Heidi Emmerling Jones, RDH, BS
Dental hygiene`s struggle for professional standing and self-regulation is one of our most important and intense issues. I believe part of our struggle is because of dental hygiene`s predominantly female gender in the male-dominated, patriarchal setting of dentistry. What exactly is the solution to overcoming our lesser (i.e., marginalized) status as women and as hygienists, to emerging from dentistry`s typically male shadow?
Other female-dominated professions, such as elementary teaching, have faced similar struggles with "feminization." While some equate "feminization" with weakness, others have found that a "feminine" image need not be negative. In fact, some feel feminization actually furthered their profession by capitalizing on "feminine" traits such sensitivity, nurturing, and caring. Perhaps dental hygiene could benefit from at least looking at this theory (sometimes termed the "theory of difference") and see how this might broaden our scope and enhance our profession.
The theory of difference
This month I present the "theory of difference." Next month I will offer a more critical discussion of the theory. However, we must exercise caution and be aware that no "solution" or theory is free from critique.
Some women point out that our male-dominated, patriarchal culture is designed to preserve traditions that regulate power and status within and among communities. To me, this is obvious in the dental community. A lower-status female identity is evident in dental hygiene. The view of our profession as auxiliary to dentistry is perpetuated by its "masculine" power.
As we know, dental hygiene has typically attracted women. Traditionally, hygienists were women looking to merely supplement their spouses` incomes by working part-time. She could earn some cash while still having the ability to be a proper mom and spend more time with the kids. The biologic fact that women give birth has set the framework for judging women`s roles primarily in terms of reproductive function. Many scholars and lay people have considered the mothering role an inevitable determinant of female personality. (We certainly wouldn`t have expected men to work part-time to supplement the wives` incomes, and we wouldn`t expect men to work part-time to spend time with their children.) Of course, this image is changing as more and more hygienists see this as a long-term professional career.
So what else draws women to dental hygiene? Perhaps the health field appeals to nurturing, caring individuals - typically feminine traits.
And the male-dominated power structure that subordinates us is maintained. Dentists are still overwhelmingly male. Restrictive practice acts ensure that men/dentists control women/hygienists. Men claim the "higher" professional status. Women are relegated to the typically lower status of providing preventive services and serving the needs of others.
Because we so thoroughly believe that dental hygiene is service-oriented work, we should hardly wonder that it is given over to, and attracts, women. But we also believe, and rightly so, that our work is meaningful. Educating our patients about the importance of oral health leads to improved overall health.
Consequently, our profession began its competition for a place within health care as a gendered, but blurred identity. Outsiders perceive our role as the doting, self-sacrificing, maternal figure like June Cleaver. They might see us as the janitors of the oral cavity, the cleaning ladies, the maids, the servants, sort of like Hazel. Or they might even view us as bossy, pain-inflicting, disciplinary, sadomasochistic dominatrixes like Barbarella. Thus, our image has included triple roles.
Claiming "equality" has its drawbacks in our male/female professional circumstances. By doing so, we may be buying into and supporting the values of male domination. Yet, we are unable to "combat" this male domination. Some women maintain the problem with such attempts at equality is that it contributes to an improved status that continues the very hierarchies and privileging of which we complain.
One part of our strategy might be to represent the "feminine" field as anti-authoritarian rather than victimized. For example, a successful approach for dental hygiene has been showing our desire to reach all patients, including the elderly, AIDS afflicted, and the indigent - not just an elite group of wealthy or insured citizens.
By raising a "different" voice, a more collaborative voice, we might reveal existing "feminine" structures in our profession. Some may believe that improving our status depends on unifying our resistance to an oppressive, restrictive system.
Attempting to make dental hygiene more "masculine" or "tough" indicates we need to overcome our feminized identity. If we want to displace either our symbolically "soft" or actually marginalized status and our female majority, some female hygienists would argue that we will not accomplish this by "combating" our identity to achieve so-called successful status.
Some women claim that creating a more masculine image for dental hygiene will fail us. The reason? It may potentially alienate us from our status which links us to being the "consciousness" of dentistry, to having the "principles." They fear we might become aggressive, profit-motivated, and power-hungry - traits commonly associated with male-domination. After all, is it not usually the hygienists who, for example, insist on appropriate sterilization methods, who decline to treat patients who forget to take their premedication, who are advocates of optimum care, who refuse to "sell" unnecessary work? By donning the boxing gloves and the male identity, we could conceivably be adopting methods that ring false among many who resent dentistry with which they have disapproved.
Nonetheless, dental hygiene need not necessarily be oppressed by our "feminized" status. Rather, we might be able to capitalize on our strengths by resisting negative feminization and traditions that are true cultural embarrassments.
Heidi Emmerling Jones, RDH, BS, is a consulting editor for RDH and practices dental hygiene in Sparks, Nevada.