Introduction
One of the unexpectedly pernicious challenges the authors of this chapter have encountered when presenting our research on workplace sexual harassment has been deciding how to ‘tell the story’ so that our audiences can hear and acknowledge the problem. We have presented our work in a range of contexts, from private consultations to conference presentations, talking with intelligent, empathic, passionate people who care deeply about making the world a better place. Nevertheless, it has been our experience that individuals can struggle to accept that sexual harassment can occur in the cold, hard light of day in a busy teaching hospital.
There is a wealth of evidence that doctors do sexually harass other doctors in a variety of working relationships and contexts, at a range of career stages, across diverse specialties and roles, and even in the presence of formal interventions and prohibitions aiming to eradicate the problem. (1–6) Yet it has been our experience that this evidence is often discounted, because of the cognitive dissonance and rape myths surrounding the sexual harassment and abuse. ‘My story is not the right story’ said one of the participants in our original study, (Reference Stone, Phillips and Douglas7) ‘I mean these things happen in a hospital. It’s not a dark alley.’
Medical audiences have normative expectations about the sequence a narrative of empirical inquiry should follow, the questions that ‘should’ be asked first in any research story. They expect presentations and publications to start with the question: ‘based on prevalence, is this problem a real and serious one?’ This is the first question that is asked by ethics committees when assessing a research proposal, deciding if the project has merit. If we were to follow this expected narrative arc, we should present prevalence statistics first, demonstrating the significance of sexual harassment in medicine, leading the audience to engage in the problem. However, in this case, we find that prevalence statistics are marred by more fundamental questions around what sexual harassment really is. Is it an extension of sex discrimination, or similar to physical assault? Is it only about women? Is it a problem of safety, or just a personal problem transplanted into the workplace? Health professionals have been taught to critically appraise data, and can and do disengage from a discussion if they feel the data is flawed in the way it is collected, measured or applied. In this case, we have to work with competing narratives that are embedded in policies and processes, and differ significantly. Different people in different contexts hold strong views about what sexual harassment is, and this shapes their understanding of how to measure and address it. Because the beliefs around sexual harassment in medicine are so strong, we have found it necessary to understand and address these hidden beliefs using different narrative structures. In doing so, we reference some of the fundamental differences in the way sexual harassment has been understood in the past, and how it has changed over time.
What Are Narratives and Why Are they Important in this Field?
Narratives offer conceptual frameworks structuring the way people understand and approach phenomena. (Reference Alcoff8–Reference Scott10) It can be difficult to understand which narratives we need to address (and how one might attempt to do so) in a given context, particularly where some narratives have become so normalised or ingrained that people adopt specific positions unconsciously. However, language can inform our understanding of positionality. The particular words a person chooses to utilise when talking about workplace sexual harassment can give us some insight into what kinds of conceptual frameworks and positions they are bringing to bear on the topic. As a social process, the meaning or significance of language can also be context-sensitive: people may use the same word or phrase in different ways depending on the narratives and positions they use to craft their messages. (Reference Scott10)
In a similar way, there are a range of ideas and priorities shaping potential ‘solutions’ for the problem of doctors sexually harming other doctors. This book presents a diverse but non-comprehensive collection of narratives brought to bear on this issue from a variety of positions. The editors have consciously preserved many variations between chapters: the book does not adopt a unified position on the language used to operationalise ‘workplace sexual harassment’; the theoretical or bureaucratic frameworks that offer the most complete understanding of the phenomenon; why workplace sexual harassment exists, how it persists, and what to do about it. This chapter will further muddy the waters by exploring historical perspectives in a non-linear fashion, teasing out conceptualisations of the term ‘workplace sexual harassment’ in context to interrogate how this term developed, what kinds of problems and frameworks it has been used to describe, and how this term has been used to agitate for social change.
We wrote this chapter to equip readers for the road ahead – through the book, and more broadly. This chapter situates the book’s non-consensus positions within the ebb and flow of broader discourses on workplace sexual harassment, laying out the unique positions, goals, resources, and approaches embedded in the contexts in which these frameworks developed. In doing so, we are attempting to sensitise readers to the notion of ‘workplace sexual harassment’ as an ongoing dialogic negotiation within and between social groups and across society, to equip them with tools to attend to the narratives and positions being adopted in a given context, to critically consider their significance and meaning, and to tailor the narratives and positions they use in context to communicate effectively to a broad audience. We believe this narrative understanding is essential if cultural change is to be achieved.
