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Healthy Environments for Women in Academic Nursing: Addressing Sexual Harassment and Gender Discrimination

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Jessica Castner, PhD, RN-BC, FAEN, FAAN


Gender harassment, and retaliation for addressing discrimination, are pervasive in the higher education setting. Healthy work environments that prevent and eliminate gender harassment are necessary to fully support the leadership, career trajectories, and contributions of women in academic roles, including academic nursing. A synthesis of the evidence reveals that gender bias, even when subtle, results in limited hiring, promotion, and leadership opportunities for women in academia. A 2018 National Academies of Sciences, Medicine, and Engineering report provides the much needed action blueprint for academic sector-wide improvements. Recent federal-level attempts to improve the structures for gender equality by grant-funding agencies are a promising contemporary action to strengthen healthy work environments for women in academic careers. This article begins by offering basic definitions and examples and discusses both individual and organizational risk factors, a relevant Supreme Court decision and individual exemplars. The author also discusses initiatives and solutions and identifies gaps and future directions to eliminate sexual harassment and gender discrimination in academic settings.

Citation: Castner, J., (January 31, 2019) "Healthy Environments for Women in Academic Nursing: Addressing Sexual Harassment and Gender Discrimination" OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 1, Manuscript 6.

DOI: 10.3912/OJIN.Vol24No01Man06

Key Words: sexual harassment, nursing; gender, social discrimination, environmental health nursing, nursing research

When there are problems with sexual harassment and discrimination in nursing, to whom do members of the discipline turn to for leadership and solutions? Often, collaborations and leadership initiatives are established among practice and academic partners to generate new knowledge and standards for the profession, incorporate new content in higher education, or provide leadership about contemporary issues through professional organizations. Ironically, women faculty in college and university institutions experience the second highest rates of sexual harassment and discrimination in the entire workforce, second only to women in the military (National Academies of Sciences, Engineering, and Medicine [NASEM], 2018).

...the nursing discipline is positioned with the opportunity to implemented long-overdue reform and solutions for healthy work environments. How can we enable the academic leaders of our discipline to improve working conditions of nurses in all practice settings if they, themselves, experience the problem most profoundly? As the #MeToo social movement empowers women to share experiences of sexual harassment and gender discrimination, and as more women break the glass ceiling into the highest levels of leadership, the nursing discipline is positioned with the opportunity to implemented long-overdue reform and solutions for healthy work environments. While there is little research specific to sexual harassment and discrimination for academic nursing, a better understanding of the problem in the broader academic setting applies. The purpose of this article is to synthesize evidence and reports on the unique challenges of sexual harassment and discrimination for women in the academic environment.

Definitions and Examples

Correcting the discrimination in academia may serve as a model for other sectors and organizations where nurses work... The National Academies of Science, Engineering, and Medicine (NASEM) released a hallmark report in 2018 entitled Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine (NASEM, 2018). The report findings and recommendations are specific to the long-standing problem of sexual harassment and discrimination in academia. Correcting the discrimination in academia may serve as a model for other sectors and organizations where nurses work, in order to achieve gender equality and adequate working conditions. While sexual harassment and discrimination can be targeted toward men, this synthesis focuses on women as the group predominantly, and negatively, affected.

The NASEM report uses the definition that sexual harassment is a form of discrimination and includes 1) gender harassment 2) unwanted sexual attention, and 3) sexual coercion. An example of gender harassment is when equally qualified women are excluded from power structures or decision-making where men are included, or patterns of assignments to women that are less likely to lead to promotion. An example of unwanted sexual attention includes assault, i.e., spoken or physical advances of a sexual nature that are unwelcomed. In a healthy work environment, individuals are able to clearly express that sexual attention is unwanted without fear of retribution or retaliation. An example of sexual coercion includes budget or promotion resources that are made accessible through sexual activity or expressions, and are unattainable when the woman indicates that sexual advances are unwanted.

Direct and Indirect Harassment
Harassment can be both direct and indirect. In direct harassment, the target experiences one or more of the three types of discrimination (NASEM, 2018). Indirect harassment includes witnessing sexual harassment targeted to others where the acts are culturally tolerated, excused, or covered up. Indirect harassment also includes the hostile work environment that results from organizational failures to respond justly and with accountability to direct or indirect harassment (NASEM, 2018).

