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Casual misogyny and the myth of 'feminization' in dentistry

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The Dalhousie scandal, and the subsequent response, not only exposed the misogyny of the "DDS Gentleman's club 2015," but pulled back the curtain on the dentistry profession's wider tolerance of this culture. The posts by the male students against their female colleagues displayed a distaste for women in the profession, and the confidence to use Facebook as a collective platform revealed they felt they could behave this way. There was an undercurrent of permission they felt they had from their instructors (like the one who showed a video of the bikini-clad women), school, and society. As a female dentist, I am appalled that many people, including my colleagues, are more concerned with issues such as privacy breaching and the consequences to these "gentleman's" careers than they are for the impact this has on women.   

Within the dental profession, there has rightfully been condemnation of the posts, but the main concern has been on the impact of the scandal on the reputation of dentists, rather than what we can do to support women and challenge sexism. The Canadian Dental Association calls on us to resist "the temptation to label this student behavior as being solely a gender-related issue," and should instead be about a "culture of respect." But failing to identify and challenge sexism is part of the problem that allows it to fester, a problem that permeates dentistry and society at large.

While some of my male colleagues have minimized the Dalhousie scandal, the desire of my female colleagues to see justice speaks to their own experience, a position I can comprehend. In dental school, while performing a procedure on an anesthetized patient in the operating room, the supervising dentist patted me on the behind twice while I was working. In dental practice, I have had patients flirt and sexualize me and my female assistants and office staff.  In my third year of dental school, a clinical instructor told me it was "a waste of time to train female dental students, you all end up working part-time anyway."  I refrained from responding because he was in the process of marking my clinical performance for the day. 


The idea that men are the norm of dentistry, and women are interfering and undermining the profession, has been popularized in the theoretical journals of dentistry -- using the term "feminization." In the 2012 article, "The Feminization of Dentistry: Implications for the Profession," from the Journal of the Canadian Dental Association, it warns that "the profession may shift toward less entrepreneurship, more urbanization and, possibly, fewer clinical hours available to the population as a result of feminization." In addition, The Ontario Dental Association has an ongoing series in their journal Ontario Dentist (not available to the general public) on "the feminization of dentistry," a term I and many others find offensive.

The term "feminization" suggests that women are dominating -- or, in a more perverse, way infecting profession -- and that "us bros (should) stick together," as one Dalhousie post claimed.  Currently, the number of female dental students is about 50 per cent of the student body.  This is representative of the population, and therefore should be the goal of the profession. The equal representation of women in dentistry should be celebrated, not seen as a warning or a pathological process to be studied. Even with greater than 50 per cent of new graduates as women it will take years for women to equalize with men across the profession in numbers -- which doesn't address multiple other inequalities in the profession.  Today, women still account for a minority of all practicing dentists.

The term "feminization" also implies that women entering the profession will disturb the (male-dominated) status quo. If feminization is "defined as an increase in female presence and a corresponding shift in the occupation," why not use the term "equalization?" There was never a panic about the past century of "masculinized" dentistry, so why the concern about women? Dentistry is also becoming more ethnically diverse, and it would be equally problematic to introduce the highly offensive term "racialization" of dentistry. It's ironic that a profession that does not want to use gendered language to discuss male students posting about "hate fucking" women, feels perfectly comfortable using gendered language to warn about women having equal access to the profession.


 "Implications for the profession"

The impact of such loaded language is apparent when considering the "implications for the profession." One panic is the that

women [dentists] work less. The average length of the career of a female dentist in Canada is 20 years v. 35 years for men, potentially creating future shortages as more women enter the profession....A study in Washington State found that...for every five per cent increase in female dentists, 1.2 per cent (15,000) fewer patients would be treated annually.

This arithmetic, taken at face value, assumes the gender discrepancy, and then blames women for a provider shortage. If there is a lack of access to dentists, heightened in rural areas, it is certainly not the fault of women who are in the profession.  Perhaps the legacy of male-dominated dentistry should be held accountable for rural shortages. 

The same article explains that "having children reduces women's work time by seven hours/week, while it has no impact on men." It is not a biological fact that women work part time and raise children, but a byproduct of society's pressure on women. The problem is not that "women work less" but that women work more -- and for free -- at home, and therefore have less time for paid work. This is not the fault of women but of a society that uses women for unpaid domestic labour.

The Ontario Dental Association and the Canadian Dental Association, could explore why having children has zero time impact on male dentists, who have the luxury of working six days a week because they "work less" at home, but instead the problem is framed as "feminization."  It is not women who are interfering with dentistry, but dentistry and society that interferes with women: "after controlling for factors affecting income (practice ownership, age, work hours), U.S. female dentists have a mean net income 22 per cent below that of men." This includes not having the time to specialize, needing to remain in urban centres near their families, and accommodating their career for their partner.

Women do face challenges, and there are helpful women's organizations and forums within the dental profession that are available to female dentists. The Ontario Dental Association, for example, provides seminars and support for female dentists. However, by framing my presence in the profession as "feminization," I feel separate and difference from my male colleagues, and as a result I feel less valued. 

The take home message of the "feminization of dentistry" series in the Ontario Dental Association journal (2014) and in the previously published article in the Canadian Dental Association journal (2012), is that women are a "feminizing" threat that will ultimately undermine patient care.  This line of thinking will only encourage the misogyny on display at Dalhousie and ignore societal inequalities, while scapegoating women for deficiencies within the profession. If the goal is good patient care and a "culture of respect," we need to encourage the equalization of dentistry, as part of the equalization of society.

Dr. L is a dentist in Ontario.

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