How Is ‘Workplace Sexual Harassment’ Understood around the World
Sexual harassment is a social practice. Social practices have lives, institutional lives and semiotic lives. And so social practices like sexual harassment have histories. Considering sexual harassment in historical perspective allows us to ask some fundamental questions about the nature of the practice, the terms in which it has been contested, and the rules and rhetorics by which law constrains – or enables – the conduct in question. (Reference Siegel, MacKinnon and Siegel11)
It is likely that sexual harassment has been experienced throughout history, but the term itself, and the ideas behind it, are relatively recent. There have been a number of international commitments to the elimination of workplace sexual harassment over the last sixty years. In 1992, the UN formed a committee to implement the Convention to Eliminate All Forms of Discrimination Against Women (CEDAW), stating that ‘equality in employment can be seriously impaired when women are subjected to gender-specific violence, such as sexual harassment in the workplace’. This committee called for ‘effective legal measures, including penal sanctions, civil remedies and compensatory provisions to protect women against all kinds of violence, including … sexual assault and sexual harassment in the workplace’. (12) More recently, the International Labour Organization (Reference Carlson13) included a clause that required countries to ensure ‘protection against victimization of or retaliation against complainants, victims, witnesses and whistle-blowers’. (Reference Heymann, Moreno, Raub and Sprague14)
There have also been regional approaches to addressing sexual harassment in employment. The European Union Directive on the equal treatment of men and women at work explicitly defined sexual and sex-based harassment as discrimination, urging employers to take preventive measures against it. (Reference Masselot15) In Africa, the 2003 Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa – commonly known as the ‘Maputo Protocol’, calls for governments to increase transparency around recruitment, and address sexual harassment. (Reference Budoo-Scholtz, Lasseko-Phooko, Durojaye, Nabaneh and Adebanjo16)
Each of the charters adopts different definitions and conceptualisations of sexual harassment. This framing of sexual harassment may invoke any of several core ideas, which can lead to quite different understandings of the problem. For example, some differentiate harassing behaviours into types. This often includes distinguishing between ‘quid pro quo’ situations, where the powerful demand sexual favours as ‘payment’ for employment benefits, and ‘hostile environment sexism’, in which sexual harassment can be more subtle or diffuse. Sexual harassment can also be seen as a form of gender discrimination and an assertion of unequal power with the workplace (Reference McCann17). Another approach is to frame workplace sexual harassment as a problem of occupational health and safety. Risk mitigation approaches to sexual harassment are common internationally, (Reference McCann17) drawing on narratives commonly used in industrial settings. The concept of psychological safety (Reference Newman, Donohue and Eva18) in the workplace is gaining momentum, basing its approach on the work of industries like manufacturing, farming and health care and their efforts to reduce physical risks. For example, the NHS in the UK has used this framing to develop its sexual safety charter for patients and staff. (Reference Rimmer19) This approach has led to some workplaces discussing ‘sexual safety’ as a concept (Reference Rimmer20) or incorporating sexual harassment into a safety framework, either explicitly or by implicitly conceptualising sexual harassment to align with prohibitions against other forms of misconduct (Reference McCann17). Some legislative frameworks set out a ‘positive duty to report’. The positive duty is a legal obligation on organisations and businesses to take proactive and meaningful action to prevent relevant unlawful conduct from occurring in the workplace or in connection to work. (21) This positive duty is embedded in national legislation for more than 50% of high-income countries, and less than 30% of lower income countries. (Reference Heymann, Moreno, Raub and Sprague14)
The following part of the chapter will outline an ‘origin story’ of the term ‘workplace sexual harassment’ that describes key developments in theorising sexual harassment in relation to power and discrimination. This part also contextualises these frameworks by highlighting their roots in feminist theorising, grassroots activism, and advocacy for legal changes in the US of the 1970. (Reference McCann17; Reference Backhouse22–Reference Baker23).
Sexual Harassment as an Emerging Field of Interest and Action
In the US, activist movements of the 1960s precipitated significant shifts in the sociocultural, politico-legal, and economic structures of society. (Reference Siegel, MacKinnon and Siegel11; Reference Borstelmann24) By the mid-1970s, the idea of a ‘working woman’ had changed and diversified. There were shifts in women’s employment conditions, the diversity of women who were able to work, the roles they played and the workplaces they occupied. Shifts in women’s work were accompanied by discursive changes in what it meant to be a working woman and broader challenges to binary and hierarchical gender roles and norms. Meanwhile, feminist theorising and organising began to focus increasingly on new theories and methods of organising around sexual violence and sexualised economic coercion. (Reference Backhouse22; Reference Borstelmann24)
In this environment of social change, there was increasing community and legal pressure on institutions to respond to injustice. The ‘origins’ of the term ‘sexual harassment’ in grassroots advocacy have been attributed to Lin Farley, Susan Meyer, and Karen Sauvigné’s work in Cornell University’s working women’s programme, with significant theorising occurring through their independent consciousness-raising efforts. (Reference Siegel, MacKinnon and Siegel11; Reference Backhouse22; Reference Baker23; Reference Beiner, Brake, Chamallas and Williams25)
Turning ‘Personal Problems’ into Political Problems: The Role of Consciousness-Raising Groups and Collective Action
The phrase ‘the personal is political’ has been used by feminist activists to politicise issues, activate public sentiment and agitate for structural change. (Reference Backhouse22; Reference Mahoney, Häberlen, Keck-Szajbel and Mahoney26–Reference Bruley28) This phrase challenged the narrative that ‘women’s issues’ were ‘personal’ problems. A ‘personal’ problem implies that the individual experiencing the problem is responsible for causing and/or enduring or resolving it, which can in turn stigmatise and silence those experiencing the problem. Silence reduces opportunity to identify how widespread an issue is, thereby perpetuating perceptions of the problem as ‘personal’ and through this foreclosing advocacy for change. By politicising the personal, activists could propose an alternative narrative that embedded ‘personal’ problems in societal structures, enabling them to be perceived as widespread phenomena that are legitimate targets for political action. (Reference Backhouse22; Reference hooks29; Reference Kelland30)
Consciousness-raising groups can be an important strategy to politicise the ‘personal’ and thereby develop momentum towards cultural and political change. Consciousness-raising groups bring oppressed people together to discuss their shared experiences of oppression or marginalisation otherwise considered ‘unspeakable’ in broader society. (Reference Peters27; Reference Bruley28; Reference Kelland30) In some ways, this book reflects that approach.
