Intersectional Invisibility in Women's Diversity Interventions

Systemic and organizational barriers and facilitators to the advancement of ethnic minority women nurses in healthcare leadership: A meta-synthesis

OBJECTIVE

This meta-synthesis explored system and organizational-level barriers and facilitators for women in nursing from ethnically minoritized backgrounds that impact their advancement in healthcare leadership. This topic is important because nursing accounts for a significant proportion of the global health workforce, and women represent the majority of the nursing profession, yet, women nurses are underrepresented in healthcare leadership. This disparity is further compounded for women nurses from ethnically minoritized backgrounds, including migrants.

DESIGN

Systematic review methods incorporating meta-synthesis.

DATA SOURCES

Six databases (MEDLINE, EMCARE, EMBASE, PsycINFO, PubMed, and CINAHL) were searched from January 2000 to November 2024 for terms including: "women", "nurses OR midwives", and "leadership". The search was limited to the English language.

REVIEW METHODS

Template analysis was performed to identify system and organizational-level barriers and facilitators that impact on ethnically minoritized women nurses' career progression. Methodological quality of included studies was assessed using the Joanna Briggs Institute Cross-sectional and Prevalence Studies criteria and Critical Appraisal Skills Programme-Qualitative Studies Checklist.

RESULTS

Twenty-one papers were included in this review. Under four main categories, seventeen sub-themes were identified: 1. Systemic/outer setting barriers (skills, education and qualification recognition for migrants; societal racial bias), 2. Systemic/outer setting facilitators (policies; supportive nursing organizations specific to ethnically minoritized women; research, evidence and awareness on racism; representation across all stakeholders in nursing), 3. Organizational/inner setting barriers (lack of support for organizational processes and policies; institutional racism; discriminatory organizational culture; limited access to effective mentoring and networking; ineffective support tools; impact of persistent barriers), and 4. Organizational/inner setting facilitators (organizational processes and policies; organizational culture; mentoring and networking; support tools; training and development).

CONCLUSION

Women nurses from ethnically minoritized backgrounds encounter systemic and organizational-level barriers to healthcare leadership, contributing to their underrepresentation in leadership. Recruitment, promotion, and retention processes for leadership positions are adversely affected, primarily due to bias, inadequate support mechanisms, and discrimination. Addressing these issues and removing structural barriers for women nurses from ethnically minoritized backgrounds requires a systemic and organizational-level approach. By identifying these disparities, healthcare systems can work towards creating equal opportunities for all nurses to advance, resulting in more comprehensive and equitable care delivery.

Discrimination on the basis of race and color

The heightened focus on racism and colorism in recent years has deepened scholarly attention to the pervasive emergence and impact of racism and colorism within organizations. In this review, we begin by exploring the diverse ways in which racism manifests within organizations. We then address the complexities and variations that exist within racial categories - exploring colorism and the ways targets of racism and colorism manage their identities. Finally, we present strategies to address and mitigate these evolving issues of racism and colorism, and we offer insights for both practice and future research.

Passion is key: High emotionality in diversity statements promotes organizational attractiveness

To attract and retain a more diverse workforce, organizations embrace diversity initiatives, expressed in diversity statements on their websites. While the explicit content of diversity statements influences attitudes towards organizations, much less is known about the effect of subtle cues such as emotions. In three pre-registered studies, we tested the effect of positive emotionality in diversity statements on attitudes towards organizations. Study 1 focused on the degree to which 600 European organizations employed emotionality in their diversity statements, finding that although their statements differed in the level of emotionality, on average, organizations avoided highly emotional words. Study 2 (N = 220 UK participants) tested the effect of original diversity statements on readers' attitudes towards an organization, demonstrating that the level of emotionality in the existing statements did not influence positive attitudes towards the organization. In Study 3 (N = 815 UK participants), we thus modified the diversity statements so that they contained high levels of positive emotionality that triggered more positive emotions and resulted in more positive attitudes towards an organization. Taken together, highly emotional words (e.g. passionate; happy; wholeheartedly) are key in diversity statements if organizations wish to increase their attractiveness among potential employees.

