Today is the International Day for Women and Girls in Science. To celebrate, here's a thread on the history of women in surgery based on my research #WomenInScience 1/13

Much has been written about women’s entry into the recognised medical profession in the 19th century and the earliest pioneers have become household names. By 1892, there were 135 women on Britain's Medical Register 2/13

As historians have shown, however, these pioneers encountered staunch resistance from the public and their fellow surgeons. Despite this, by the mid-1930s, 10% of registered practitioners were women 3/13

In September 1914, Louisa Garrett Anderson described the extent of her surgical role, ‘We have a lot of surgery: sometimes I am in the theatre from 2 to 9 or 10 at night, and have eight or more operations’ 4/13

Following the foundation of the NHS in 1948, and amidst wider social pressure to provide equal rights to women, female participation in the labour market expanded. A need to increase numbers doctors was met by an increasing number of female surgeons from the 1960s onwards. 5/13

And yet, the ‘marriage bar’ (which curtailed the employment of women after marriage or pregnancy) lasted well into the mid-20th century. The problems were not just structural, but cultural as well. 6/13

Popular culture often portrayed women as unfit for medical work and even in the '60s and ‘70s (the decades of Women’s Liberation) the profession remained implicitly and explicitly hostile to female surgeons. 7/13

Mid-20th-century surgeons upheld a masculine and socially elite culture that made certain macho behaviours appropriate and necessary for full participation in the profession. In doing so, they implicitly excluded women from the surgical world 8/13

For example, one consultant from Glasgow would take his medical students and members of his firm on hikes over the rugged West Highlands of Scotland, stopping only to swim naked in the cold mountain streams 9/13

Others conducted much of their business on the gold course, on grouse shoots, and in the hospital bar. Of course, women can hike and enjoy golf, but these habits and hobbies made surgery seem like a man's world 10/13

Ofc, surgery has changed since then. But perhaps not enough. The ratio of male:female consultant surgeons in the UK is approx. 8:1 and sexual harassment and 'banter' in professional circles excludes women both implicitly & explicitly @BMJ_Latest 11/13 https://blogs.bmj.com/bmj/2019/01/24/agnes-arnold-forster-sexism-in-surgery-little-has-changed/#:~:text=Survey%20data%20recently%20published%20in,evidence%20comes%20as%20no%20surprise.

It is also worth pointing out that the culture of 20th-century surgery was also overwhelmingly White and socially elite, excluding people of colour (not least, women of colour) and surgeons (aspiring or otherwise) from working class backgrounds 12/13

While it is vital to address the structural barriers to women entering and enjoying a surgical career (such as parental leave and part-time work), it is also vital to keep a close eye on the cultural history of surgery and its lasting impacts! 13/13