Does physiotherapy’s hidden curriculum exclude men?

A recent article in The Conversation explored how training to be a surgeon subtly marginalised women and promoted the idea that surgery was a man’s world (link).  Surgical training was described as ‘powerful, visible, gendered and discriminatory’.

Over the last few months I’ve been writing and thinking a lot about the gendering of physiotherapy.  Much of that has revolved around the ways that women masseuses in World War I first came into contact with young male bodies, and the brutal ways they went about rehabilitating them.  (The image above is from a classic series of postcards that depicted the dominating and and fearful WWI masseuse – see Carden-Coyne, 2008).

Anders Ottosson’s recent papers looking at physiotherapy’s herstories have also  given me cause to think about our profession’s longstanding gendering.  And while I’m not entirely convinced by Anders’ superbly executed and researched arguments that physiotherapy’s masculine history was lost when physiotherapy became predominantly female in the early 1900s (Ottosson 2015 & 2016), they do offer a poignant reminder that one way in which we can begin to better understand our profession’s past, present and future, is through some of the obvious structural features of our profession.

Hearteningly, there has been quite a swell of interest into physiotherapy’s gendered history recently (see selected readings below), and much of this suggests that physiotherapy’s history, in this regard, may be unique.  Physiotherapy has not followed the path of many other female dominated caring professions, and in many ways it is closer to medicine and surgery than nursing and occupational therapy.

So recent questions about the gendered bias inherent in surgical training are worth thinking about.  If surgery subtly excludes women and promotes androcentric (male-centred) ideals, with the end result being macho language, behaviours and attitudes, how do we promote our particular way of being gendered practitioners through our curricula, daily practices, cultural objects and professional attitudes?  How do we perpetuate the gender distribution within the profession such that it always seems to remain 60-70% female?  How is this achieved?  Is it simply about entry criteria, or something much more subtle and pervasive?  What are we doing to maintain this status quo that, perhaps, we are entirely unaware of?  And what might it mean for our professional identity to change this?

References and selected readings

Carden-Coyne, A. (2008). Painful bodies and brutal women: Remedial massage, gender relations and cultural agency in military hospitals, 1914-18 . Journal of War and Cultural Studies, 1(2), 139-158. doi:10.1386/jwcs.1.2.139/1.

Dahl-Michelsen, T. (2014). Sportiness and masculinities among female and male physiotherapy students. Physiotherapy Theory and Practice, 30(5), 329-37. doi:10.3109/09593985.2013.876692.

Dahl-Michelsen, T., & Solbrække, K. N. (2014). When bodies matter: Significance of the body in gender constructions in physiotherapy education. Taylor & Francis. doi:10.1080/09540253.2014.946475.

Hammond, J. A. (2009). Assessment of clinical components of physiotherapy undergraduate education: Are there any issues with gender? Physiotherapy, 95(4), 266-72.

Hammond, J. A. (2013). Doing gender in physiotherapy education: A critical pedagogic approach to understanding how students construct gender identities in an undergraduate physiotherapy programme in the united kingdom. Doctor of Education.

Linker, B. (2005a). The business of ethics: Gender, medicine, and the professional codification of the american physiotherapy association, 1918-1935. Journal of the History of Medicine and Allied Sciences, 60(3), 320-354.

Linker, B. (2005b). Strength and science: Gender, physiotherapy, and medicine in the united states, 1918-35. Journal of Women’s History, 17(3), 106-132. doi:10.1353/jowh.2005.0034.

Ottosson, A. (2016). The age of scientific gynaecological masseurs. Non-intrusive male hands, female intimacy, and women’s health around 1900. Social History of Medicine. doi:10.1093/shm/hkw013.

Ottosson, A. (2015). One history or many herstories? Gender politics and the history of physiotherapy’s origins in the nineteenth and early twentieth century. Women’s History Review. doi:10.1080/09612025.2015.1071581.

Owen, G. (2014). Becoming a practice profession: A genealogy of physiotherapy’s moving/touching practice. PhD.

Sudmann, T. (1997). Gender is (also) a job! Female physiotherapists’ handling of physical proximity to male patients in treatment. Nordic Physiotherapy, (4), 172-85.

Sudmann, T. (2009). (En) gendering body politics. Physiotherapy as a window on health and illness.  PhD thesis.