Consciousness-raising groups can perform several functions. First, they offer group members access to practical, emotional and psychological supports. Discussing shared experiences provides group members therapeutic relief by validating their experiences of struggle and facilitating social bonding to alleviate the loneliness that is associated with traumatic experiences. (Reference Mahoney, Häberlen, Keck-Szajbel and Mahoney26; Reference Kelland30) Second, groups can foster a positive group identity and a communal bond; this facilitates healing through the development of a positive sense of self for members. (Reference Mahoney, Häberlen, Keck-Szajbel and Mahoney26) Third, groups can be effective in assisting their members in coping. Coping can take on different forms, ranging from the provision of mutual aid within the group, such as offering material supports, to the taking of collective action such as protesting in order to change the oppressive conditions shared by group members. In this way, consciousness-raising groups may best be understood as one of a battery of tools used in an overall political strategy, and which tends to be more effective when used together. (Reference Peters27; Reference Bruley28) Finally, the group functions for the collective generation of experiential knowledge. This theory-generating function involves developing models that describe the problem and potential solutions to traumatic experiences, challenging dominant narratives of ‘personal problem, personal responsibility’ and through this liberating group members from self-blame. (Reference Bruley28; Reference Kelland30; Reference Gash and Harding31)
Social interactionism, as a theoretical framework, explores how social reality emerges from the cumulative social interactions that occur in society. In essence, by interacting with others about a concept or object, we can produce a shared social meaning. (Reference Scott10; Reference Kelland30) Some feminist theorists have drawn on this theoretical foundation to highlight how social taboos on body parts or experiences can have an oppressive function, and how language can perform liberatory functions in this context. (Reference Kelland30) Making an experience like sexual violence ‘unspeakable’ deprives people of ‘rules’ to help them interpret the meaning of objective events that they have experienced, and the thoughts and feelings associated with that experience. This social silence perpetuates stigma and shame, but can also deprive people of the language they would need to enable them to talk about their experiences. (Reference Kelland30) The absence of language inflicts fracture between the experience itself and the social reality in which the experiencer exists. It becomes impossible to develop rules for how to interact with, how to comprehend, the invisible thing: the invisible thing lacks frameworks people can use to interpret its meaning and derive meaning from it. (Reference Kelland30)
Within this theoretical framework, consciousness-raising groups perform a reality-shaping function through the collective development of language. Consciousness-raising groups are the site of collective language-generation; they create a ‘bubble’ in the social reality where group members can start to make sense of their experiences. (Reference Kelland30; Reference Gash and Harding31) Through offering alternative languages and narratives, groups can start to explore new possibilities, different ways to imagine social and political environments, and how they might (or ought to) be transformed.
Turning ‘Personal Problems’ into Theory: A Narrative Inflection Point in Feminist Theorising on Workplace Sexual Harassment
Carmita Wood was an administrative assistant at Cornell University who experienced persistent sexual harassment by her boss. In 1975, she resigned due to stress-related health issues precipitated by the harassment. She was denied unemployment benefits, but was directed to Cornell’s working women’s programme, where she spoke about her experiences.
Lin Farley, Susan Meyer, and Karen Sauvigné had begun to expand their discussions beyond the Cornell programme to form Working Women United (WWU), to organise their research and advocacy efforts including using consciousness-raising groups. Sauvigné later described Wood’s story as precipitating discussion that highlighted that sexual harassment was ‘widespread’ despite its under-acknowledgement in public discourse. (Reference Baker23) Farley, Meyer, and Sauvigné drew on past experiences in other feminist collectives to reflect that consciousness-raising may be a necessary first step just to enable people to talk about their experiences. (Reference Baker23) The WWU groups debated a range of terms to capture the diversity of experiences disclosed in their discussions, but ultimately settled on the term ‘sexual harassment’ to convey that the phenomenon includes ‘not only blatant examples of sexual abuse but also more subtle behaviours’. (Reference Baker23) This work laid the foundations to develop language to describe and theorise a range of sexualised and discriminatory behaviours in the workplace: to understand what they mean, why they happen, and what can be done about it.
This story is often framed as a kind of ‘origin story’ for the term ‘sexual harassment’. (Reference Siegel, MacKinnon and Siegel11; Reference Backhouse22; Reference Beiner, Brake, Chamallas and Williams25) These groups undeniably generated language and theorising that informed a wealth of feminist research and advocacy thereafter, but it is important to understand this theorising as being entangled with the specific and highly situated needs and narratives within those group contexts. Sauvigné later represented Wood’s story as an inflection point in the group’s political organising as well as its theorising: group discussions highlighted that existing options for formal redress were failing to protect people from sexual harassment in their workplaces. (Reference Baker23) The group’s work led to a campaign of action in which Farley, Meyer, and Sauvigné wrote to feminist organisations and attorneys, seeking to connect Wood with legal and practical support, and to improve sexual harassment literacy among the actors with institutional power to detect, measure, and address it. This campaign of letter-writing now acts as documentation to support the common claim that this story is the ‘origin story’ of the term ‘sexual harassment’. (Reference Baker23)
Turning ‘Personal Problems’ into ‘Women’s Problems’: A Narrative Inflection Point in Legal Scholarship on Workplace Sexual Harassment
The WWU’s letter-writing campaign provides documentary evidence of the process of early theorising that led to the term ‘workplace sexual harassment’ being coined and disseminated. Their letters, including correspondence with feminist legal scholar Catherine MacKinnon, also provide connective tissue between key developments in feminist theorising on workplace sexual harassment and key legal developments in conceptualising workplace sexual harassment.
