It has been more than 15 years since Tarana Burke started the MeToo movement to forge solidarity for socially marginalized victims of sexual harassment and gender-based discrimination. Although the social media uptake of #MeToo and #TimesUp that followed has increased visibility of the problem of sexual harassment in the workplace, most of our workplaces have not yet been transformed to spaces with zero risk for sexual harassment. We think that reclaiming some of the intersectional principles that were embedded in the MeToo movement from its inception will be important if we are to truly eliminate sexual harassment from the workplace.
Sexual harassment remains a persistent problem across society, and our intensive care units, hospitals, and universities are no exception.1 Recent studies estimate that 60% of female nurses and about 30% of male nurses worldwide report an incident of sexual harassment.2 In a recent systematic review,3 the pooled prevalence of sexual harassment against female nurses was estimated at 43.2%, which included verbal, nonverbal, psychological, and physical acts. In this same study, the perpetrators against these female nurses included patients, patients’ families or visitors, physicians, other nurses, and coworkers.3 Similarly, across multiple specialties in medicine, women at all levels of training report disturbingly high rates of sexual harassment and gender discrimination. In a survey of postgraduate physician trainees across multiple specialties, 61% of participants reported personal experience of gender-based discrimination during residency training and 87% attested to observing such discrimination during their training; only 4.5% of the respondents reported the discrimination.4
A full reckoning of the consequences of sexual harassment must start with an empathic recognition of the potential negative developmental, physical, and psychological impacts of trauma for the victims. Numerous studies have documented that victims of sexual harassment report decrements in physical and mental health well-being; sexual harassment has been associated with lower job satisfaction, increased risk of job withdrawal, lower commitment to the organization, and lower productivity and performance.1
Recognizing that nurses are uniquely vulnerable to verbal and physical abuse in the workplace, the American Association of Critical-Care Nurses (AACN) released a position statement in 2019 that called for health care facilities to ensure the safety and security of staff, patients, and visitors.5 Nurses and other clinicians being sexually harassed by patients or patients’ visitors is a particularly thorny challenge. Viglianti et al6 described the publicly available patient bill of rights across 50 hospitals in the United States and found that although nearly all of the hospitals specifically delineated patients’ rights to be free from harassment, none contained specific language against patients or visitors’ perpetrating sexual harassment.
The sheer prevalence and scope of the problem suggest that for most workspaces, only a complete transformation in the organizational climate and culture will lead to meaningful improvement. By suggesting that such a transformation requires an intersectional lens, we are suggesting that organizations must account for people’s multiple and overlapping social categories (eg, race, gender, ethnicity, nationality, disability, and sexual orientation) as they create and sustain a work climate free from sexual harassment.7 An intersectional framing acknowledges that systems of oppression are interconnected and that such interconnectedness invites strategies of resistance from other social justice movements into the fight to end sexual harassment in the workplace.
“[O]rganizations that trust their staff’s testimony and proactively listen to the women in their workforce may be better positioned to eliminate sexual harassment.”
We highlight 3 communal intersectional principles that we think have the potential to help organizations create and sustain a work climate with zero sexual harassment.8 To say that these are communal practices necessarily localizes these at the group level. The first principle asks organizations to acknowledge the communication vices and virtues that sustain and resist injustices, respectively. The second principle encourages groups to complicate blame and responsibility. The third principle encourages groups to create space and time for reflection.8
Interpersonal communication vices that help sustain gender discrimination and sexual harassment include such things as arrogance, lack of curiosity or closed-mindedness, and either-or thinking.8 For example, if organizations do not have structures and processes to track reports of sexual harassment, this active lack of curiosity makes it easy for leaders to deny that there is a problem. Ideologies of color blindness or gender blindness within an organization can implicitly create a culture of silence around specific kinds of mistreatment. If an organization’s policy is rooted in the false notion that only “bad” people can be guilty of sexual harassment, then such thinking makes it hard for organizations to hold people that they hold in high esteem accountable for their missteps and mistreatment of others.
Communication virtues, on the other hand, are interpersonal practices within social groups such as humility, acknowledging the importance of affect/emotion, equanimity, or slowness to judge that can help resist injustices.8 For example, organizations that are willing to trust their staff’s testimonies and engage in proactive listening to the women in their workforce may be better positioned to eliminate sexual harassment. In calling these types of group practices “virtues,” we remain agnostic to the more common practice of virtue signaling, where organi zations express their support for a particular social justice issue through social media or other advertisement campaigns.
By asking organizations to consider approaching blame and responsibility as a complex problem, we are asking organizations to analyze each case on its merits by looking at the multiple social, organizational, and individual factors that could have contributed to the conduct in question. We worry that a one-size-fits-all approach or the often expressed “zero-tolerance” policies may more often serve as another means for organizations to signal their virtue while ignoring the organizational climate that sustains sexual harassment.
In asking organizations and groups to spend time and create space for reflecting and imagining together, we mean to suggest that it is not enough for organizations to strive for compliance with their local and regional laws and regulations. Rather, it becomes important for organizations to create space for diverse groups of people to reflect on the key features of the work climate they imagine would be crucial for eliminating sexual harassment. A prerequisite for such reflexive work is for organizations to invite into the imagination space an intentionally diverse group of people. Here again, diversity is not another means for organizations to signal their virtues. Rather, intentional diversity is a key ingredient to creating enough tension or friction8 to spark the most productive communal imaginative work. For example, an organization in which most of the leaders are from the Baby Boom generation may do well to elevate young and queer voices in their collective musings about how they want to change their work climate to get to zero sexual harassment. Individuals invited into the group are burdened with the shared responsibility to speak from their individual lived experience, from their own social knowledge of the others within the group, and from their own knowledge of the organization as it is and the organization as it could or should be.
“Intentional diversity is a key ingredient to creating enough tension to spark the most productive communal imaginative work.”
Social media campaigns and virtue signaling alone will not eliminate sexual harassment from our workplaces. Instead, transformational changes in our intensive care units, hospitals, and universities will be required. Such a transformation must incorporate and value difference as a strength. As Audre Lorde stated in her essay, “The Master’s Tools Will Never Dismantle the Master’s House,” we must be able to “make common cause with those others identified as outside the structures … to define and seek a world in which we can all flourish.”9
The statements and opinions contained in this editorial are solely those of the coeditors in chief.
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