An example of indirect harassment would be when a woman starts at a new position, and her male supervisor is engaged with or has recently had romantic relationships with several of her peers. While he has not directly pursued a sexual relationship with her, she is concerned that her performance evaluations, assignments, and letters of reference will be influenced by the presence or absence of romantic associations in the workplace. She does not feel she is evaluated based on her performance, thus creating a hostile work environment. A colleague from another department shares that she has experienced unwanted sexual attention from this supervisor and was passed over for a promotion a few months after she had reported it to human resources. She became aware of at least three women who had previously worked for him who did not engage in a romantic relationship with him, or even “harmless” flirtation. All of these women had made lateral career moves to other institutions around the time a promotion would have been normally expected. There was only one woman in the executive level of administration (e.g., president, vice president, and provost) when she started her position at the institution. This woman had since returned to a faculty position, leaving no female academic in the higher ranks of the institution. Several female colleagues at various ranks in other departments reinforced that tolerating sexual harassment, if experienced, was much more likely to be rewarded in the institution. Further, opposing sexual harassment, making it very clear sexual advancements from senior male colleagues are unwanted, or reporting sexual harassment according to policy generally harmed women’s careers in the organization.

Hostile and Benevolent Sexism
Hostile sexism results in decreased motivation to compete and feelings of anxiety. Sexism is often divided into hostile and benevolent (Zakrisson, Anderzen, Lenell, & Sandelin, 2012). Gender harassment in the forms of unwanted advancement and inappropriate comments or physical contact are examples of hostile sexism. Hostile sexism results in decreased motivation to compete and feelings of anxiety (Lemonaki, Manstead, & Maio, 2015; Pacilli, Spaccatini, Giovannelli, Centrone, & Roccato, 2018). Benevolent sexism is much more covert, and therefore often more difficult to identify and correct. Benevolent sexism focuses on gender-normed socializations, such as unconscious bias that men are more competitive and logical while women are more virtuous or communal. As a caring profession, benevolent sexism is often applied inappropriately to nursing by overlooking scientific contribution, technical skill, and leadership inherent to the unique body of knowledge of the discipline. Benevolent sexist views alone can be very harmful to the potential for nurses to engage in and receive credit for scientific and mathematical endeavors needed to advance the discipline.

Experiencing benevolent sexism is more than a social nuisance; it impacts individual performance and behavior (Pacilli et al., 2018). Benevolent sexism decreases the cognitive performance of women who experience it, even more so than hostile sexism (Dardenne, Dumont, & Bollier, 2007). This decreased cognitive performance includes mental intrusions, preoccupation with self-doubt, and decreased self-esteem. Labeling, branding, and marketing the nursing profession exclusively as a caring profession, rather than also as a scientifically-based, technically skilled, and cognitively disciplined endeavor increases problematic benevolent sexism for academic nurses. Addressing benevolent sexism as a root cause of gendered expectations and opportunity limitation may provide a key avenue by which to reduce career barriers. Confronting and reversing benevolent sexism is needed to support female nurses in academic settings to reach their full potential.

Individual Risk Factors

...not all women who experience harassment and discrimination experience subsequent harm to individual careers. Many women never experience sexual harassment and discrimination. Further, not all women who experience harassment and discrimination experience subsequent harm to individual careers. Women whose behavior or appearance do not conform to traditional gender-norms are most at risk for becoming targets of sexual harassment and discrimination (Livingston, Rosette, & Washington, 2012; NASEM, 2018). Unfortunately, this includes women with traditional “male” socialized leadership traits and characteristics, such as a dominant personality, directness, and interest in engaging in competitive activity (Berdahl, 2007).

Translating into a dual loss, women who might be most ambitious and most capable of leadership roles are also those who are most likely to have sexual harassment and discrimination derail and limit their careers (Phelan, Moss-Racusin, & Rudman, 2008). Bisexual or lesbian women are also at higher risk for becoming targets of sexual harassment for non-gender normative behavior (NASEM, 2018). Philosopher Kate Manne refers to this risk as the “shock collar” response (Manne, 2018). That is, when a woman no longer demonstrates behavior that is useful to a male superior, or useful to the usual structures in a male dominated social order, she experiences a punitive response or backlash.

Bias in Collaborative Work
High performing female researchers early in their career are particularly vulnerable targets to harassment and discrimination, especially before achieving tenure. Assigning adequate credit for expertise and work completed is essential in the academic environment, and can be problematic for women in collaborative teams. When a female researcher works with male colleagues, she may experience a collaboration penalty in which her contribution tends to be misappropriated disproportionately to her male colleagues (Sarsons, 2017). Despite her actual contribution, unexamined unconscious bias may perpetuate an assumption that male colleagues have more competence and contribution than what actually exits (Ginther & Kahn, 2015). High performing female researchers early in their career are particularly vulnerable targets to harassment and discrimination, especially before achieving tenure (Binder, Garcia, Johnson, & Fuentes-Afflick, 2018; NASEM, 2018).

