The recent controversy and backlash surrounding Kamala Harris’s Vogue cover shows that it is still fashionable to diminish powerful women.  It also is the latest example of the sad fact that no matter how far we have come, women are still held to a different standard—by both men and women.

As a female vascular surgeon, I have spent my career pushing back on ideas about what a woman should be, how she should look, and what she should accomplish.  Yet these stereotypes continue to crop up, suggesting that women should live up to a different set of expectations than men—a poisoned idea that propels discrimination and holds women back from attaining promotions or positions of leadership.

Yes, society is making progress when it comes to gender equity.  Just think of what our grandmothers—not to mention our grandfathers—would have thought of a black female vice president, the extraordinary life and legacy of Ruth Bader Ginsberg, or the #MeToo movement.   Even medical schools are finally enrolling more female than male students; in 2019, the AAMC reported 50 percent of students were women and 49 percent were men.

But delve just a bit deeper, and it is clear that toxic gender disparity still exists. Last year the Journal of Vascular Surgery reported persistent gender disparities in academic vascular surgeons, with proportionally fewer women in vascular surgery leadership positions than their male peers.  This is the same publication that not a year earlier had published a paper on unprofessionalism among young vascular surgeons based on a “study” where a panel of male researchers evaluated doctors’ social media accounts and determined their “professionalism” based off various criteria, including photos.  Women in bikini pictures were labeled as unprofessional.  The public backlash was so fierce that not only was the paper retracted, but the journal later hired two additional female editors.

We easily and almost reflexively blame men for women’s stereotypes, disadvantages, and misrepresentation, but as the Vogue incident shows, women are capable of applying a double standard to each other.  I experienced this paradox firsthand when I was in my surgical training.  I was leading a code and called out loudly to check if anesthesia had arrived yet.  As anyone who has watched Grey’s Anatomy knows, a code is not calm nor quiet. There are at least eight people crowded into a patient’s room, chest compressions are being performed, the monitor is beeping, and people are calling out medications and time.

I asked, “Where is anesthesia?” in a loud, authoritative voice. The next day, I was informed that a young female nurse anesthetist heard me “yelling in a rude unprofessional manner” and reported me to my program director.  A couple weeks later, that same nurse anesthetist was involved in another code, this time with one of my male co-residents, who was yelling and barking orders even louder and more abruptly than me.  She made no complaints about his performance.  When my program director, a male surgeon, sat me down to discuss the incident, I was told that while it may not be fair, I should be mindful of my tone and how I come across in the future.

I wondered why a fellow female in medicine had targeted me, and why women continue to propagate the gender stereotype in medicine, chipping away at any progress we make.  I can’t count the number of female patients who have referred to me as a nurse, or female nurses who prioritized my male coresidents’ orders over mine, or female surgical staff who created an atmosphere of underhanded hostility in the OR reminiscent of the movie Mean Girls.

I also wondered whether the discussion would have been different had my program director been a female surgeon, if paradoxically the scarcity of women in my field—women make up only six percent of all members of the Society of Vascular Surgery—creates the conditions for double standards. The AMA reports that women in medicine bring a different perspective to mentorship, patient care, and overall health outcomes.  And a study of female leaders in urology supported calls for a gender-diverse workplace, reporting better decision-making and innovation, higher economic productivity, and improved patient outcomes when more women were included in the health care team.

Vogue defended their choice of cover saying that Harris was portrayed as “much less formal … very, very accessible, and approachable.”  This perfectly summarizes the struggle women experience in the real world every day.  A successful female politician should not have to diminish her success to be viewed as “approachable.”  A female surgeon should not have to soften her voice so she doesn’t come across as arrogant instead of confident and strong.  And women should be the last, not the first, to enforce these outdated gender norms.

There is no easy fix to this broken idea of our modern-day woman, but we can start with this: Women will never win this battle against the gender stereotype if we are also fighting ourselves. Yes, we need more women in positions of leadership and power. Yes, that will help inspire and motivate our female youth to strive to achieve dreams of success.  But, first we as women need to become unified around a confident and bold new vision of what a woman can be, one that we create for ourselves.

Michele Richard is a vascular surgeon.

Image credit: Shutterstock.com