In many jurisdictions, workplace sexual harassment that did not constitute a criminal charge (such as cases that did not include physical violence) could be pursued through employment law as a form of ‘sex-based discrimination’. (Reference Siegel, MacKinnon and Siegel11) However, the legal system tended to conceptualise ‘discrimination’ in a way that poorly aligned with the social realities of workplace sexual harassment. Feminist legal scholar Catherine MacKinnon described this framework as a ‘differences approach’ to discrimination: employees were divided into groups for comparison, and ‘discrimination’ was detected where all members from one group received inferior treatment than all members of a second group, because of their respective group memberships. (Reference Siegel, MacKinnon and Siegel11) The ‘differences approach’ to discrimination positioned demographic categories as the central ‘problematic’: gender discrimination was a process of categorising workers into mutually exclusive A/B clusters that can be readily and objectively identified, and directing antipathy towards one of the two categories. Essentially, gender discrimination was ‘about’ antipathy towards the category ‘women’, applied only to women, and to all women. On its surface, this perspective fails to account for the fact that gender has many signifiers. For example, a 1976 interpretation of federal employment discrimination law argued that unfair treatment directed at the category ‘pregnant’, a separate status from the category ‘woman’, would not constitute sex-based discrimination because unfair treatment was not being levied on the basis of sex. (Reference Siegel, MacKinnon and Siegel11)
On a deeper level, the notion of discrimination targeting gendered characteristics (Reference Siegel, MacKinnon and Siegel11) still fails to grapple with the ‘social meaning’ of gender. Gender is a social role that involves a dynamic cluster of narratives: norms, expectations, structures of relations and positions in society, all of which are continually constructed, negotiated, and contested, and all of which are applied to people in social relations. (Reference Butler32) Later feminist and social science theorising developed an alternative narrative that workplace sexual harassment acts as a means of policing social roles. (6; Reference Cortina and Areguin33) This perspective identified that it was not ‘about’ antipathy towards women-the-category; workplace sexual harassment can target different populations through varied expressions. People experiencing workplace sexual harassment are not all women; perpetrators are more likely to be men but are not all men; LGBTQIA+ people tend to be at higher risk of victimisation in general; perpetrator–survivor dyads are not always ‘heterosexual’. (1; Reference Butler32) Today, social role-policing narratives can better account for differences within marginalised groups in harassment experiences, intersectional expressions of sexual harassment (e.g. racialised harassment), and variations in hierarchical organising and expression embedded in differences between the structures of different social environments (e.g. varying the salience and/or relative empowerment of a given ‘social category’ in different contexts). (6; Reference Butler32)
Proving sex-based discrimination involved identifying and tackling several dominant narratives. One narrative was the notion that workplace sexual harassment is ‘about’ sex, in that it was a behaviour motivated by one individual’s ‘misplaced desire’ towards another individual. (Reference Siegel, MacKinnon and Siegel11; Reference Beiner, Brake, Chamallas and Williams25) This narrative function renders workplace sexual harassment firmly a ‘personal problem’: harassing behaviours can’t be discriminatory if they only target a specific person, because they don’t direct unfair treatment towards all employees within a given (gendered) category. (Reference Siegel, MacKinnon and Siegel11) The notion of harassment being ‘about’ sex was later used to argue that harassment does discriminate according to gender if the alleged perpetrator’s sexual orientation aligns (exclusively) with the targeted person’s gender. (Reference Siegel, MacKinnon and Siegel11)
Turning ‘Personal Problems’ into Problems of Power and Dominance: The Importance of Legal Reform
Catherine MacKinnon is credited with navigating such narrative challenges by adapting a specific strain of feminist theory to fit the pre-existing legal landscape. (Reference Siegel, MacKinnon and Siegel11; Reference Beiner, Brake, Chamallas and Williams25; Reference Cortina and Areguin33). She drew on feminist theory (including that informed by the WWU) to define sexual harassment as ‘dominance eroticised’, proposing narrative alternatives within the legal profession to the ‘discrimination on the basis of sex’ argument (Reference Siegel, MacKinnon and Siegel11; Reference Backhouse22; Reference Baker23; Reference MacKinnon34). Her work transformed the legal landscape in this field. To MacKinnon, sexual harassment was ‘an expression of dominance laced with impersonal contempt, the habit of getting what one wants, and the perception (usually accurate) that the situation can be safely exploited in this way – all expressed sexually”. (Reference MacKinnon34). Her position reframed sexual harassment such that its defining features included power, coercion, and exploitation, to challenge the dominant narrative in legal spaces that sexual harassment was about sex and sexuality.
MacKinnon’s reframing targeted the legal definition of ‘sex-based discrimination’, offering ways of thinking about sexual harassment that would enable the means to meet legal thresholds and strengthen the capacity of the legal system to offer justice for people experiencing workplace sexual harassment. This included proposing an alternative way to ‘test’ that an unfair treatment was gender-differentiated, other than the ‘differences approach’: ‘how can you tell that this happened because one is a woman, rather than to a person who just happens to be a woman? The basic answer … is: a man in her position would not be or was not so treated.’ (Reference MacKinnon34, p. 192)
MacKinnon promoted the understanding of unfair practices as ‘status harms’, operating within formal and informal interacting systems of oppression and marginalisation, rather than problematising practices themselves as a primary and sole source of harm independent from their broader context. MacKinnon’s proposed ‘inequality approach’ facilitated an understanding of practices as discriminatory due to their discriminatory function rather than requiring that we aim to prove a discriminatory purpose. This provided a key narrative to build literacy in structural analysis of gender and its social construction in legal arguments. (Reference Siegel, MacKinnon and Siegel11; Reference Baker23)
Turning ‘Personal Problems’ into Change: The Role of Theorists and Advocates
Collective movements and legal communities have thus responded to and informed one another. There has been considerable cross-pollination over time between grassroots, academic, and political spheres of action on sexual harassment. Researchers in social sciences have built on these foundations to develop frameworks designed to support empirical inquiry into sexual harassment.
