Abstract
I
Competing vs. “Catfighting”
As among men, women's interactions with other women occur along a continuum from largely positive to toxic “relational aggression.” 1 When women who are skilled at collaborating work together, the sky's the limit. But out of proportion to their numbers, women professionals report other women as enemies. 2 The so-called Queen Bee and Dragon Lady are familiar images: a senior-level woman who has internalized the low status of women and who seeks to minimize competition from other women. 3 For instance, a professional society's president wants to increase the number of women on their board, but the only woman currently on the board shoots down each woman candidate proposed.
In addition to internalization of women's comparatively low status, differences between women's and men's experiences with competition and power are a big factor in these negative dynamics. Physical competition with clear rules of play are built into the daily lives of most boys, and winning is encouraged. Girls' aggression and ambition tend to get channeled into less direct outlets, such as gossip and ostracism of other girls, which may escalate into what are termed “catfights.” Parents of junior high–age girls report multiple negative consequences of these behaviors, which may have lasting impact on some girls' self-confidence. This phenomenon of striking out at another oppressed group member has been discussed as a form of horizontal violence, that is, an acting out of internalized negative stereotypes. 2 Even girls who are healthy tend to focus on personal appearance, on who likes whom, and on keeping the power dead-even (e.g, nobody wins at dolls). 4 Competition between women is therefore more complex than between men and is often dismissively labeled as “catfighting” or worse.
A related dimension of this dynamic is cultural ambivalence about how much agency and authority women are to be allowed. Men are expected to be agentic (i.e., assertive and decisive) and women to be communal (i.e., nurturing and egalitarian). 5 Perhaps especially in healthcare fields, both men and women expect women to be likeable and warm in ways that men are not expected to be. Similarly, humility and a willingness to stay “behind the scenes” in the workplace are considered virtues in women but not in men.
Women thus enter the workplace less experienced than men with navigating organizational hierarchies and with competing for resources, along with a more precarious exercise of authority. Although not admitting to preferring a male boss, many men and women have been found to be willing to take a lower salary in order to get one. 6 Even when women bring equivalent qualifications and are skilled at negotiation, they are offered less than male peers and experience more pressure than men to concede. 7 Thus, for women to effectively negotiate—indeed to manage all interpersonal situations at work—they must be skilled at handling the often hidden gender-related dynamics in relation to women as well as to men.
Common Dilemmas
Difficulties that arise between women in academic medicine often fall under one of several interrelated headings.
Relationships between women physicians and nurses
Situation
New to a clinical service, a woman resident notices that many of the nurses are more responsive to her male peers and even to male medical students than they are to her; she gives examples of these behaviors to their supervisor, who makes light of them, saying, “Let's just try to get along here.”
Comment
Physician-nurse relationships have traditionally been a dominant-subservient relationship in terms of both professional status and gender. 8 When both the nurse and the physician are women, however, women physicians report pressures to do both the nurses' work and their own and to try to make friends with nurses to ensure their cooperation. Studies have found that many women physicians discern that they must “clearly calculate and negotiate behavior to avoid conflicts…[whereas] men don't have to involve themselves in such negotiations in order to get respect and the service work done” (p. 202). 9 Women physicians who do successfully forge cooperative relationships while remaining in the physician role do so by taking care to treat nurses and staff respectfully as team members, thanking them and soliciting their input as appropriate.
The interface between professional roles and friendships
Situation
Two physicians who trained together have stayed friends in the same department; now A has become division chief and B has lost her research funding and has developed a reputation as a whiner.
Situation
After achieving a promotion, a research assistant overhears women she considered her friends gossiping that she's “gotten too big for her britches”; one of those women is apparently even lying about her to their boss.
Comment
Compared to men's relationships with each other, women tend to have more fluid boundaries between their personal and professional relationships. For instance, because of their children's shared activities, a woman may interact as equals with both her research assistant and her boss or the wife of her boss. Women employees also tend to expect women more than men bosses to listen to and sympathize with their personal and family issues. This blurring of boundaries may enhance collegiality, but in order to meet her responsibilities, the woman boss must sometimes draw a line between professional and personal roles. Work relationships are “conditional,” that is, dependent on roles and contexts that frequently shift. When work relationships become conflated with “unconditional” relationships (i.e., friendships), a change in role often creates difficulties in the friendship and vice versa. If either party compounds these difficulties with gossip or feelings of betrayal, both the friendship and the professional relationship are jeopardized.
