As part of the first SWIU (Society of Women in Urology) Census, we sought to quantify what we have anecdotally known to be true—that women in urology can feel objectified, underestimated, harassed, or threatened in their line of work. Sexual harassment and gender discrimination toward female physicians, and especially female surgeons, is a well-recognized issue. In a 2019 survey of female surgeons, 58% of respondents experienced sexual harassment in the prior 12 months. Furthermore, 84% of incidents were not reported to any institutional authority.¹

We thought it important to assess the prevalence of sexual harassment within urology, which has seen a slow increase in female practitioners over the last several years, although women still comprise only 1 in 10 providers.² To do so, we disseminated an anonymous electronic survey census among members of SWIU, as well as via social media and correspondences with residency programs. Responses were collected between February and May 2022. In addition to demographic data, we solicited information about whether respondents experienced sexual harassment and allowed for free-text descriptions of any such events.

Of the 379 respondents, 63% reported experiencing sexual harassment in either training or practice. When asked about the relationship of the source of harassment, patients were cited by 69% of respondents, male colleagues by 44%, and other colleagues by 15%. Other sources were identified in 7% of cases, and almost 3% preferred not to disclose the relationship. Common themes of harassing behaviors included comments about physical appearance or clothing, inappropriate sexual comments or questions, inappropriate physical touch, or sexual advances.

In line with previous literature on the subject, 84% of respondents who experienced sexual harassment chose not to report these events. Common reasons for not reporting included intimidation due to power dynamics and fear of retaliation as well of uncertainty about institutional procedures for reporting. Alarmingly, respondents also cast doubts about whether reporting was worth their time or effort, and some believed that their institutions would be indifferent to their concerns.

Notably, we did not include any set criteria for sexual harassment and instead allowed respondents to define their own experiences. Had we done so, the distribution of answers may have differed, although it is unclear how prevalence would have changed. It is important to acknowledge that public awareness of sexual harassment and sex-based discrimination has evolved over time; however, reporting behaviors among women urologists suggest there is still a significant amount of reluctance to challenging such behavior through institutional channels.

These data demonstrate that sexual harassment of women urologists is common and grossly underreported. Identifying ways to create safe spaces remains vital to the continued recruitment and retention of female faculty and trainees. Our data also highlight avenues for improvement. Sexual harassment is commonly perpetrated by patients and colleagues, which offers opportunities for education and interventions to create safe work environments. Women who experienced sexual harassment expressed doubts about both the process and outcomes of reporting their experiences via institutional channels. To forestall such concerns, institutions should actively affirm their commitment to receiving and addressing reports of sexual harassment. Policies should be clear and widely disseminated. Male and female providers should feel supported in identifying and addressing problematic behaviors. Effectively addressing sexual harassment in the workplace is a critical step toward improving workplace safety for all urologists.