Gender and Race
Biases and discrimination can be nuanced by more than one type of identity or category, and there are special considerations at the intersection of gender and race. Overall, white male candidates are viewed favorably by evaluators of all genders and races, and often unduly receive higher credit for subjective potential rather than objective performance (Milkman, Akinola, & Chugh, 2015). According to several studies, black women do not tend to incite as much harassment for non-gender confirming behavior compared to white women, enabling a smoother path to leadership (Livingston et al., 2012). However, black women are met with more biased assumptions that they are less competent (Muh, Niemann, Niemann, González & Harris, 2014) and are penalized more harshly for mistakes or competence-related judgments (Rosette & Livingston, 2012). Members of other racial and gender categories are often given the benefit of the doubt or allowed to correct mistakes before a career penalty is issued (Rosette & Livingston, 2012). Little is known about the interplay of other factors as a risk for sexual harassment, such as rural, urban, suburban, cultural, religious, immigrant, and socioeconomic identities.

Risks and Consequences
Because of gender, women and girls are less likely to face expectations for brilliance and intellectual potential than male counterparts, which can become a self-fulfilling prophesy of limited opportunity (Ginther & Kahn, 2015; Muh et al., 2014). Equally qualified female students are less likely to be hired as research laboratory managers (Moss-Racusin, Dovidio, Brescoll, Graham, & Handelsman, 2012). Teaching evaluations can be fraught with inappropriate gendered expectations from students and do little to measure true teaching effectiveness (Boring, Ottoboni, & Stark, 2016). Women are frequently hired and promoted for warmth and likeability, and not fairly evaluated for competence and knowledge (Hesli, Lee, & Mitchell, 2012; Phelan et al., 2008). Attempting to negotiate promotion and salary increases is a risk for women, as the appropriately assertive behavior is often met with discriminatory backlash (Mitchell & Hesli, 2013).

Organizational and sector-wide reforms to dismantle these barriers are long overdue. Women face a collaboration penalty, where their contributions in groups are often misattributed disproportionately to male colleagues (Filardo et al., 2016; Sarsons, 2017). Women who display workplace characteristics of courage, mastery, competitiveness, independence, success, and assertiveness face disproportionate career penalties from gender bias and harassment (Berdahl, 2007; Greider et al., 2017; Livingston et al., 2012). Last, women who report harassment often face career setbacks through retaliation (Binder et al., 2018). At every phase and stage of an academic career, many women in the current system face disadvantages and barriers for no other reason than gender. While the majority of the evidence is from the larger college or university as a whole, understanding these risk factors is key to appraising the contextual and larger organizational factors under which academic nurses function. Organizational and sector-wide reforms to dismantle these barriers are long overdue.

Organizational Risk Factors

Sexual harassment is a multi-level and multi-faceted problem with individual, organizational, and broad governance and social structure influences. In the academic setting, the majority of the risks, and therefore needed solutions, are at the leadership and organizational level. The NASEM report includes five institutional risk factors that need to be addressed to create healthy work environments in academia that are free from sexual harassment: perceived tolerance for sexual harassment; male-dominated work settings; hierarchical or unbalanced power structures; symbolic compliance with discrimination law; and leadership (NASEM, 2018). These five institutional risk factors are presented below with additional consideration for organizational strategy, structure, and policy root causes that increase the vulnerability to systemic gender harassment and discrimination (Stamarski & Son Hing, 2015).

There cannot be a culture of tolerance for sexual harassment within the institution (Fairchild, Holyfield, & Byington, 2018; Mitchell & Hesli, 2013; NASEM, 2018; Stamarski & Son Hing, 2015). When known harassers receive no or minimal consequences, and women who report face retribution and repercussions, the workplace culture continues to allow and perpetuate the behavior with impunity.

Hallmarks of a problematic climate include little or no benefit in reporting, additional harm due to reporting, and retribution. What are the subsequent actions and consequences for a woman in an organization who reports or appeals discrimination and harassment behaviors or decisions? The answer to this question provides an important screening for organizational climate. Hallmarks of a problematic climate include little or no benefit in reporting, additional harm due to reporting, and retribution. Further, general expectations at any level of the organization where female contribution differs from male contribution to work are problematic. Norms and beliefs on gendered differences in the ability and competence to lead or fully commit to work and career enable discrimination and harassment (Stamarski & Son Hing, 2015). Expectations that women are inherently better suited for supportive, entry-level roles with relational or emotional intelligence skills can create an overall tolerance for women being excluded from cognitively challenging, mission-critical or advanced leadership opportunities.

