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Daring to Care: Male Caregivers Fight Gender Discrimination

Caregiving should be considered one of the most admirable professions out there. After all, caregivers are entrusted to care for loved ones who often in extreme pain from chronic illness. They are typically called upon to support families during incredibly difficult times. Caregivers frequently work long hours throughout both days and nights to ensure that their patients are as comfortable as possible. Few careers require such compassion, patience, energy, and poise in the face of tremendous responsibility. So how is it that caregiving is such an unrecognized and underappreciated profession – especially for male caregivers?

The problem may lie in the way that the profession is perceived by society in general, and by the medical community in particular. Historically, caregiving roles have (and in most ways continue to be) perceived as feminine. Because women bear the brunt of the world’s unpaid labor, providing subsistence for their families and caring for children, aging parents, and sick relatives, the vast majority of human cultures see caregiving as a distinctly gendered practice. To fly in the face of traditional caregiving roles is to risk being ostracized for breaking social taboos, something that stay-at-home dads, concerned sons caring for aging parents, and especially male nurses can tell us plenty about.

Gordon Rogers, an ER nurse for the past thirty years at University Hospital in Columbia, Missouri, explains how it took a long time for even his own mother to stop asking him when he was planning to become a doctor.

“It took her a while to get over the idea that no, I wasn’t going to ‘graduate up’ and become a doctor. That I was happy doing what I was doing.”

Rogers says it isn’t uncommon for his patients to make the same mistake, explaining that he frequently hears comments from patients who assume that his position as a male nurse is only a stepping stone. Many people find it hard to believe that he wouldn’t be using his male privilege to move on to a higher paid and better respected position as an MD.

Jerry Lucas of Male Nurse Magazine concurs:

“Our problem is that that’s the perception, this is a feminine thing, that you can’t be a nurse unless you’re feely-touchy.” Lucas feels, however, that popular perceptions about caregiving are slowly starting to change. “It’s not feely-touchy anymore. It’s taking care of patients the way you would take care of your family.”

But, with male nurses comprising as little as 5% of the nursing work force, discrimination is still something many male nurses deal with on a daily basis. Lucas recounts:

“I had a lady come in one night who was probably having a heart attack. In that setting we have a lot to do in a short amount of time. And we get her undressed so that we could hook her up to her monitors and everything – and then she requested that we turn our backs. I said ‘ma’am please get undressed so we can get you on this monitor’ because there were only two nurses there and we were both males. But until we turned our backs, this lady would not undress – even though she was dying of a heart attack!”

Lucas believes that the problem lies in society’s basic ideas about gender, particularly when it comes to intimate procedures like inserting a catheter or assisting in the delivery a baby.

Nigerian-born Sylva Emodi, who taught as associate professor of nursing at a California university, said that the discrimination he experienced while teaching labor and delivery in a California hospital disturbed him so much that he eventually got out of maternity care and pediatrics altogether.

“I remember going to a rotation at a local hospital. The head nurse made it difficult for me to be able to supervise students in labor and delivery, pediatrics and postpartum, I think, because I’m a guy. She’d say, ‘You are not a medical doctor, you cannot go into labor and delivery.’ After a while, I had had enough, so I went to the doctor directly and said, ‘I need to be here with the students. The students need to see what is going on.’ The doctor said, ‘Sure, help yourself. Come on in.’ “

While the head nurse eventually apologized for her behavior, Emodi says that he still experienced hostility from other faculty members. Finally, he became so fed up that he left both the university and hospital where he was teaching. Today, Emodi is supervisor of the Palo Alto VA Health System’s psychiatric unit in California and says that he’s glad he pursued a career in nursing, despite the discrimination that he experienced.

Still, many men feel intimidated to even enter the nursing profession. And Lucas adds that it’s not only men that feel hesitant to pursue caregiving careers.

Like schoolteachers, nurses are in high demand. Nurses and caregivers are rarely given the respect that they deserve, especially within the medical community, in large part because these roles are perceived to be feminine. As a result, few people are choosing these professions.

While some people suggest that a minority of male nurses are being pitted against female nurses who dominate the industry, in reality, male nurses who experience gender discrimination are actually just getting a taste of the same patriarchal oppression that their female counterparts experience on a daily basis. Any woman working in a profession perceived as socially-acceptable for women, such as being a nurse, caregiver, childcare provider or receptionist, is likely to receive worse treatment and less pay than she would in a male-dominated job that requires the same skills. While this situation seems bleak, the fact that men are entering the nursing profession means that they have the opportunity to use their male privilege to speak out against gender discrimination.

Nursing professor Susan Boughn, who teaches at the College of New Jersey School of Nursing in Ewing, studies why men and women choose nursing careers.

“If we had all nursing students concerned up front about their basic human labor rights and empowering not only themselves and their patients but also the profession, that’s a good place for students to be,” says Boughn. “I think if we had a long history of that, we would not be where we are today with the nursing shortage.”

