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From microaggressions to overt discrimination: Policy offers guidance to avoid gender-based harassment

August 22, 2022

Although sexual harassment has long been a concern of the AAP, recent attention has highlighted the pervasiveness of the issue and identified underrecognized harassment concerns.

A revised AAP policy statement, Creating Work and Learning Environments Free of Gender-Based Harassment in Pediatric Health Care, provides guidance for pediatricians, employers, educators and others working to improve the health and well-being of children.

The policy, from the Committee on Pediatric Workforce, is available at and will be published in the September issue of Pediatrics.

The statement reaffirms a lack of tolerance of sexual harassment, encourages reporting, and calls for prevention of retaliation, appropriately addressing perpetrator behavior and support for victims. It also emphasizes the experiences of gender minorities, such as transgender or nonbinary individuals, and notes the importance of intersectionality, where people with more than one marginalized identity often experience an enhanced form of discrimination.

The statement notes that sexual harassment of men should not be tolerated either, which is especially important as men become the minority of pediatric providers.

In addition to defining gender more broadly, the statement recognizes subtler forms of harassment such as microaggressions. Beyond zero tolerance toward overt forms of sexual harassment, the medical community must remain vigilant against subtle comments and actions that make people feel diminished, sexualized or excluded. Advocates can teach victims and bystanders what to do in such moments and empower them to respond.

Patients and their families also have been recognized as potential perpetrators of harassment, and practice sites are encouraged to state expectations for respectful behavior by patients and those who accompany them in the clinical setting.

Work and learning environments free of gender-based harassment support pediatric physicians, enhance vitality, advance equity and improve patient care.


Following are among the recommendations in the policy. 

  • Work and learning environments should not tolerate gender-based harassment by employees or educators. Employers and institutions should investigate reports of harassment by employees and act against the perpetrator when verified.
  • Clear policies and practices in each place of employment and education should ensure no tolerance of harassment based on gender, gender identity or sexual orientation as part of a broader antidiscrimination and harassment policy.
  • Gender-based harassment by patients or family members, although more complicated, should not be tolerated.
  • Practices should establish a list of expected patient behaviors to protect all care providers from harassment and develop a protocol for managing harassment by patients.
  • Those who report gender-based harassment deserve support and protection from retaliation.
  • To ensure accountability, data regarding the incidence of harassment in a workplace should be shared among staff in a way that maintains confidentiality.
  • Institutions should offer training to increase awareness of gender-based harassment and its consequences as well as training to prepare those witnessing discrimination and/or harassment to respond and report appropriately.

Dr. Byerley is a lead author of the policy and a member of the Committee on Pediatric Workforce.

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