Why We Should Stop Trying to Fix Women: How Context Shapes and Constrains Women's Career Trajectories

In this review we examine two classes of interventions designed to achieve workplace gender equality: (a) those designed to boost motivations and ambition, such as those that aim to attract more women into roles where they are underrepresented; and (b) those that try to provide women with needed abilities to achieve these positions. While such initiatives are generally well meaning, they tend to be based upon (and reinforce) stereotypes of what women lack. Such a deficit model leads to interventions that attempt to "fix" women rather than address the structural factors that are the root of gender inequalities. We provide a critical appraisal of the literature to establish an evidence base for why fixing women is unlikely to be successful. As an alternative, we focus on understanding how organizational context and culture maintain these inequalities by looking at how they shape and constrain (a) women's motivations and ambitions, and (b) the expression and interpretation of their skills and attributes. In doing so, we seek to shift the interventional focus from women themselves to the systems and structures in which they are embedded.

Gender differences in perceived legitimacy and status perception in leadership role

The present study examined the difference between women and men in perceiving leadership roles. Two experiments, one conducted online and the other in a lab, investigated the subjective experiences of Japanese men and women when they are assigned with different roles (e.g., leader vs. subordinate). Both studies revealed that women perceived their role as less legitimate when they were assigned leader role (vs. subordinate role). In contrast, men did not differ in their perceived legitimacy according to the assigned roles. This discrepancy in legitimacy perception in response to different roles between men and women accounted for a significant variance in women's lower sense of status when they were a leader (vs. subordinate), but not among men. Our study results illustrate the psychological barrier operating for women in organizations that are embedded in a cultural context in which women leaders are highly underrepresented.

Addressing workplace gender inequality: Using the evidence to avoid common pitfalls

In this Landmark article I outline four common missteps that are made when designing and implementing workplace gender equality initiatives: (1) when we don't go beyond describing the numbers; (2) when we try to 'fix' women rather than fix systems; (3) when we are overly optimistic about the progress we have made; and (4) when we fail to recognise the intersectionality of the experiences that women face. I will briefly consider each of these missteps in term, presenting research that suggests alternative ways of approaching gender equality initiatives.

Masculinity and Leadership Effectiveness (Self-)Perceptions: The Case of Lesbian Leaders

In line with the gay glass ceiling effect, sexual minorities are often target of discrimination within work-related contexts, thus potentially undermining their wellbeing at work. For gay men, discrimination may partially be attributed to gay men's stereotypical feminine perception, which does not fit with the stereotypically masculine traits required for leadership positions. Yet, when considering lesbian women, the masculine stereotypical view associated with them may come to represent an advantage in work-related contexts, especially when compared to heterosexual women. In Study 1, N = 303 heterosexual participants rated a lesbian vs. a heterosexual woman as a job candidate on stereotypical gender (masculine vs. feminine) traits as well as leadership effectiveness. Results showed that being lesbian was associated with higher levels of masculinity (but not femininity), which in turn was related to high leadership effectiveness. In Study 2, N = 268 lesbian and heterosexual women rated themselves on the same measures. Results showed that both groups associated masculine traits with enhanced leadership effectiveness. These studies provide a better comprehension regarding how lesbian women may be perceived in work-related contexts and shed light on the role played by gender stereotypical perceptions in shaping both heterosexual and lesbian perceptions of leadership effectiveness.

U.S. Women Faculty in the Social Sciences Also Face Gender Inequalities

There is a national interest in United States women's underrepresentation in science, technology, engineering, and mathematics (STEM); however, gender inequality in the social sciences has not received similar attention. Although women increasingly earn postgraduate degrees in the social sciences, women faculty still experience gender inequities. Consistent gender inequities include slower career advancement, blunted salaries, unequal workloads, work-life conflict, systemic gender biases, underrepresentation in positions of power, and hostile work environments. Cultural biases suggest that once women have achieved parity, gender bias no longer exists. This review challenges that notion by providing evidence from social science domains in which women are well-represented but continue to face systemic gender biases. We examine cultural influences on gender representation and career advancement in psychology, economics, political science, sociology, and anthropology. We make interdisciplinary comparisons of career trajectories and salaries using national data, documenting patterns across the social sciences. For example, women economists face gendered standards in publishing, and women political scientists are less likely to have their work cited than men. Furthermore, data show that salaries become stagnant as the representation of women in these fields increases. These disparities reflect cultural biases in perceptions of women's competence stemming from social role theory. We discuss best practices to address these problems, focusing on the ADVANCE organizational change programs funded by the National Science Foundation that target (a) improving academic climate, (b) providing professional development, and (c) fostering social networking. Federally supported interventions can reveal systemic gender biases in academia and reduce gender disparities for women academics in the social sciences.