One foundational theoretical model of sexual harassment in social science is the ‘tripartite model’, which conceptualises sexual harassment as an ‘umbrella term’ (Reference Cortina and Areguin33; Reference Berdahl35) that encompasses three sub-categories of behaviours. The first two (‘sexual coercion’ and ‘unwanted sexual attention’) involve behaviours that directly and explicitly centre on sexualised experiences. ‘Sexual coercion’ involves explicit or implicit attempts to leverage employment conditions to make ‘sexual demands’ or obtain ‘sexual favours’. Unwanted sexual attention involves ‘expressions of sexual interest’ levied towards a target who does not want them, ranging from ‘unwanted sex talk’ to non-consensual sex acts. The third form of sexual harassment is ‘gender harassment’, and includes incidents where sexuality is deployed or weaponised, but the behaviour ultimately aims to communicate ‘denigrating, demeaning, or hostile attitudes based on gender or sex’. (Reference Cortina and Areguin33; Reference Berdahl35; Reference Madsen and Nielsen36)
While this framework aligns in many ways with the ‘discrimination’ narrative of sexual harassment described above, in law and feminist theorising, there are also nuanced differences. Feminist theorising aims to make sense of the world around us and to evaluate short- and long-term political strategies by developing mechanistic narratives that can help us see social phenomena as part of a social system. (Reference hooks29) In contrast, law is generally more focused on the problem of ‘translating everyday affairs into legal issues’, (Reference Smart37) functioning to ‘supply normative benchmarks and put down parameters that can narrow one’s vision of and regulate responses to sexual violence’. (Reference Gash and Harding31) Social science frameworks, like the tripartite model, are designed to operationalise phenomena: to prepare concepts for a process of being interrogated through scientific methods, to constitute a legitimate ‘field of inquiry’.
While these conceptual frameworks of sexual harassment overlap and inform each other, they can differ in meaning for the people who use them. Legal frameworks come with their own limitations: they are inextricable with the pre-existing legal systems to which they respond, and so are necessarily specific and limited in the kinds of questions they are equipped to ask and answer, and the kinds of ‘solutions’ they imagine possible for a given problem. Feminist theories of sexual harassment have been critiqued on the basis that causal directions are often unclear and challenging to empirically test: is power the environment that enables sexual harassment to occur, is sexual harassment motivated by wanting power or perceived status threat, is sexual harassment a way to express power, is sexual harassment a way to get power over others or a form of power itself? Thus, while a legal scholar, a gender theorist and a sociologist might all agree that they adopt a ‘discrimination framework’ for understanding sexual harassment, what they mean by this may differ.
Turning ‘Personal Problems’ into Problems of Deviance: The Dynamic Nature of Sexual Harassment
Thus, ‘workplace sexual harassment’ can be conceptualised through narrative frameworks that overlap and differ in important ways. Narratives respond to the priorities and goals of actors in specific positions and contexts, working within, on, and around specific pre-existing political infrastructure and sociocultural structures. This means that theoretical variation can exist alongside intercultural variation in narratives, practices, and structures.
Such conceptual variation poses challenges for researchers. Some researchers may use national formalised systems explicitly prohibiting workplace sexual harassment to provide a unified, locally relevant definition or ‘snapshot’. This approach is necessarily limited, particularly as formal systems are not the only way that workplace sexual harassment may be understood or addressed in a given society. Lack of national legislation explicitly prohibiting sexual harassment does not necessarily mean that a country lacks any narratives to understand, or strategies to address, sexual harassment. (Reference Bacchi and Jose38)
Earlier in this chapter, we described a challenge to the narrative that workplace sexual harassment is ‘about’ sex. However, this narrative can be helpful for understanding how workplace sexual harassment is conceptualised, problematised, and challenged in different contexts, through mechanisms other than explicit legislative prohibitions.
Sex is a social act. Sociocultural narratives articulate and describe which behaviours ‘count’ as sex, and what ‘sex’ means. (Reference Rubin and Rubin39; Reference Seidman, Seidman, Fischer and Meeks40; Reference Vance, Berger, Watson and Wallis41) This necessarily involves negotiating what constitutes acceptable (‘normative’) or unacceptable (‘deviant’) sexual behaviour. (Reference Rubin and Rubin39; Reference Vance, Berger, Watson and Wallis41) When we try to define what ‘counts’ or ‘does not count’ as workplace sexual harassment, what workplace sexual harassment means to people and why we think it’s a problem, we often draw on broader discourses about the nature and boundaries of normative and deviant sex. For example, this might include narratives that workplace sexual harassment is bad because it involves economic coercion in a working relationship: sex is ‘deviant’ here because of the relational context. These layers of social meaning are highly situated, but they’re constantly being negotiated as we talk through these narratives and reshape them in our social interactions. (Reference Rubin and Rubin39; Reference Vance, Berger, Watson and Wallis41)
‘Discipline’ describes formal and informal regulatory mechanisms that produce, communicate, and enforce social norms. It includes formal systems of governing society, such as legal systems that punish deviant behaviour. It also includes informal social mechanisms like social sanctions, such as attaching stigma to ‘inappropriate workplace behaviour’. (Reference Seidman, Seidman, Fischer and Meeks40) Disciplinary mechanisms can inform one another, but the ways they operate alongside and interact with one another can sometimes be unpredictable. For example, some cases have achieved formal redress for sexual harms in the absence of explicit formal prohibitions: this has involved leveraging narratives about ‘appropriate’ conduct, particularly gendered sexual narratives such as ‘sexual etiquette’ or ‘damaged virtue’, to imbue experiences of sexual harms with a sense of severe moral injury. (Reference Bacchi and Jose38) Such narratives make sexual harassment ‘about’ sex in ways that may implicate gender or power without necessarily being ‘about’ discrimination, leveraging informal systems of social sanction to navigate formal disciplinary systems. Alternatively, formal disciplinary systems can also be ineffective where they conflict with social norms. For example, sexualised conduct can be socially normalised among powerful groups, even within organisations that adopt ‘zero tolerance’ policies for sexual harassment in the workplace.
Thus, notions of workplace sexual harassment and systems of redress are embedded in complex, highly situated discursive systems that structure social relations in a given context. These dynamics produce cultural specificity and complexity of social meaning that make it challenging to research sexual harassment, particularly for researchers aiming to detect and interpret how workplace sexual harassment is being experienced, understood, and addressed in cultural contexts other than their own.