Further, appropriately reporting gender harassment and discrimination can incite a behavior called academic mobbing as retaliation (Ozturk, Sokmen, Yilmaz, & Cilingir, 2008). Mobbing as social marginalization happens frequently in all sectors of nursing where conformity is valued, and academic mobbing is a systematic attempt to wear down a colleague and encourage her to find employment elsewhere. The target is most often a highly productive, honest, and ethical person who expects to be treated fairly. There is frequently an administratively-driven judgment that the person doesn’t subjectively “fit,” which is not coherent with objective accomplishments. Identifying this retaliatory group behavior, and focusing hiring, retention, and promotion decisions on objective performance measures can help to minimize the potential harm of this phenomenon.

Male-Dominated Work Settings
The majority of those who hold organizational power may not adequately perceive the presence or severity of the problem. The nature of male-dominated workplaces increases the risk of sexual harassment (NASEM, 2018). The majority of those who hold organizational power may not adequately perceive the presence or severity of the problem. This can occur even when the majority of the total employees are women, but men are over-represented in senior ranks while women comprise most entry-level positions of the organization. Initiatives that ensure equal gender distribution at the highest ranking levels of the organization are an important step to protect the academic workplace culture from harassment. Further, leadership decision-making, with even subtle bias, can affect organization-wide gender disparity outcomes (Stamarski & Son Hing, 2015). Since leadership sets the tone for the entire organization, having women under-represented at the highest organizational levels can translate into role modeling, mentorship access, priorities, culture, and strategies that disadvantage women at every level of the organization.

Entry Level and Advancement. There is a reversing gender hiring trend in engineering and other fields, where entry level positions are now being filled disproportionately by women (Williams & Ceci, 2015). However, increasing the proportion of women at entry levels in male-dominated institutions, and where discrimination continues for women qualified for advanced ranks, can worsen harassment and discrimination beneath an appearance of initial corrective action (NASEM, 2018; Phelan et al., 2008). Increased recruitment at student and entry levels, alone, will not solve the gendered problems if there continue to be additional barriers at every rank and promotion stage (Hesli et al., 2012; Stamarski & Son Hing, 2015). Likewise, taking a principled stance or dissenting in meetings is more often subjectively rewarded as assertive for male researchers, while misjudged as a character flaw or non-cooperative behavior for female peers, potentially tarnishing her credibility (Binder et al., 2018; Brescoll, 2011).

Initiatives that ensure equal gender distribution at the highest ranking levels of the organization are an important step to protect the academic workplace culture from harassment. Objective performance of female scientists is not associated with successful promotion and tenure (Clancy, 2014, March 31; Greider et al., 2017; Hesli et al., 2012). Rather, her gender normative, communal warmth and friendliness increase likelihood for promotion, indicating system-wide gender bias (Ramos, Barreto, Ellemers, Moya, & Ferreira, 2016). Similarly, female scientists face worse penalties for risk-taking scientific endeavors, which are ironically those most likely to also make the largest impact. Furthermore, when “reputation” is a criterion for promotion, this subjective assessment is also influenced by gender bias and gender norms (Hideg & Ferris, 2016; Jost & Kay, 2005; Zakrisson et al., 2012). In all, this body of evidence translates into pay and promotion disparities at all ranks for female scientists doing the same work and with equal scientific outcomes to male counterparts.

Composition and Consequences of Leadership. The proportion of men, compared to women, increases with each level of faculty and administrative rank (NASEM, 2018). Several research studies indicate that unconscious bias affects a woman’s ability to secure a position, promotion, or accolades in the academic environment (Hesli et al., 2012; Phelan et al., 2008). This can create an ongoing cycle of inequality, with top-level administrators who are male (especially in science, technology, engineering, and mathematics [STEM] fields) less likely to believe gender disparity and harassment evidence is credible (Handley, Brown, Moss-Racusin, & Smith, 2015). Further, without intentionally and systematically mentoring women into the highest leadership levels, the enhanced potential for sponsorship, mentorship, and critical opportunities to be assigned to males in the organization can perpetuate disparity.

...women in leadership positions may still enact gender bias that favors male subordinates. Larger proportions of women in leadership positions increase the likelihood of equality, but does not automatically hardwire gender equality at all levels of the organization. For example, women in leadership positions may still enact gender bias that favors male subordinates. There is research evidence that identical job applications for student research laboratory manager, faculty resumes, and research abstracts are ranked more favorably when a male name is listed, even when the judge is female (Moss-Racusin et al., 2012). In research-intensive universities, external funding gender inequalities can create a self-reinforcing disparity in an activity crucial to career survival and promotion. When a hiring committee, faced with the fact that 69% of National Institutes of Health (NIH) funding goes to male awardees, must select between a more qualified female and minimally qualified male candidate, the problem is perpetuated when he appears more “fundable” and likely to achieve long-term success (Hechtman et al., 2018). Routine expert review, monitoring, and evaluation of policy and policy enactment is one needed solution. In particular, the review should focus on diversity initiatives, pay equality, bias training, hiring, retention, performance evaluation, promotion, termination, and sexual harassment and discrimination initiatives.

