As if major surgery isn’t stressful enough, now there’s another thing to worry about: what if your surgeon is a man?
A recent study based on over 700,000 surgeries in Ontario between 2009 and 2019 claims to show a 3 percent decline in “major morbidity” – that is, significant post-operative complications including death – within 90 days of surgery when the share of female surgeons and anaesthetists at an individual hospital rises above 35 percent. As lead author Julie Hallet, a surgeon at Toronto’s Sunnybrook Health Sciences Centre, told the CBC, “It’s not only about equity and justice. It’s really about increasing performance and providing better care.”
Evidence that women are better at surgery than men can also be found in two other Ontario studies. One examined nearly 1.2 million operations performed from 2007 through 2019 that found patients with male surgeons had significantly higher rates of post-operative complications than those with female surgeons. The second compared surgeries performed by males and females and concluded total health care costs were $6,000 lower when a woman held the scalpel.
What might explain this? Since female surgeons take an average of 15 minutes longer to complete comparable surgeries than do men, the authors suggest they are more careful in the OR, and hence make fewer mistakes. Other research suggests women doctors spend more time communicating with their patients and are more aware of possible complications and concerns. All of which suggests a noticeable advantage for patients lucky enough to be operated on by a woman.
There are, however, big differences in the sorts of surgeries performed by men and women. Of 58,912 neurosurgeries in one study, 56,049 – or 95 percent – were performed by men. Cardiothoracic and orthopedic procedures had the same relative shares. In Hallet’s study, hospitals with greater than 35 percent female representation accounted for a mere 1.7 percent of cardiac operations in Ontario, and only 10.3 percent of neurosurgery.
As careful as they may be, female surgeons tend to focus on routine procedures while their male counterparts overwhelmingly handle the riskiest and most difficult tasks. The authors all claim their statistical work corrects for these huge discrepancies, but an expert second – and perhaps third – opinion seems warranted.
Setting this skepticism aside, however, it remains plausible that women actually are better at surgery than men. Given the well-established differences between men and women in terms of risk-seeking, emotional intelligence, communications skills and so on, there may well be a distinct and measurable benefit attributable to female surgeons. And then what?
If women make better surgeons because of immutable sex-based characteristics, it stands to reason men must be better-suited to other jobs that take advantage of their unique traits and strengths. This suggests historical male dominance in certain sectors or occupations may not be evidence of patriarchal or systemic discrimination, as is often claimed, but rather an efficient sorting of tasks.
Consider firefighting, once the exclusive domain of men. Unlike for surgery, there is no centralized dataset available to examine the efficacy of male versus female firefighters when putting out blazes, prying open mangled automobiles or rescuing cats from trees. There is, however, ample evidence on how the two sexes bear up to the job’s physical challenges. And according to academic research on Canadian firefighters “Women experienced a 1.4-1.6 times greater likelihood of sustaining musculoskeletal” injuries than men. Another study found the “fitness profiles of female firefighters consistently differ in comparison to their male counterparts, in terms of cardiovascular levels, muscle strength and endurance.”
This doesn’t mean women cannot or should not be firefighters. But if efficiency and effectiveness are our measures, it appears men hold an edge because their bodies are better-suited to the tasks involved.
The same observation holds for soldiering. The U.S. military has been fully integrated since 1994, with all tasks – including combat roles – open to both men and women. But according to a comprehensive review of gender statistics from combat missions in Afghanistan and Iraq, female soldiers suffered 17 percent of all injuries despite accounting for only 11 percent of combat troops over this time. Conversely, women comprised just 1.6 percent of all U.S. Army deaths in Afghanistan and 2 percent in Iraq. It appears women tend to get injured more often, but are rarely placed in the direct line of fire. An army assembled along strict efficiency grounds would almost certainly be all-male. Yet it remains a political objective to increase the enlistment of women in both the Canadian and U.S. militaries.
Directing movies is another male-dominated occupation that faces similar pressure to enlist more women. In the Academy Awards’ 96-year history, only three women have ever been named Best Director; the first being Kathryn Bigelow for her male-centric war movie The Hurt Locker in 2008. This factoid is frequently cited as prima facie evidence of rampant gender discrimination in Hollywood. But what if there is a distinct sex-based advantage to directing movies similar to that for female surgeons?
In 2022, provocative Hollywood blogger Sasha Stone claimed that men are simply better-suited to commanding a set and crafting a coherent visual message. “Men are uniquely built to be great directors because they are more visual/spatial than women,” she wrote on her much-read website AwardsDaily. “They’re great at the visual stuff, which is why they make great movies.” As might be expected, Stone’s observations set off an explosion of social media outrage.
While it makes intuitive sense that men and women could be better suited to different jobs, this logic only seems to work one way. Evidence that women may bring intrinsic advantages to certain tasks is generally greeted with great applause and acclaim, while evidence pointing in the opposite direction – that men may be innately suited to other jobs for analogous reasons – is treated with scorn and condemnation.
If there are benefits to society to be had from identifying sex-based differences in occupational performance – by improving outcomes or better matching workers to jobs, for example – this is the wrong way to go about it.
Peter Shawn Taylor is senior features editor at C2C Journal, where a longer version of this story first appeared.