Responding to Sexual Harassment: A Complex Problem with Multiple Intersecting ‘Solutions’
This chapter highlights that the concept of ‘workplace sexual harassment’ is a moving target. Legal, social science, and feminist activist spheres offer evolving and often-diverging approaches to theorising and taking action on sexual harassment, and the sociocultural narratives that make meaning from workplace sexual harassment are constantly negotiated and contested. If we want to develop effective interventions – if we want to make a change in the world, to address sexual harassment – we have to develop some kind of understanding of the problem that lies in front of us. This tends to include asking questions such as:
How do you decide that an incident qualifies as ‘sexual harassment’?
What causes sexual harassment? What are the functions or purposes of the phenomenon? What motivates discrete incidents or behaviours?
Should sexual harassment be seen as a problem between individuals, as a problem within a collective or group, as a problem within society, or a mix of all three?
Who are the actors with the relevant power and scope to address the specified cause, at the specified level, to reduce the specified behaviours?
What, exactly, is the part of sexual harassment that makes it ‘wrong’?
Approaches to answering these questions can vary between jurisdictions, and between workplaces. These differences don’t necessarily signify an ‘incorrect’ approach. Sexual harassment is a complex problem, and it’s not ‘wrong’ to try to understand and respond to the problem from multiple angles. It is, however, important to understand that any proposed theoretical framework, proposed solutions or interventions, and even narratives framing and defining the ‘problem’ are specific ways of approaching the issue: they highlight and target specific aspects of the problem in specific ways.
For example, a campaign to promote sympathetic narratives about women responds to an understanding of workplace sexual harassment as being caused by culturally endorsed antipathy towards women. However, a problem of antipathy towards women doesn’t necessarily produce solutions that can also address sexual harassment motivated by or targeting other factors or populations. Not all people who are sexually harassed are women, and some sexual harassment (such as ‘intersectional sexual harassment’) targets marginalised identities or characteristics other than ‘woman’. (Reference Cortina and Areguin33)
Specific and targeted interventions can be effective, but approaches should fit the context. Effective action requires thinking critically about how the problem is being framed. What part of the problem are you being presented with? How does that problematisation ‘match’ certain kinds of solutions over others? What parts of the problem may be more or less effectively addressed through those solutions? It’s important to attend to the specificity of narratives we encounter, to ensure our response is effective.
Newer Grassroots Methods: Hashtag Activism
Social media tagging systems have increasingly been used to mobilise around political goals. ‘Hashtag activisms’ such as #MeToo can perform consciousness-raising functions: they afford socioemotional support structured around sharing lived-experience narratives of marginalisation and oppression, which can then be transmuted to developing a feminist consciousness to understand these experiences as structural rather than personal, which can then motivate action to contribute to social change. (Reference Gash and Harding31; Reference Mendes, Ringrose and Keller42; Reference Gleeson, Turner, Fileborn and Loney-Howes43)
The functions of hashtag activism are inherently shaped by technology. Social media can create a sense of public access to private lives, imbuing it with symbolic and practical significance for consciousness-raising and mobilising around ‘unspeakable’ issues. (Reference Mendes, Ringrose and Keller42; Reference Mendes, Ringrose, Fileborn and Loney-Howes44) Social media technologies can expand the potential reach of a movement beyond a physically located community (Reference Mendes, Ringrose and Keller42; Reference Gleeson, Turner, Fileborn and Loney-Howes43), but factors like tagging systems also allow for increased efficiencies in censorship policies and practices that suppress speech and restrict reach. (45)
Online platforms also necessitate new priorities and strategies for collectives to protect members and promote the integrity, longevity, and political efficacy of the movement as a whole. (Reference Mendes, Ringrose and Keller42; Reference Mendes, Ringrose, Fileborn and Loney-Howes44) The ‘digital labour’ of moderating content is essential, but the necessity and real costs of moderation often go unrecognised. Identified persons adopt responsibility to promote a supportive group environment, acting as socioemotional ‘buffers’ that enable group members to be vulnerable, to enable mutual support and bonding and thereby promote group efficacy and longevity. This can be labour intensive and emotionally draining, and can expose moderators to vicarious trauma and targeted abuse; furthermore, online activist environments often lack structured support or exit strategies used in other collective action environments to protect against burnout. It can create further vulnerability to moderator burnout and undermines group capacity to ‘stay the distance’. (Reference Mendes, Ringrose and Keller42; Reference Gleeson46)
Exposing the soul-baring processes of private disclosures to a public sphere also means the public can bring to that disclosure their own interpretive frameworks and expectations. (Reference Gleeson, Turner, Fileborn and Loney-Howes43) Even when groups are not being actively targeted for online abuse, they may experience challenges in managing internal supportive group dynamics alongside the social dynamics of their outward-facing advocacy efforts. For example, best practice ‘private’ responses to disclosures within consciousness-raising groups are to non-judgmentally receive and believe the disclosure, which fosters a trauma-supportive environment that performs therapeutic and theorising functions. (Reference Kelland30)
However, public allegations have a different normalised narrative trajectory: public disclosure is interpreted through a pseudo-legalistic paradigm of ‘verifying claims’. (Reference Gash and Harding31) Groups or disclosures made through social media can thus become the site of tensions between ‘publics’ of the medium and the more ‘private’ group needs, norms, and expectations around disclosure. (Reference Mendes, Ringrose, Fileborn and Loney-Howes44) This can pose challenges for collective action in which hashtag activism plays a dual role as simultaneously offering support and developing public awareness.
Thus, hashtag activism can involve negotiating layered complexities in social dynamics, both for members of campaigns and for ‘outsiders’ encountering and interacting with it. It can be as specific and targeted as any other intervention or strategy, and engaging with or responding to these efforts requires consideration for the most appropriate response in the context in which disclosures – and broader movements – are being brought to light.
