favors. Hostile work environment sexual harassment occurs when unwelcome sexual advances, requests for sexual favors, or any conduct of a sexual nature interfere with someone’s work performance or cause an intimidating, hostile, or demeaning work environment. Unlike quid pro quo harassment, the perpetrator could be anyone in the workplace, including a coworker, subordinate, contractor, consultant, patient, or supervisor. Examples of unwelcome conduct that could create a hostile work environment include sexual jokes or communications, offensive pictures, inappropriate touching, or repeated requests for dates. A 3-part classification system divides sexual harassment into these distinct categories: gender harassment, unwanted sexual attention, and sexual coercion. Sexual harassment is not necessarily about sexual activity or sexual desire. Sexual harassment is also discrimination based on gender, which includes one's biological sex and cultural gender-based stereotypes. Gender harassment includes verbal or physical behavior that denigrates or shows aversion to one's gender, gender identity, or sexual orientation. For example, calling out a man for being a "sissy" or telling a woman she isn't fit for a senior position in a male-dominated leadership environment may constitute gender harassment. Gender harassment can include hatred, objectification, exclusion, or giving second-class status to members of a particular gender. Sexist or heterosexist language, jokes, or comments also fall under this category. Given the circumstances, gender harassment can have the same unfavorable outcomes as one instance of sexual coercion. Unwanted sexual attention includes making suggestive statements about a person's body, spreading sexual rumors, and electronically sharing sexualized images. Sexual coercion, or quid pro quo, happens the least frequently of the 3 categories of sexual harassment but is the most reported. A large national medical center with more than 65,000 employees, including more than 4000 physicians and scientists, serves as a contemporary snapshot of the scope of the problem. A 2-year survey of more than 6200 healthcare workers, including physicians in all specialties, residents, nurses, nurse practitioners, and physician assistants, was conducted. Among physicians who reported sexual harassment, 12% were women, and 4% were men. About half of the harassers were physicians, with 37% in a superior hierarchical position. Only 40% of those who stated that they did experience harassing behaviors reported the behaviors. Of importance, 40% of the investigations could not be substantiated. In just over 3% of the claims, the patients were the alleged harassers. However, in another study, sexual harassment from patient to clinician was common, with 67% reporting inappropriate behavior. Approximately 84% of female providers reported some form of sexual harassment by patients, while 40% of male providers reported the same. Of those female providers, 42% experienced multiple episodes of sexual harassment by patients during their medical careers. The most common occurrences of patient-to-provider harassment were in outpatient clinics, with Veterans Affairs outpatient clinics reporting the highest frequency. Few providers in an inpatient setting reported sexual harassment by patients.  According to a National Academies of Sciences, Engineering, and Medicine (NASEM) report, high rates of sexual harassment in medicine compromise the integrity of education and research. Of concern to leaders of academic medical institutions, medical students experience sexual harassment considerably more often than their peers in sciences and engineering. About 45-50% of female medical students reported that they experienced sexually harassing behavior from faculty or staff members. A systematic review revealed that 33.1% of medical students, 36.2% of residents, and 30.4% of younger faculty encounter sexual harassment. Surgery and emergency medicine female residents experience eminently high estimates of sexual harassment; the leading reason is that those fields value a hierarchical and authoritative workplace. Pediatric residents reported the lowest incidence of harassment. Recently, several investigations found that medical trainee harassment is not limited to specific nations or education programs. Sexual harassment charges filed with the EEOC have increased after the #MeToo movement received international attention beginning in the fall of 2017. Between 2018 and 2021, sexual harassment charges accounted for 27.7% of all harassment charges compared to 24.7% of all harassment charges between 2014 and 2017. Of the sexual harassment charges filed between 2018 and 2021, 78.2% were filed by women, while men filed 21.8%. [See EEOC Sexual Harassment in Our Nation's Workplaces] Roughly 3 out of 4 individuals who experience harassment never report the unwelcome behavior to a supervisor or manager, usually because they fear disbelief of their claim, no corrective action will occur, blame, or social or professional retaliation.  According to the EEOC Select Task Force on the Study of Sexual Harassment in the Workplace, anywhere from 25% to 85% of women report having experienced sexual harassment in their work environments. The discrepancy in numbers was dependent on the vocabulary used in the surveys. For example, when employees were asked if they had experienced sexual harassment, 25% answered that they had. However, when employees were asked if they experienced a specific sexually-based behavior, such as unwanted sexual attention or coercion, the rate rose to 60% answering affirmatively.  Recent cross-sectional studies revealed that women younger than 55 were at increased risk of sexual harassment or violence in their current workplace compared to women aged 55–69. Women who belong to a sexual minority (lesbian, bisexual, or not defined) more frequently encounter unwanted behavior than heterosexual women. Harassment was more common among women who worked shifts and irregular hours than women who worked during the day. This may be because women who work nights more often work alone due to factors such as understaffing, and they might be in contact with third-party individuals (eg, patients, clients, or vendors). Factors such as a hierarchical structure with faculty and trainees, a male-dominated environment, and a culture that tolerates harassing behavior from those in power make an organization particularly prone to sexual harassment. Healthcare organizations, including hospitals, nursing homes, and clinics, have all these elements.