Taking a direct approach to a conflict
Situation
An intern upset about how her chief resident is assigning call complains to her friend: “The chief resident doesn't like me and isn't being fair to me, but if I go whining to her, she'll make it even harder on me.” The friend responds, “Why are you adding drama to this? Just keep this simple and present your data and suggest an alternative.”
Comment
Conflicts among needs and priorities are natural and inevitable, but women who are inexperienced with navigating role-related hierarchies often personalize predictable competing interests. 10 Whether something “feels fair” is inadequate. Building relationships while achieving one's goals requires an analytic assessment of organizational context, taking into account others' frameworks and pressures. 11 Some helpful questions to prepare for conversations about conflicts are: What commitments do we share? What are my assumptions about this situation, and where might my expectations be out of line? What additional information do I need?
Women holding other women to higher standards than they hold men to
Situation
Two women residents are complaining about a woman attending: “She's so much harder on the women trainees, plus she treats us as if there's something wrong with us for not being as driven as she is—it's not our fault she didn't stop to have kids.” “Yeah, she's the opposite of a role model.”
Comment
Beyond predictable generational differences, junior and senior women tend to clash in their expectations of each other. Whether it's because they found that they had to be twice as good as their male peers to succeed or out of less conscious motives, senior women are often harder on young women than on young men. Unfortunately, these young women expect women faculty and mentors to be more relational and supportive than they expect men to be, even though they express a desire to move beyond gender stereotypes. 12 These pedestals of unconscious expectations often produce resentments that reduce the value of the relationships.
Recommendations
The following practices will help prevent or assuage many of those dilemmas.
Women and men need to watch a tendency to hold women to higher standards than they hold men to especially with regard to “likeability” and to relationship skills.
Work colleagues who become close friends (or vice versa) should proactively address predictable role-related issues. For example, when one must evaluate or negotiate with the other, begin by discussing role-related responsibilities and tensions.
Recognize when differences in positional power may create resistance or jealousy. If doing so serves the work, consider playing down status differences. Alternatively, a senior woman who has allowed too high a level of informality might consider revisiting this on an individual basis; for example, “When we're in the park, please do call me ‘Lily,’ but to avoid confusion at work, it's important to call me ‘Dr. Black’—thanks.”
Since women professionals must take care to convey both competence and warmth, sensitive versatility is critical. If handling conflicts and communicating across differences do not come naturally, consider what resources (e.g., training programs, books, individualized coaching, observing role models) will build these capacities. However uncomfortable, it is usually necessary to seek feedback to acquire insights into ways one may be over- or underfunctioning. The most direct method of getting feedback is to ask trusted individuals to share their observations 13 (i.e., name a number of domains, such as “treating people with respect,” and ask, “If you have thoughts about how can I do better here, will you share them?”)
Continuously expand professional networks and build community in order to stay connected to sources of savvy, inspiration, and encouragement and to prevent overrelying on oneself or one's mentor or boss.
Mentor, sponsor, promote, and nominate other women for stretch positions and awards.
How Men Can Help
Men's skill and success as mentors and coaches of women depend to a great extent on incorporating an understanding of extra challenges that women face in developing their potentials, including those challenges that women themselves contribute to. Standing outside of the dynamics discussed here, men who accurately interpret woman-to-woman conflicts can bring a welcome objectivity. They are well positioned to remind women about the pitfalls of expecting different behaviors of other women than they do of men, about the conditional nature of relationships at work, about the advantages of handling conflicts in direct while respectful ways, and about navigating organizational hierarchy.
Also, many men can do more to lift up women's accomplishments and nominate women for opportunities. If a woman responds, “I'm not ready” or “I can't right now because of other responsibilities,” don't give up on her but instead take the long view of career development by, for instance, responding, “Let me know when you're ready for me to nominate you.”
Conclusion
Women who are leading with their strengths as team builders and relational communicators are helping to transform individualistic, hierarchical cultures into workplaces in which the sharing of talent and information is advancing critical missions. In organizations in which many women are becoming leaders, in which the playing field is leveling, and in which collegial relationships form naturally, the gendered difficulties addressed in this editorial are likely diminishing. But where these trends are not occurring and where it feels as though it's “every woman for herself,” the frameworks and strategies suggested here may aid in handling many predictable woman-to-woman challenges.
Footnotes
Acknowledgments
The author thanks Diane Magrane, MD, and Page Morahan, PhD, for their help with an earlier version of this editorial.