Positionality and Competing Narratives
The stories we have told in this chapter include a narrative about the term ‘workplace sexual harassment’. The position of this story as an ‘origin story’ of the term ‘workplace sexual harassment’ (Reference Siegel, MacKinnon and Siegel11; Reference Backhouse22) shouldn’t be understood as the ‘first’ kind of efforts to address workplace sexual harassment, nor as the genesis of the concept.
What was left in or out of this ‘origin story’ are narrative choices, and they serve a purpose. (Reference Bacchi and Jose38) We have highlighted individual ‘trailblazers’ to ‘lead’ the movement, included the story beats about one individual’s lived experience catalysing broader action, situated the story in spaces accessible to institutionally empowered actors, and described a narrative trajectory of linear progress: the law didn’t work well, people worked hard to change that, and now it works better. Simply put, it’s an academic hero’s journey.
Some histories of feminist organising emphasise ‘unity through sameness’: a narrative that bonding over shared, similar experiences of injustice and oppression empowered people to work collectively to effect change. This ‘sisterhood’ narrative is critiqued for seeking to strengthen collective voice by subsuming or marginalising ‘divergent’ concerns and points of difference between members of the collective, in favour of ‘focusing on women’s issues’ in ways that reify a particular notion of what a ‘working woman’ is. (Reference Scott10; Reference hooks29; Reference Brown47) In short, the ‘sisterhood’ narrative normalises a specific perspective and implies it to be universal.
Axes of power and domination shape dynamics of oppression in ways that deeply influence social life. However, some of these axes are not necessarily visible or of central concern from certain positions in society.
For example, some contemporary strains of feminist theory on workplace sexual harassment problematised ways that economic relations structured gender and sexual relations. (Reference Siegel, MacKinnon and Siegel11) The dominant, simplified narrative to explain that framework often draws on white, middle-class, heteronormative notions of the home and family: men are ‘breadwinners’ and women are ‘housewives’, and these positions in society confine women’s labour, sexual lives, and social lives to the home, inextricably entangling women’s labour and economic power to their sexual relations in the home and subjugating them relative to men. Work empowers women by liberating them from the home and from economic dependency and subjugation; workplace sexual harassment puts women ‘back in their place’ by reinstating sexual subjugation within women’s working lives. (Reference MacKinnon34)
Brown highlights the specificity of this narrative by exploring the meaning and significance of workplace sexual harassment for Black women. What it means to be a ‘working woman’ differs where intergenerational knowledge and practices for keeping oneself safe in exploitative workplaces were developed through a history of ‘domestic service’ and chattel slavery; theorising workplace sexual harassment as a problem of ‘male dominance’ is a risky strategy for a community that remains vulnerable to racialised harms in the face of enduring narratives that villainise Black men’s sexuality as posing inherent, uncontrollable danger of sexual violence specifically to white women. (Reference Brown47)
Different positions also produce different approaches. For example, some feminists contemporary with WWU drew on their theorising, but had to adapt it to facilitate legal reform in their own countries. (Reference Backhouse22) One contemporary collective, the Alliance Against Sexual Coercion (AASC), was relatively more service-oriented than the WWU (later, the WWUI), in part due to its genesis in rape crisis centres; (Reference Baker23) the AASC, while still publishing prolifically, focused less on legal reform relative to the WWUI, reasoning that the existing legal system (particularly enforcement) reproduced oppressive patterns such that anti-harassment laws would be unlikely to afford justice to ‘a poor, Third World or lesbian woman, particularly if harassed by a “respectable” man’. (Reference Baker23)
Engaging with diverse standpoints, particularly at intersecting axes of marginalisation, can highlight expanses of marginalising and oppressive structures of society and rich, highly situated strategies and scholarship, (Reference Richardson and Taylor48) that may otherwise go un-attended by the movement. It does not make sense to conceptualise all instances of workplace sexual harms as stories of ‘men sexually abusing women’. There are many kinds of power in society, and the stories we tell attend to particular axes of power to make sense of them; the ones we neglect to attend to tend to become invisible. For example, the needs and safety of precarious workers and workers in stigmatised or illegal employment conditions are still rarely centred in discussions of workplace sexual harassment. Understanding workplace sexual harassment through the lens of multiple interacting axes of power offers nuance and flexibility to respond to the conditions of workers experiencing multiple marginalisations. Sexual harassment tends to increase where working conditions are exploitative, where there are dependent aspects of workplace relations that enable coercion, and where rigid hierarchies produce steep power differentials within the workplace. Obviously, these characteristics are common in professions, including law, the military and medicine.
Furthermore, the universalising narrative obscures the ways that differences are mutually constituted or relational, thereby potentially reproducing oppressive and marginalising patterns that silence the voices of people experiencing multiple intersecting forms of marginalisation and oppression. (Reference hooks29; Reference Brown47) In short, perpetuating a single universalising narrative can foreshorten the vision of a movement and inhibit effective responses to complex sociopolitical environments.