Hierarchy and Power Structures
A hierarchical power structure increases the likelihood of harassment... A hierarchical power structure increases the likelihood of harassment, especially when a female subordinate’s career is poignantly dependent on one advisor, supervisor, mentor, ranking member, or administrator (NASEM, 2018). A solution is to structure clear and alternate supervisory structures for a lower ranking employee to succeed in her work without retribution if harassment is encountered.

Gender-segregated networks, such as predominantly female nursing schools, represents structures of inherent gender inequality (Stamarski & Son Hing, 2015). In addition to the limited access to leadership in male-dominated organizations, predominantly female networks and working groups tend to be devalued, especially when pay is determined or adjusted at the department level. Over-representation by women can also create lower workgroup status within the larger organization, with fewer opportunities for group resources from the larger organization or promotion opportunities outside of the school or group. This type of gender discrimination is often tolerated and explained away, inappropriately, as a simple difference in discipline or preference by females for lower paid positions.

Symbolic Compliance with Discrimination Law
A veneer of compliance is problematic when human resources and internal investigation resources are devoted to protecting the liability of the institution, rather than addressing root causes or creating a culture of zero tolerance for sexual harassment (NASEM, 2018). In essence, organizations police their own compliance, and this can create bias in favor of protecting the reputation of the institution from an allegation, rather than creating safety and justice for the victim and her successors. A solution is ensuring a reporting structure and accountability to an external organization or non-biased referee, also called an ombudsperson.

Colleges and universities, as prestigious institutions, are also at higher risk to perpetrate institutional betrayal towards those who speak up about gender discrimination and harassment (Smith & Freyd, 2014). Institutional betrayal is when a powerful institution, such as a university, hurts employees and students who are dependent on the fairness of the institution for safety from harm and well-being. This institutional betrayal is measured as failing to prevent abuse; normalizing abusive contexts; making reporting procedures difficult with inadequate responses; contributing to cover-ups and misinformation; and punishing whistleblowers and victims.

Expert policy review is critical to shining a light on root causes of gender discrimination and harassment. Expert policy review is critical to shining a light on root causes of gender discrimination and harassment. Routine review is essential to ensure policies do not prioritize institutional liability once a problem is encountered. Systematic prevention and elimination of gender harassment and discrimination must become the focus of gender equality policy. Overall, organizational policy can be protective of workplace diversity and fairness, or another vehicle of discrimination and bias. For example, performance evaluations that favor evidence of formal mentorship when the mentorship is disproportionately available and effective for males is discriminatory (Efstathiou, 2018). Similarly, failure to create, update, enact, and enforce policies that address key issues of gender pay inequality or retaliation for reporting sexual harassment is not acceptable.

Having a sound written policy in place is important, but not sufficient without a careful examination of how policies are enacted to reduce or exacerbate gender discrimination. Regular monitoring and evaluation for bias in current policy, and the organization-level metrics that indicate consequences of bias are crucial. Simple language updates to ensure gender-neutral terms, assurance of compliance to the most recent state and federal regulations, and expert review for root cause areas that existing policy neglects are needed. Having a sound written policy in place is important, but not sufficient without a careful examination of how policies are enacted to reduce or exacerbate gender discrimination.

Leadership Commitment
When leadership equivocates or does not prioritize strong, consistent, and clear actions that communicate zero tolerance for sexual discrimination, the problem often festers and metastasizes beneath a seemingly compliant surface appearance. It is essential to recruit thoroughly engaged and committed leaders at every level of the organization, willing to prioritizing gender equality and diminish organizational power of known perpetrators of harassment and discrimination.

Organizational Strategy. Leadership sets the tone and norms for organizational strategy. Organizational strategy can institutionalize gender discrimination and harassment when different standards are intentionally structured into employee decisions (Stamarski & Son Hing, 2015). Gendered dress codes, grooming, or communication style differences by department depending on the gender-dominated leadership preferences can exacerbate inequalities. For example, if the predominantly female nursing department is expected to demonstrate more caring, communal, and relational behavior to the exclusion of time committed to individual career goals and scientific experiments necessary to achieve equality in the larger organization, the faculty member faces within-department expectations are at odds with adequate external-department contributions, promotion, and advancement criteria.

Further, without policies to address students’ gendered bias and expectations, or with common practices that reinforce student bias, female faculty are disadvantaged. If a routine practice is to assign students who demonstrate additional needs for individual attention or psychosocial support to female faculty advisors with the gendered expectation for more nurturing interactions, the faculty advisor is informally expected to contribute additional unpaid labor for student advising, compared to male counterparts. Female faculty are often faced with a lose-lose choice of anticipating lower student evaluation scores for the same behavior as equally qualified male counterparts, or investing additional uncompensated labor to satisfy more nurturing and matronly expectations from biased students. When common organizational practices and strategies reinforce, or do not adjust for, these common biased expectations, women are further disadvantaged and must invest in time-consuming activities with little formal institutional recognition or reward.