However, many in the nursing and caregiving profession are beginning to empower themselves. Several male nurses throughout the U.S. and the U.K. have filed gender discrimination lawsuits in recent years – and won. In a landmark case, the U.K. Equal Opportunities Commission supported 29-year-old nurse Andrew Moyhing, who filed suit against a National Health Service hospital after the hospital required that Moyhing be accompanied by a female chaperone when performing intimate procedures on female patients. While the hospital claimed that the regulation was in place “as a safeguard against the generalised risk of assault upon a female patient and/or false accusations of assault against male nurses,” the Tribunal ruled that the regulation was based on an assumption that all men are sexual predators.

Jenny Watson, Chair of the Equal Opportunities Commission, said:

“The women and men who work so hard in our hospitals are professionals and deserve to be treated as such. This type of discrimination against men based on misconceptions about their behaviour does nothing to help ensure patient safety.” Watson also concluded:

“This case has wider implications. EOC research shows that over a quarter of boys in school are interested in caring work, yet only one in ten nurses is a man and only 1 in 50 childcare workers. This disconnect between levels of interest and the tiny numbers of men entering the caring professions won’t be closed until we challenge our assumptions about the type of jobs that modern men should do, and start enabling young men to make their own choices, free from outdated stereotypes.”

While we have a long way to go before we can put these stereotypes behind us, cases such as these demonstrate that some progress has been made. Within his first ten days in office, President Obama signed the Lilly Ledbetter Fair Pay Act of 2009, which guards against gender discrimination in the workplace. And in 2002, Johnson & Johnson launched a long-term campaign to promote the nursing profession, with male nurses factoring prominently in television ads that aired nationwide. Alluding to the courage required of many male nurses and caregivers dealing with gender discrimination, the campaign’s slogan was, “Dare to Care.”

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Gender Bias in Schools Revisited

Fifteen years ago, at the height of the focus on the alleged gender bias against girls in our educational system, I wrote an article for a professional newsletter that argued it was actually the other way around. Boys were at least equally disadvantaged in the classroom, if not more so. The key difference was outside the classroom where girls grew up in a society that didn’t value their achievements and opportunities in the marketplace and on the athletic field. I took some flack for my point of view back then. Now, in 2008, it’s still a critical and misunderstood issue.

It is essential to put this issue of how boys perform in school into a historical perspective. Since the first public school opened in Boston in 1635 until the middle of the 20th century, the abundance of boys who did not fit the necessary mix of academic intelligence (learning best in a language-based environment) and who lacked a “successful-student-personality” (calm, organized, eager to please) were not a problem. Those boys generally left school by the eighth grade to go to work on their father’s farm, learn his trade/ business, or, as unions became dominant, took on apprentice roles and went on to good jobs. After WWII, everything began to change. Fathers began commuting to work, farms disappeared, unions gradually diminished, and all boys were now expected to be successful students.

Since this didn’t work for many boys, terms like “minimally brain damaged” and “hyperkinetic” became the labels to explain their failures (currently replaced by a multitude of labels such as Attention Deficit/Hyperactivity Disorder, Sensory Integration Disorder, Non-Verbal Learning Disabilities, Dyslexia, and Spectrum Disorders). For decades, many of these boys still managed to get through the system and find reasonable jobs waiting for them. But now they face the information revolution, where jobs are increasingly language-based. This has caused schools and parents to put even more pressure on all boys to succeed in school. Thus, the marked increase in concern about the many boys who still don’t fit our school system, which has never adapted its model to accommodate the varied learning styles not only associated with gender but across all children.

Many of you may be familiar with some of the many statistics that back up these concerns. It begins early. In elementary school boys are twice as likely to be identified with learning disabilities, emotional and behavioral problems, and to end up in special education. Young boys are 60% more likely to repeat a grade. By middle school, it’s not just the appearance of test score gaps that concern us. It’s data that shows boys skip school more often, get injured in fights much more often (though I do realize that girls hurt other girls in non-physical ways that can be even more devastating) and suicide rates, though small, are three times as likely in boys.

Then we get to high school. Boys are a third more likely to drop out and to be doing heavy drugs. Test scores and participation in advanced classes now significantly favor girls. These gaps are even more pronounced in our urban schools but be clear, they are not limited to poor, inner city children. Teenage boys dominate special classes and have significantly higher suicide rates. (The girls show their distress through high rates of eating disorders and rising rates of smoking.)

The pattern continues beyond high school. 58% of undergraduate students are now female and the higher ratio of women continues right on into graduate school. It won’t take more than another generation before boys and men can’t find a male to be their primary care physician.

Of course some will argue this matters little since women allegedly still have their glass ceiling and there is still a lack of equal pay for equal jobs. But within a decade or two, the shortage of reasonably educated men will change this. Some women note that females have suffered for centuries. They suggest males in our society will need to face up to this “new” problem and do something about it just the way women did in the latter part of the 20th century.