In this chapter, we have not discussed many details about the people in the ‘origin story’. The story was stripped of much of the context necessary to understand how specific and situated the definition of ‘workplace sexual harassment’ developed really was. The work of the WWU was informed by the histories, skills, social capital and resources that Farley, Meyer and Sauvigné developed through their activist backgrounds and their academic backgrounds; it was informed by Cornell University’s priorities and initiatives that contextualised the programme, and by the American legal and sociocultural landscape the WWU and Catherine MacKinnon navigated. Another way to frame the origin story is a working women’s organisation, drawing on the ideas, resources and precedents of diverse communities of working women before them, theorised through experiential knowledge generation and engaged actively in dissemination and translation of that knowledge back into community, as well as institutions like law and the academy. (Reference Baker49) Farley’s, Meyer’s, Sauvigné’s, and MacKinnon’s class positions and connections to institutions enable the story to adopt a sense of legitimacy for people with institutional power, but constructing them as figurehead-theorists erases the labour of the workers whose experiential knowledge was fundamental to developing the language of workplace sexual harassment – the labour was inescapably a collective effort. (Reference Baker49)
By laying out a range of ways of thinking about and approaching this ‘origin story’, we are highlighting another kind of contextualisation that shapes the narratives we encounter, beyond broad categories like ‘culture’ and ‘discipline’. We are on a completely different side of the world from many of our contributors; we each may look at the Earth and see different features, and while our views don’t invalidate each other, none of us are necessarily seeing the whole celestial sphere. (Reference Haraway50) Positionality involves reflecting on one’s position, and particularly how that may shape one’s perspective. This is the final layer of context we offer in this chapter: this chapter was written by a white queer person on unceded Kaurna country and, later, unceded Awabakal country. We drew on texts in English accessible as determined by intellectual property agreements between academics, publishers, universities, associations, and international bodies. Our educational background affords us some fluency in academic dialects across a range of social sciences and humanities disciplines, though this too has been shaped by the contexts in which we grew up and entered our learning life. We have chosen, in this chapter, not to explore sexual harassment movements or law across different countries or times. Instead, we offer a specific story as a framing device to highlight the ways that workplace sexual harassment is conceptualised as a form of highly situated and contextually specific problematisation of a social phenomenon.
Medicine and the Role of Power and Agency in the Medical Hierarchy
Collectively, doctors have layers of institutional power: they have academic power to generate ‘legitimate’ knowledge, they have direct and epistemic power over patients’ bodies, and they often have some form of legal power through legislative frameworks. People tend to struggle to understand that doctors can and do experience sexual harassment at work: if sexual harassment is ‘about’ power and hierarchy, and if doctors have power, it logically follows that doctors must perpetrate sexual harassment, but can’t be vulnerable to it. When confronted with a case of sexual harassment between doctors, they may offer alternative narratives to reconcile the dissonance: perhaps the ‘victim’ can be seen as flawed or weak or complicit, and therefore not worthy of being seen as a ‘doctor survivor’. This social narrative is pervasive and challenging to navigate when trying to develop momentum to address sexual harassment in medicine.
The realities do not fit this social narrative. Power is not unidimensional and concrete: empowerment in one way or one context doesn’t protect people from disempowerment or vulnerability in other contexts or other ways. The structures constituting medical hierarchies are not ahistoric, immobile, and quarantined from all other social hierarchies and discourses.
Power is better understood as a social dynamic than a category. Doctors can be disempowered in their workplaces while simultaneously being empowered relative to others in their workplaces. As discussed in this chapter, social realities are dynamic and contested. Analysing sexual harassment requires accommodating more than one axis of power, and may require accommodating power dynamics unique to a particular context. This could include considering the rigidity of hierarchies within the medical profession or within specific kinds of workplaces like hospitals; it could include considering the ‘invisibilising’ effects of enculturating an expectation of ignoring or suppressing one’s embodied experiences in the course of work; it could include attending to working conditions that create dependent dynamics such as rotations or working visas.
Power dynamics could also include intersecting marginalisations on broader social hierarchies. How does a doctor with disabilities navigate work-based pressures to ignore or suppress embodied experience, particularly in inaccessible workplaces? How do International Medical Graduates experiencing racialized violence in isolated rotations manage tensions in their working relationships when their external avenues are constrained? (Reference Pascoe4) Other forms of positionality that aren’t necessarily axes of marginalisation may also be important to account for. For example, doctors can experience profoundly different realities of work than other workers even in the same workplace, and if the positions of doctors are different from those of nurses or administrators or janitorial staff, it may be helpful to tease out what those positions mean in order to anticipate and account for differences in the ways a given strategy or approach may affect different workers.
Balancing Consensus and Complexity: The Importance of a Narrative ‘Toolkit’
There is clearly a lack of consensus around what sexual harassment is, and how it should be addressed in the medical workplace. We have discovered in our research that although there may be some consensus in the policies around sexual harassment, discussions rapidly reveal that people using those policies have different conceptualisations around what sexual harassment actually is. We are often questioned about our definitions of sexual harassment, and the language in those questions indicates that there are different narratives at play. For instance, some will focus on discrimination in the workplace, questioning whether women in the workplace are as vulnerable as we suggest. Others will debate the ‘edges’ of the narrative, questioning whether an act can be considered harassment if there is no assault. In doing so, they often talk about young doctors being ‘over-sensitive’ or ‘insufficiently resilient’.
These arguments are based on three narratives that have been foundational for much work on sexual harassment over the years. Sexual harassment can be seen as an extension of discrimination, an extension of physical assault, and/or an extension of occupational harms. Because these narratives are so powerful, it is impossible to offer a universal consensus statement on why sexual harassment persists, and how it should be managed. This chapter offers narrative tools to critically engage with discourses and positionality, which can be crucial components of effective and strategic communication and advocacy.
When reading this book, it may be helpful to consider what narratives are dominant in the reader’s context. There has been a deliberate attempt by the authors and editors to highlight how sexual harassment is framed, understood and managed in different contexts, and it may be helpful for the reader to consider how these contexts shape the way sexual harassment is understood. Like many social processes, there is no one ‘right’ way to address the problem, because there is no one ‘right’ type of experience. Advocacy for doctors who experience sexual harassment by other doctors requires a lexicon of narratives and counter-narratives in order to make the phenomenon seem possible. Narratives that make the behaviour visible, as well as invisible, need to be considered before advocates can craft effective strategies to manage it. To do so, the community needs an effective narrative toolkit, which must account for different positions in the medical social world, as well as the different stories to which they respond.
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