Sex, power and gaslighting

With female surgeons coming under attack for speaking out about sexual assaults, Pulse columnist Dr Shaba Nabi looks at why even highly successful women are targeted

You’ve probably been living in a cave if the recent publicity about sexual assault among female surgeons has passed you by. Perhaps it wasn’t a huge surprise for many of us, who have either witnessed or been on the receiving end of similar behaviour. More shocking was the attempted justification of such assault by dinosaurs like retired anaesthetist Peter Hilton. In a letter to The Times, he referred to women brave enough to speak of their experiences as ‘snowflakes’, and told them to ‘toughen up’.

Among my peer group (we have a class of ’92 WhatsApp group), opinion was split over whether the paper should have published his letter. The anaesthetists were the most enraged, presumably because their usually agreeable profession had been brought into disrepute. But I am not a big fan of censorship, and only by airing all opinions can we start discussing things in an adult way. And let’s face it, his letter and attitude illustrate the issues perfectly. 

So, what are those issues? Perhaps sexual assault is a misnomer, as this behaviour has nothing to do with sex and everything to do with power. And the power can sometimes belong to the victim, as well as the perpetrator, and sex is used to topple them from their throne. 

I’m sure, like me, you have reflected on experiences during training when you had no power. You may have been a busy ward SHO, at the bottom of the food chain, being asked to show the surgeon some X-rays in theatre. You may have hesitated at the door because you were not wearing scrubs in a sterile environment, and you may have articulated that you had clothes on. And then you may have heard a booming, male voice telling you they wanted to see you with your clothes off, followed by raucous laughter. And then you may have run to the on-call room in tears, wondering why you’d worn such a short skirt that day. 

We can only speculate on the drivers of this type of behaviour: popularity (‘Look how funny I am’), power (‘I can say anything I like and people will laugh’) and misogyny (‘The operating theatre is no place for girls’). 

Fortunately, the world of general practice has been less boorish in this respect, but it has become apparent that acquiring power and influence has been no inoculation against these advances. And the behaviour is then even further removed from anything sexual. 

When a woman is at the top of her game, what could be more discombobulating than to use sex as a weapon to bring her down a notch or two? Confident and accomplished female leaders have been transformed into emotional wrecks through the deployment of this weapon. During this process, the power is transferred from victim to perpetrator, who becomes addicted to the dopamine hit. 

These hits require ever-greater risk to maintain the buzz. And what could be higher risk than to target a female leader, who is much more likely to have the confidence to speak up than a ward SHO? But if she does speak up, she is faced with denial and gaslighting, meaning her confidence is replaced with self-doubt. Take indecent exposure: with a prevalence of around 2% and a conviction rate of 0.05%, it is a crime hidden in plain sight, and impossible to prove without witnesses or CCTV footage. 

So, sex is an incredible weapon to either display or undermine power. And we seem to be stockpiling these weapons, rather than disarming them.

Dr Shaba Nabi is a GP trainer in Bristol. Read more of her blogs here