From #MeToo to #TimesUp in health care: can a culture of accountability end inequity and harassment?

Elsevier, The Lancet, Volume 393, Issue 10171, 9–15 February 2019, Pages 499-502.
Esther Choo, Carrie Byington, Niva-Lubin Johnson and Reshma Jagsid

A 2018 report by the US National Academies of Science, Engineering, and Medicine identified sexual harassment as an enduring problem in scientific fields, and especially in medicine. Harassment and inequity are interdependent processes, and it is no coincidence that harassment is rife in environments that foster gender disparities in compensation, opportunity, and advancement. Flagrant examples of abusive and discriminatory treatment continue to emerge, such as sexual harassment and assault of trainees doing scientific fieldwork, manipulation of entrance examination scores to limit the number of women at a Japanese medical school,and the unremitting gender pay gap in medicine and science in North America and other countries. Potential corrective actions are hampered by a hierarchical, male-dominated culture that accepts abusive behaviour as part of professional socialisation and avoids holding offenders accountable, particularly when they are leaders, well-funded researchers, or deemed valuable to the organisational mission. The estimated costs of workplace harassment are staggering, with established detrimental impact on physical, psychological, and professional wellbeing of both the targets and bystanders. 

The #MeToo movement has brought the scope and severity of harassment and inequity to the forefront of public consciousness. The hashtag trended in at least 85 countries. Women in medicine and science participated using hashtags such as #metoomedicine, #metooscience, and #metooSTEM. #MeToo was tremendously effective in raising awareness and, crucially, was a bridge to action, giving rise to goal-oriented organisations such as TIME'S UP, which coordinates responses to gender discrimination and harassment and develops solutions to address them. Initiatives of TIME'S UP have included establishing the TIME'S UP Legal Defense Fund, issuing strong statements from high-visibility platforms such as major entertainment industry events, and shining a light on harassment and inequity outside of entertainment, including among food service employees.