Beyond Employees. Combating unconscious bias and differential treatment of scientists because of gender pervades well beyond academic administration and employees. For example, human subjects enrolled in research studies respond with differences in psychological and behavioral measures, depending on the gender of the experimenter (Chapman, Benedict, & Schioth, 2018). In the clinical setting, harassment perpetuated by patients and families is commonplace (Dzau & Johnson, 2018). Ensuring effective zero-tolerance policies with consistent enforcement and support structures is essential. This patient and research participant response also opens an important, and largely unexplored, avenue for future research on gender bias in science.

In summary, organizational level characteristics, culture, policies, and committed leadership are the most profound risk factors and areas for improvement to reduce and eliminate gender discrimination and harassment. Institutions that take a reactive, individual approach are less effective in creating healthy work environments than those with multi-level organizational reform and individual accountability practices (NASEM, 2018; Stamarski & Son Hing, 2015; Tricco et al., 2018).

A Relevant Supreme Court Decision

The U.S. Supreme Court, in Vance v. Ball State, stripped the rights of many workers to make a claim of hostile work environment, harassment, or discrimination unless it is alleged against an individual with the power to officially hire, fire, demote, promote, transfer, or discipline the victim (U.S. Supreme Court, 2013). This case reviewed lower court decisions on discrimination and harassment of a catering staff member by the person who made her daily work assignments. In the complex matrix structures of the academic work environment, this decision opens untenable loopholes by which discrimination and harassment can harm women in the workplace.

Supervisors and supervisory structures for academic staff and faculty are often nebulous and ill-defined. Supervisors and supervisory structures for academic staff and faculty are often nebulous and ill-defined. Supervisory authority is highly contextual. For academic faculty, the Dean or President makes the official hiring and contract decisions. Supervisory evaluations may be completed by department chairs, program directors, assistant and associate deans. Assignments that are crucial to retention and promotion, such as for teaching, service, and student mentorship may be made by administrative staff, program directors, committees, assistant or associate deans. Intramural funding decisions for research, also often crucial to successful circumstances of retention and promotion, may be made through a variety of processes. Counseling and disciplinary action may be handled by any designee or mentor senior to the target. Associate or assistant deans may make additional pragmatic assignments that affect the day to day work of women in academic nursing.

The matrix nature of academic supervisory lines of authority is often further blurred on funded research work. In fact, academic faculty are often hired by a separate foundation or non-profit entity to support the grant-funded research portion of their salary. These separate, non-profit entities become the hiring agency for an ever-changing proportion of the academic faculty’s salary. Some hiring and supervisory status may then be assigned to a foundation operations manager or liaison. For co-investigators and study staff, supervisory status may be assigned to a principle or co-principle investigator.

The NASEM report (2018) includes recommendations for legislative action to re-balance the harmful impact this decision has on the complex supervisory structures that increase risk for gender harassment of academic nurses. Clear organizational charts, supervisory responsibilities, and reporting structures, with accountability for harassment and discrimination in these areas, are essential to achieve a healthy work environment for academic faculty. Full clarification in all aspects of her role is a crucial improvement opportunity to ensure accountability and clarify supervisory relationships. However, academic faculty still must rely on a diverse set of scholars to provide letters of recommendation for research funding, promotions, and awards. In a sector where gender harassment is rampant and frequent, each of these dependencies opens another potential opportunity to reinforce zero tolerance for harassing or retaliatory behavior.

Individual Exemplars

Several case examples highlight gender discrimination in academic settings. These interdisciplinary examples illustrate the broader context of the academic environment in which academic nurses work. Ben Barres, a pioneering neurobiologist, was a powerful advocate for junior female scientists (Barres, 2006). As a transgender male, he had lived experience working in the academic environment as both a male and female scientist. His writing includes anecdotes that resonate with many women, such as being passed over for prestigious awards in favor of a less qualified male counterpart. After he transitioned to a man, his colleagues overheard his work being praised as much better than his sister’s in a mistaken identity for his own work presented in his female appearance. He also routinely shared stories of how he was treated with a great deal more respect, expectations of competence, and interrupted less as a man. Evidence from his objective analyses also supported that there were no innate differences between male and female aptitude and ability for science and math. Rather, the disparity in performance was due to social programming and biases, including discrimination.

