Gender Assumptions: A Study of Pronouns Used by Anesthesiology Trainees when Referring to a Surgeon and a Nurse

Abstract

Gender stereotyping remains prevalent in health care, shaping specialty choice, professional identity formation, and patient interactions. Despite growing gender diversity in medicine, assumptions that surgeons are male and nurses are female persist. We investigated whether anesthesiology trainees unconsciously reinforce these stereotypes during a simulated patient encounter. All anesthesiology trainees at a large US academic center participated in an 8-min standardized patient (SP) simulation in 2022. The SP used gender-neutral references to an unseen surgeon and nurse, prompting trainees twice about each role. Observers recorded any gendered language or pronoun use, and Chi-squared testing assessed differences by trainee gender. Sixty-four (female: 34 [53%] and male: 30 [47%]) trainees participated, providing 128 potential gender references (one each for surgeon and nurse). After excluding ambiguous responses, 84 analyzable instances remained. Gendering was avoided in 55/84 (65%) cases and assumed in 29/84 (35%) cases. The surgeon was identified as male in 20/21 (95.2%; 95% CI: 76.2%–99.9%) cases and female in 1/21 (5%) cases; the nurse was identified as female in all 8/8 (100%) cases. No significant differences emerged between male and female trainees. In conclusion, while most trainees avoided gendered language, implicit stereotypes persisted when pronouns were assigned. Educators can address this through intentional use of counter-stereotypical examples to promote gender equity.