The limits of feminization: gender composition and mental wellbeing in the medical profession

Abstract As more women enter traditionally male-dominated professions, it is important to understand how feminization has—or has not—impacted work cultures, with implications for women’s mental wellbeing. Research on proportional representation and mental health suggests that as professions feminize, women’s mental wellbeing should benefit from shifting peer cultures. However, gender stratification scholars argue that interactional cultures are also shaped by macrolevel factors like institutional rules and hegemonic beliefs that may temper cultural change. We examine the case of medicine, a profession that has feminized rapidly but unevenly over recent decades, to investigate the extent to which increasing representation of women shapes not only local peer cultures, but also the professional logics and rules that frame those local cultures, in ways that may affect women’s mental wellbeing. Drawing on interviews with physicians and trainees in more- and less-feminizing specialties, we find that masculinized norms persist across fields, regardless of feminization, because these ideals are codified through enduring professional rules and logics. These ideals can negatively shape women’s mental wellbeing, as they either disengage from their work or grow frustrated with sexist expectations—especially those in more feminized specialties who expected a more “women-friendly” experience. Our findings suggest that increasing proportional representation may be necessary but insufficient for prompting profession-wide cultural change and improving women’s mental wellbeing, given the complexity of the gender structure.