Sexism in the workplace is often associated with overt hostility, harassment, insults, discrimination, or intimidation. But what about the subtler, seemingly well-intentioned behaviors that can still hinder women’s advancement? Our study explores benevolent sexism (BvS) in academic medicine and how it may quietly limit women’s careers, even in environments committed to gender equity.

What is benevolent sexism?

Coined by Glick and Fiske in 1996, benevolent sexism refers to attitudes that appear positive, such as the desire to protect or help women. Unlike hostile sexism, which is aggressive and overt, one of the ways BvS manifests is protective paternalism (or maternalism, as seen in our study), assumptions about women’s inherent fragility, or reinforcing ideas that women are better suited to certain roles.

Examples might include offering unsolicited help, advising women against taking leadership roles for fear of burnout, or assigning them tasks that do not advance their careers.

Why it matters in academic medicine

Academic medicine is a field where representation, leadership, and equity are critical, and where women still face persistent disparities. The AAMC StandPoint Faculty Engagement Survey (2023) found that 27 percent of women felt disrespected at work, often attributing it to their gender. This was especially true for women from underrepresented racial and ethnic backgrounds, who reported higher rates of unfair treatment and slower career progression.

While hostile sexism and gendered microaggressions have been widely studied, BvS remains under-examined in academic medicine despite evidence that it also correlates with broader patterns of gender inequality.

The study

In 2022, we conducted our department of medicine’s first climate survey, targeting the experiences of women faculty. This included an adapted version of the Ambivalent Sexism Inventory that measured experiences of benevolent sexism through 25 targeted items.

Seventy-two women faculty responded to this section of the survey. The findings revealed subtle but troubling trends.

Key concerns included:

• Being perceived as less capable due to gender
• Receiving unsolicited advice or “mansplaining”
• Feeling overlooked for leadership opportunities
• Being asked to complete non-promotable, gendered tasks

Women also expressed frustration at being expected to “smile more” or accept poor support without complaint, including being punished for rejecting paternalistic assistance.

Six items from the BvS scale were statistically significant, including:

• Unfair treatment by male colleagues
• Different standards of judgment compared to men
• Unequal compensation
• Assignments to gendered, non-career-advancing tasks
• Being “mansplained” constantly
• Receiving unsolicited advice about life or job choices

While some items here were part of “protective” behaviors by the perpetrators, they were perceived not only as condescending but as structurally harmful, inevitably affecting how women are viewed, judged, and supported in their careers. In a system where career advancement depends on mentorship, sponsorship, and visibility, BvS subtly communicates that women are less suited for leadership or high-stress roles.

Beyond the professional consequences, participants described emotional fatigue and internalized doubt. Some expressed confusion or guilt for feeling offended by comments that others perceived as kind. Others shared how even female leaders, acting out of a sense of “protection,” unintentionally limited their progress.

A poignant quote from a faculty member summed it up:

“As a junior faculty with young children, hearing that I was not considered for a position because I was ‘most likely needed at home’ felt incredibly disheartening. Intended perhaps as helpful, the message was that I wasn’t seen as capable.”

What women had to say

Open-ended responses painted a fuller picture. Many women felt frustrated by the persistence of unconscious gender bias, some noting the unfair expectation that they remain cheerful, tolerant, or accepting of subpar support.

Some powerful suggestions from respondents included:

• More leadership opportunities for women
• Directly addressing benevolent sexism through training
• Creating spaces where women feel safe speaking up
• Increased accountability for inappropriate behavior

Why this study matters

This work is significant because it names a phenomenon many women recognize but struggle to articulate. Benevolent sexism often hides behind the language of support or care, but its effects are real. It leads to missed opportunities, punishes ambition, and labels women as “ungrateful” when they resist the kindness associated with BvS.

We argue that benevolent sexism, especially the form rooted in protective paternalism, is a key barrier to women’s advancement. Because it is harder to recognize and often culturally normalized, it may go unchallenged—reinforcing inequality under the guise of kindness.

Moving forward

Understanding and addressing BvS requires more than individual awareness. Institutions must:

• Train leaders to recognize subtle biases
• Audit decision-making processes for gendered assumptions
• Reward contributions that may go unnoticed due to gender norms
• Create structures that ensure equal opportunity for leadership and advancement

Benevolent sexism is not about malice. It is about how even well-intentioned actions can preserve systems of inequality. For real progress, academic medicine must look beyond hostile sexism and challenge the quiet, “helpful” behaviors that hold women back.

Sylk Sotto is a bioethicist.