Rosalind Franklin was crucial to this discovery, yet evidence suggests she was not given proper attribution for her contribution. In addition to Dr. Barres example as a scientist in both female and male form, there are several informative case examples of the unacceptable failure of academic institutions to adequately address sexual harassment and discrimination. Inequalities for female scientists in history are evident in teams such as James Watson and Francis Crick, Nobel Prize winners for discovery of the DNA double-helix structure. Rosalind Franklin was crucial to this discovery, yet evidence suggests she was not given proper attribution for her contribution. Further, a more mature Watson relayed that she endured harassing and sexist conditions in her work environment, which included actions from Watson and Crick as well as from discriminatory workplace norms (Lloyd, 2010, November 3). Questions about the abuse of power, gendered work dynamic, proper attribution of credit, and a system that discarded a talented female scientist from the work provide insight into how gender harassment may tarnish science’s highest accolades and fundamental discoveries.

A more recent illustrative case of sexual harassment and discrimination occurred at the University at Rochester. Faculty member Florian Jaegar’s repeated inappropriate behavior included multiple sexual relationships with students and repeated unwanted sexual attention towards students and colleagues (McAllister & Olivarias, 2017). As a learning organization, relevant policy and leadership have been replaced as the institution attempts to restore a workplace free from gender harassment. Because the institution’s previous policies were inadequate to protect women from sexual harassment and the resulting hostile work environment, the organizational and external authority responses, in this case, worsened the problem. The institution and the Equal Employment Opportunity Commission (EEOC) in this case violated common sense by finding that the egregious behavior did not technically violate policy, and he was promoted during the process of investigating complaints. The legal team, responsible to protect those reporting sexual harassment, did not redact their names in a released document, creating vulnerability for retribution. After an emailed response with a tone questioning the complainant’s credibility, the university president resigned (Leanord, 2018, January 11). The faculty did censure Jaegar as a symbolic gesture of peer disapproval.

Jaegar, with a long and well-documented pattern of predatory sexual behavior, remains at the institution while many of the female scientists who stepped forward to report and request accountability have now departed. Replacing their positions with mostly male faculty in the department would create a vulnerability, further exacerbating the lack of safety for female students and colleagues. The case highlights largely symbolic investigations that review technical policy without adequate consideration for preventive action to establish a work environment free of sexual coercion, and prevent retaliation for women who report sexual harassment. This case only emboldens other perpetrators to act with impunity by manipulating the subtle bias of those in leadership and exploiting loopholes between antiquated policy and governance processes. In particular, there were lengthy patterns of well-known and documented inappropriate sexual behavior, lengthy timeframes from complaint to resolution, and little or no institutional personal consequences for the offender.

Initiatives and Solutions

The NASEM (2018) report includes specific recommendations, and additional guidance to implement each recommendation in the report document. The Table provides a summary of the recommendations to reduce sexual harassment in academia.

Table 1. Recommendations to Reduce Sexual Harassment in Academia

  • Create diverse, inclusive, and respectful environments
  • Address the most common form of sexual harassment: Gender harassment
  • Move beyond legal compliance to address culture and climate
  • Improve transparency and accountability
  • Diffuse the hierarchical and dependent relationship between trainees and faculty
  • Provide support for the target
  • Strive for strong and diverse leadership
  • Measure progress
  • Incentivize change
  • Encourage involvement of professional societies and other organizations
  • Initiate legislative action
  • Address failures to meaningfully enforce Title VII’s prohibition on sex discrimination
  • Increase federal agency action and collaboration
  • Conduct necessary research
  • Make the entire academic community responsible for reducing and preventing sexual harassment

(NASEM, 2018)

External oversight of institutional response to gender harassment is essential, since a major portion of gender harassment problems are at the university or college organizational level. This year, the National Institute of Health (NIH), an important federal institution that funds nursing research, has demonstrated a renewed commitment to gender and racial equality (National Institutes of Health, 2018, September 17). Historically, the high-risk awards, such as awards in the Director portfolio, have gone to a disproportionate number of male applicants (National Institutes of Health, 2018). As described above, women have faced disproportionate and substantial barriers in research-intensive institutions to secure student research positions, faculty positions, appropriate mentoring (Hesli et al., 2012; Moss-Racusin et al., 2012). Women also face a lack of adequate response to harassment and discrimination, and little objective and fair evaluation for promotion (Binder et al., 2018; Takeuchi et al., 2018; Wagner, Rieger, & Voorvelt, 2016). As a result, fewer qualified women reach the point where they are able to apply for NIH funding initial awards or continuing awards (Byerley, 2018; Newsome, 2008).

Fortunately, once awarded, female scientists are just as likely as their male counterparts to maintain their funding, but an opportunity still remains to ensure the funding is at equal dollar amounts (Hechtman et al., 2018). The timeliness, depth and corrective impact of this renewed commitment with long overdue policy reform to hold offenders accountable is yet to be determined. Additionally, recent reforms and policy change, such as the National Science Foundation’s new reporting system, if carried out as intended, have the potential to balance past inequalities (National Science Foundation, 2018).

