Joe Biden’s election triumph over Donald Trump brought the historic election of the first woman to the vice-presidency of the United States. Kamala Harris is destined to become one of the most influential and powerful women in the country, if not the world.
The daughter of a Jamaican father and Indian mother, Kamala Harris addressed the country dressed in an all-white trouser suit as a homage to the Suffragette movement. As she paid tribute to her immigrant mother, I was particularly struck by these words: “And to the children of our country, regardless of your gender, our country has sent you a clear message: dream with ambition, lead with conviction, and see yourself in a way that others might not see you, simply because they’ve never seen it before.”
I had just been stunned, when I called my family to discuss Kamala Harris’s election, to find that my mother had assumed she was the wife of Joe Biden. Why else would she have been up on that stage? It was an abrupt reminder that women can still view women through the lens of men.
I grew up in a patriarchal Punjabi family surrounded by male doctors. At four years old, my ambition was to be a doctor and emulate my father. My school career was focused on entering medical school to achieve this dream. But aged 17, my father made the decision that medicine was not the best career for a woman. I had the necessary grades, but this was the early 1990s, and my father was a consultant obstetrician and gynaecologist in a small English town. He could see the difficulties of being a female doctor—the struggle to maintain a family life alongside a demanding career, the pressures and the gender disparity in senior positions. Very few consultants at that time were women.
My mother was a stay-at-home mum, cooking and taking care of my brother and I as my father ran between hospital and family life. I was essentially being told, “Don’t be a doctor — marry one instead.” Despite medicine being my lifelong dream, I acquiesced. I entered pharmacy, my second-choice career, and accepted a ‘part time’ lifestyle more amenable to childcare. Perhaps I thought I would learn to know my limits. Instead, I cheered from the sidelines as my younger brother reached dizzying heights of success — as a doctor.
As I grew older and became more confident, I gave myself permission to fulfil my dream, finally. I applied successfully to Cambridge University and, in 2007, became the first female doctor in my family. Fast forward to 2020, where I am on the verge of becoming a consultant in obstetrics and gynaecology, and I am brought to a moment of reflection at what lies ahead.
I wonder if things have truly changed. In the 1960s, less than 10% of doctors were female; now almost 60% of registered doctors are and most of those are of childbearing age. Yet only a quarter of medical directors are women and in some surgical specialties only one in ten are women.
Despite the fact that over 50% of entrants into medicine are now women, women doctors make up only 25% of the specialist register and only a minority are in senior roles. If you come from a Black, Asian and Minority Ethnic backgrounds, the challenges are even starker—doctors in senior positions are more likely to be white and those in staff grade positions are more likely to be from ethnic minorities. Moreover, research has shown that ethnic minority doctors’ experience of medicine can be sharply different to that of their white colleagues. In particular, ethnic minority doctors, overseas graduates, older male doctors and some non-specialist doctors are more likely than their counterparts to be referred to the GMC by employers or healthcare providers.
This is not unique to medicine. The Colour of Power survey, revealed that a mere 52 out of the 1,099 top roles in the country are filled by non-white individuals. This amounts to just 4.6%, despite the fact that ethnic minority groups make up 14% of the population.
The current pandemic has also brought into sharp focus the potential experience of people of colour and covid-19. Many analyses have shown that older age, ethnicity, male sex and geographical area, for example, are associated with the risk of getting covid-19, experiencing more severe symptoms and higher rates of death.
In my own specialty of obstetrics and gynaecology, there is clear evidence black and minority ethnic women are five times more likely to die in pregnancy, childbirth or in the postpartum period compared to their white counterparts. Preterm birth is significantly more common in women who are Black Caribbean, Indian, Bangladeshi, Pakistani and Black African than for White British women. These ethnic differences do not appear to be wholly explained by area deprivation or other sociodemographic characteristics and suggests that disclosure of symptoms or pain may not be taken as seriously in minority ethnic populations due to unconscious and implicit bias in healthcare settings.
Watching the scenes of jubilation spread across the US after the election results does bring hope and possibility. We are starting to talk about assumptions based on race, class, ability, age and other sources of oppression, and institutions like the NHS are beginning to understand the importance of addressing race inequalities in the workforce.
I strongly believe that Kamala Harris taking the office of vice-president can only be good for women, and especially those of colour, not only in the US but also in the UK. Rather than facing a chorus of lack of support for career and life choices, not being promoted or not being heard, she can be the beacon to ensure that her words “While I may be the first woman in this office, I will not be the last” ring true for all of us.
Reena Aggarwal, Specialist Registrar in Obstetrics and Gynaecology at the Royal Free NHS Trust. Twitter: @drraggarwal
Competing interests: None declared