In November 2017, 40 per cent of a random sample of Swedish female doctors reported to have been exposed to sexual harassment or abuse by patients, colleagues or superiors (13), and in an article in the Aftenposten daily in December 2017, 20 per cent of the members of a Facebook group of female doctors reported to have been exposed to sexual abuse or harassment from healthcare service employees (2). The difference in incidence, both between these two studies and in relation to our figures, may be due to a number of issues.
Increasing awareness of this topic in the wake of the #MeToo campaign and a lowered reporting threshold may probably help explain the higher incidence in these two studies when compared to data from 2015.
The differences may also be due to the fact that unwanted sexual attention was measured differently in these studies. Previous studies show, for example, that a direct question of exposure to unwanted sexual attention (with or without a definition of what this implies) returns a lower incidence rate than a concrete question that refers to exposure to a range of specifically defined comments and actions (14, 15).
Nor are the two reports from 2017 necessarily representative of doctors as a group in Norway or Sweden. Previous studies have shown that research on unwanted sexual attention is especially vulnerable to reporting bias, both because of the difficulty involved in defining the concepts and the dearth of representative samples (14).
Most likely, the differences between the Norwegian and Swedish figures from 2017 are also related to whether this harassment or abuse was committed by colleagues, vs. by colleagues and patients/clients. The Living Conditions Survey 2016 reported that 79 per cent of the unwanted sexual attention stemmed from customers, clients, students or other non-employees, 20 per cent from colleagues and 6 per cent from superiors.
Measures against unwanted sexual attention must be adapted to whether it is committed by employees or non-employees. In future studies, it will be crucial to distinguish between these groups in order to provide employers, trade union representatives and the medical profession as a whole with a better basis for choosing necessary measures to reduce unwanted sexual attention.
Since our question about experience of unwanted sexual attention is directly comparable to the one posed in Statistics Norway's living conditions survey regarding the working environment ('Exposed to unwanted sexual attention, comments or similar, a couple of times per month or more often') (3), we can see that the incidence among doctors was fairly similar to the incidence in the population in general in 2014, for women (7.8 % vs. 7.0 %) as well as for men (2.2 % vs. 2.0 %) (3).
Over the last 20 years, including before the #MeToo campaign, we can see an increase in the occurrence of unwanted sexual attention, especially among women (doctors from 5.2 % to 7.8 % and in the general population from 4.0 % to 7.0 %). This could be due to a gradual change in attitudes and attention to this, and may thus be an expression of changes in the understanding of the phenomenon. On the other hand, in the same period we can find no corresponding change in the incidence of bullying or violence, which we identified in parallel (12, 16).
According to Statistics Norway, nurses constitute the group which is most frequently exposed to unwanted sexual attention (3). The major difference between the proportion of nurses (17 %) and female doctors (7.8 %) may be related to differences in the rate of contact with patients, clients or their next of kin. As described above, studies indicate that the occurrence of unwanted sexual attention is higher in occupations with extensive contact with customers or users (4).