External oversight of institutional response to gender harassment is essential, since a major portion of gender harassment problems are at the university or college organizational level. With evidence that organizations often fail to adequately police themselves for compliance, or conduct surface-level or only symbolic compliance, external regulatory and funding agency assurance of accountability provides a much needed and high-level influence to correct harassment problems. Journals and editors are also in crucial positions to address discriminatory practices in the dissemination phase. Successfully reporting, achieving justice, and changing institutional leadership and culture must become a more common occurrence to make headway on the industry-wide problem of sexual discrimination and harassment against women in academic settings (NASEM, 2018).

Professional nursing organizations offer a powerful collective force to address gender discrimination and harassment in all sectors of nursing. Professional nursing organizations offer a powerful collective force to address gender discrimination and harassment in all sectors of nursing. The American Nurses Association (ANA) has initiated a “Stop Nurse Abuse” campaign that raises awareness, provides education and advocacy about harassment for nurses in all settings (ANA, 2018). Specific to academic nursing, the American Association of Colleges of Nursing (AACN) currently has several resources to foster diversity and inclusion in academic nursing (AACN, 2019). Focused toolkits and applications of the NASEM report to academic nursing academic nursing leaders are needed. Education, policy development, and advocacy by the American Academy of Nursing is necessary for solution-focused action steps. Last, specialty nursing organizations are also crucial resources for research, education, policy, and leadership solutions.

Gaps and Future Directions

There is little research available on gender harassment and discrimination of academic nursing... There is little research available on gender harassment and discrimination in academic nursing, unique from the context of the broader institutional environment. As the proportion of women in a discipline or work unit increases, the overall pay of the entire unit decreases and vice versa. Thus, common practices of adjusting pay analyses for a discipline may mask an insidious gender pay and promotion disparity at the nursing group level. Since nursing faculty are still predominately female, the gender discrimination context described here may be amplified beyond the individual and apply to the group or school level as a whole. Additional research is needed to parse pay and promotion inequities among disciplines in the academic settings, as well as for individuals.

Since gender discrimination in academia is currently so prevalent, it is unclear if this problematic culture spills into a difference in academic medical centers and hospitals, compared to non-academic counterparts. Lastly, outside of the nursing student experience, there is a paucity of research on both the gendered privileges and risks for discrimination of male nursing faculty. Since men in nursing advance the boundaries of traditional gender-normative choices, further support for a better understanding of the intersection of gender, race, and occupational choice is extremely relevant.


In conclusion, gender harassment and discrimination of women is extensively pervasive in the higher education setting. As a predominantly female discipline, this harassment impacts the ability for nursing faculty and scientists to lead and contribute to the profession in a healthy work environment, and limits the capacity to lead initiatives to reduce harassment and discrimination for nurses working in other sectors.

...even subtle bias results in limited hiring, promotion, and leadership opportunities for women in academia... Several factors that increase risk for sexual harassment and discrimination in the academic setting include non-gender normative behavior and several organizational characteristics. A synthesis of the evidence reveals that even subtle bias results in limited hiring, promotion, and leadership opportunities for women in academia, regardless of objective qualifications and accomplishments. Illustrative cases exemplify challenges throughout history for the proper attribution for work; differential treatment because of gender; ineffective university responses; and recent federal-level attempts to improve the structures for gender equality by grant-funding agencies. The 2018 NASEM report outlines specific recommendations to reduce sexual harassment in academia as a much needed blueprint for system-wide improvements.


Jessica Castner, PhD, RN-BC, FAEN, FAAN

Dr. Castner earned a PhD in Nursing from the University of Wisconsin-Milwaukee; a Master’s in Public Health Nursing from the University of Missouri-Columbia, and a Bachelor of Science in Nursing from Marquette University. She is a Fellow in the Academy of Emergency Nursing and the American Academy of Nursing, board-certified emergency nurse (CEN), Asthma Educator (AE-C), and Trauma Nursing Core Course (TNCC) Provider and Instructor. Dr. Castner’s significant scientific innovations center on integrating the physical environment determinants of health, data science, and emergency department outcomes. The founder and President of Castner Incorporated, Dr. Castner is a pioneer in developing a forerunning research-intensive institution with a foundation in environmental health nursing research, and uniquely poised to overcome the contemporary pervasive, and seemingly intractable, barriers to the advancement of women in science. In addition to clinical nursing, her work experience includes entrepreneur, academic faculty, editor, consultant, and administrator.


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© 2019 OJIN: The Online Journal of Issues in Nursing
Article published January 31, 2019

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