Are you a woman, and your sanity has been questioned? Congratulations: You are now an activist.

There is such a thing as implicit bias in which we may not be aware of how our subconscious thoughts are affecting our conscious thoughts, opinions, or actions we have daily.

They manifest in all aspects of life. Whether you come to see me for a surgical consultation and when you walk into the room, you think to yourself, “She is too young to be a doctor, too pretty to be smart, too feminine to be a good surgeon.”

Before I have uttered a word, you have already decided a narrative in your head. It is instant, unconscious, but it is there. It is just running in the background, like the music in the elevator that brought you to the office. Or like the air conditioner that keeps you cool, but you are not aware of it until you are conscious of the music, or too uncomfortable and hot if the air conditioner turns off.

Why does implicit bias matter? It matters how women are and have been labeled since the beginning of time.

Joan of Arc was burned at the stake because she was considered insane, and therefore, insanity was handled by burning at the stake. That is the way that women who have different ideas or advocate for injustice are silenced: call to question their sanity and either die at the stake or destroy their career, their ability for promotion, or gaslight them because clearly, they imagine the injustice.

Women will be told, “Gender discrimination cannot truly be there. This is just a matter of perspective. This is how older generations see things. It is not that bad. No others have ever spoken before you.”

It is no wonder that a study from the New England Journal of Medicine in 2018 showed that in academic medicine especially, a tiny fraction of < 10% of women ever report injustices. This is why #speakuportho was started. To bring awareness of the bias, inequities, and harassment toward women physicians in a male-dominated field.

There will be no upside for the courage to speak up. It will only be met with stigma, isolation, dehumanization, repeated trauma from having to relive the injustice during a drawn-out and expensive investigation or litigation — meant to convey to you to give up the fight.

But the perpetrators, who claim they believe in justice, equality, respect, communication and a racially equal world, are the same ones who perpetuate the opposite of this. And their sanity is never questioned.

I read accounts of this over and over in social media or lawsuits. Women advocate for equality, maternity leave, for patient protection or safety. Instantly, we are called publicly “conspiracy theorists,” “insane,” or we are recommended to pursue mental health assessment or even placed in mandatory paid time off until our own sanity is evaluated to make sure we are not a threat to our safety or that of others.

Yet, the injustice we spoke up about, the chairperson that continues to perpetuate gender discrimination, the person who is sexually abusing others, a staff member that is putting patients at risk, or the CEO of an insurance company who clearly has a conflict of interest in how his insurers are denied lifesaving treatments and how big his paycheck is, their sanity is never called into question.

Why is there such an implicit bias and double standard we are not conscious of, in which women are treated differently when we advocate for justice? Men will have radical ideas. They will be criticized, called bad leaders, imprisoned, starved. Still, they are not called insane, forced to undergo mental health evaluations or endure stigmatization after they are absolved of their radical ideas.

Why is there such an obsession with discrediting the mental stability of women? Is this an old subconscious belief passed down to us that we all perpetuate? Is this serving us to do this to half of the globe and humanity? Is it that when we do not agree with the voice expressing the inequality, we must ignore and silence it? And if silencing does not work, we then will drag them onto the public eye to discredit them. Even after a trial of our peers has agreed with our viewpoint, life is just never the same. A scarlet letter is placed that says we are troublemakers, unstable, and need to stay in our lane.

How far have we come since 1431, when Joan of Arc was burned at the stake? Why are we still letting women die at the stake with 21st-century methodology: to discredit women, to stigmatize them? How evolved are we? Are we any better than 1431?

I hope we are. I hope we can bring consciousness and understand our implicit bias so that there can be a change that we can be aware of. Because without awareness, we will never be able to become the better version of humanity we want to be.

Be conscious, be aware of your implicit bias.

You have the power in you, and in your thoughts to change the world.

Diana Londoño is a urologist and can be reached at her self-titled site, Dr. Diana Londono, on Twitter @DianaLondonoMD, and on her blog. She is one of the 10 percent of U.S. urologists who are women, and 0.5 percent who are Latina and female. 

Image credit: Shutterstock.com