Well, part of the problem was, and still is, that both genders face issues and to remain a healthy productive society, a better understanding of boys and girls and the similarities and differences in how they develop needs to be better understood and addressed. From where I have been watching for the past forty years or so, our educational system is harmful to most children regardless of gender. So it is not my intention to slight the needs of girls in our schools or women in the work world by pausing to focus on some very significant issues facing males in our schools as well as society in general.

It has been well documented that boys develop more slowly in certain aspects of their neurology. In general, (there are always exceptions to stereotypes) young girls are more verbal, more able to sit still, and learn to read more quickly. This substantially increases their likelihood of immediate success in a school system that places early emphasis on all these skills. Given the heightened anxiety of today’s parents about their children’s early academic success determining life success, preschools have become increasingly skills oriented, starting the frustration for boys at even earlier ages. Meanwhile, as teachers are increasingly forced to teach to statewide tests, they lose the flexibility to teach in more creative ways that would benefit both genders. But it especially increases the challenges boys have to face.

While more research is needed and new teaching strategies need to evolve, I think there are a couple of additional factors that play a key role in making the life of boys particularly disadvantaged at this time in our society. Boys lack male role models for academic learning and developing a strong, positive sense of their masculinity. In addition, young boys have dramatically lost their opportunity to be physically active and to use social play as a way to explore and understand the world they live in.

Mothers, and other women, are the primary caretakers of young children. Boys are then handed off to female teachers for the next several years. Rarely do boys have the opportunity to observe and model their academic behavior after a same sex adult. But it also works the other way. Female teachers have less tolerance for a bit of chaos and roughhousing. I recall from my early days as a psychologist when I was in charge of a number of inner city preschools. When I would visit the classes, it would turn in to king of the hill battles and kids climbing all over me. My female teachers understood the importance of this and didn’t mind it one bit.

But, over the years, when I have consulted with preschools and elementary schools, teachers are more concerned with the possibility of someone getting hurt (some of which reflects our increasing litigious society) and the sense of things getting out of control than recognizing the importance of this high energy activity for boys (and many girls as well). I have watched too many female teachers reprimanding boys for behavior that should be considered normal, slightly aggressive, overactive male behavior. It should be built in to the program, not frowned upon. Meanwhile, recess and phys ed classes are being decreased so teachers have more time to raise those classroom test scores, making it even worse for boys. It doesn’t do anything for the epidemic of obesity either!

Boys (and many girls) need to be allowed to run free, ride their bikes around town, play for hours outside, wander into the woods and climb trees, bring home turtles, frogs, and bugs. Frightened parents, even in more advantaged communities, allow fear of the unlikely (stranger abduction, pedophiles) to keep boys inside. Girls, too. Now parents are paying the price of children who explore the world via the internet and are realizing this may be more risky than letting them actually leave the house!

Meanwhile, we need more male teachers. We need more men coming in to visit the elementary classrooms. We also need more Big Brothers. The problem is not just the lack of men in the school life of our boys. Between high rates of divorce and of young, poor fathers abandoning their children, it is estimated that an astonishing 40% of our boys are growing up without a father in their lives. Being a minority male in our inner cities means you are more likely to end up in jail or dead by 21 than graduating high school, no less going to college.

We need to offer boys and girls an education that addresses the total child, not just the academic skill part. We need to design middle schools and high schools that offer many pathways to earning a reasonable living and have more men involved right from the beginning. We need longer school days if a significant part of that time can be spent playing and exercising. We need to identify each child’s strengths, regardless of gender, and allow that child to use those strengths to be productive in school in a variety of acceptable ways, not just a few narrow ways that relegate most children to feeling inadequate.

Parents have an important role in addressing this problem. One thing is to err on the side of safety and regardless of how mature your son seems to be, don’t make him one of the youngest in his class. Second, too often parents will present to me a picture of a son whom they describe as lovable and caring, sensitive, having good friends and being terrific with young children. But they are distressed because he is very inconsistent in his school performance, only seems to work at what interests him, and resists doing homework because he would rather play. This is a great young boy with the kind of values and spirit that we hope he’ll continue to demonstrate when he’s a man. He might make a great teacher some day! We need parents to focus more on their child’s successes and less on their perceived shortcomings, especially with their sons. Parents must be more conscious of their own gender bias.

In addition, the very behaviors and attitudes which cause many boys to under perform in school serve them well in the real world. High energy, totally absorbed by only what strongly interests them, challenging the rules, and having strong leadership skills often are the foundation for successful entrepreneurs and great innovators in many spheres of life. Parents and educators need to be able to identify that potential and not destroy the drive and self-confidence of these “academically underachieving” boys before they get a chance to prove themselves in the real world.

And just for emphasis, I want to state again, we need boys to have meaningful relationships with men from birth on.

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