The gender equity debate

Is the proportion of women to men the true measure of gender equity in speech and language therapy? A member shares her personal perspective.

Speech and language therapy as a profession desperately needs to diversify in order to meet the needs of our patients, avoid group think and move the profession forward. I vividly remember working with a male aphasia patient and feeling unable to connect with him about topics such as golf, football and cars. Of course, women can love those things too but the fact is I don’t and neither did my female colleagues at the time. Whereas the instant connection with a female patient who loves watching cookery shows and floristry always felt, admittedly shamefully, much easier.

Whereas when I have sought promotion or seen other female SLTs take on higher management or leadership roles I have been met with attitudes that treated us as ‘career grabby,’ or with attitudes such as ‘wait your turn.’

Articles about gender and the profession in the autumn 2024 issue of Bulletin referred to the high attrition rate among male SLTs. They focused on the need for male SLT role models and the need to focus recruitment efforts on mature students in order to attract men into the profession. However, in my experience there is a high attrition rate in speech and language therapy full stop. Moreover, I have observed that male SLTs move through the NHS banding structure much more quickly than their female counterparts and are somehow expected and encouraged to do so.

On the rare occasion a male SLT is hired, I have heard female colleagues suggest that this is good because it will “lower anxiety and oestrogen in the team”. Sadly, I’ve never heard comments such as: “That’ll be helpful for all the male patients we treat”. I have even overheard young female SLT managers being described as ‘loud’ and ‘yelly’ (yells a lot) – which was simply untrue.

Men absolutely need role models within the profession to look up to and encourage them to enter and remain in the profession. But let us also be mindful of the role models that the vast majority of current female SLTs may have had (or not). We are perhaps struggling just as much too. For example, I grew up (as did most of my peers) with mums that stayed at home and brought up children and managed the house. I am the first female in my family to attain a professional qualification and a master’s degree and even attempt a career. I was told not to worry what A levels I do because I will ultimately be looked after. This was in 2010, not so long ago.

I agree that we all need to adapt our communication to accommodate and include all of those around us. We are SLTs after all and that is what we excel at. However, I do think there’s a danger that we are putting the onus of responsibility of social change onto the shoulders of women. What if instead we also asked men to consider more rewarding and caring professions from a younger age? What if men were taught to be more empathetic to topics of conversation that concern women, and understand that perhaps we are burdened by the stress of trying ‘to have it all’ in a world that doesn’t really provide ‘all’?

The attrition rate in speech and language therapy in general is high. Often people speak of issues such as raising children, looking after elderly parents. But what about menopause? Could we have extra sick leave for heavy periods? Or if we’ve been up all night with menopausal night sweats unable to sleep? Or if we have pain from endometriosis? Or is it too taboo to ask for that in a profession that is over 90% women? If we cannot ask for those things or speak openly with colleagues if we want to in a female dominated profession then where can we?

I personally think the gender pay gap is the real crux of the issue. Until traditionally ‘women’s work’ is paid equally speech and language therapy simply won’t be respected as equal in status to other professions, and will not attract more men.

I have many female colleagues that are incredibly talented, clever, highly specialised SLTs. Yet they pretty much all work part-time, all do the school runs, all do the higher share of cooking and cleaning at home. And why is that? Because quite frankly their husbands earn a lot more and it just makes pragmatic sense for the lower wage earner to be on part-time hours when managing a household budget.

I myself have been off work for two years with breast cancer in my early 30s. My partner working in finance has been able to support us both financially through this time on a salary that is twice my own in the south of England where average house prices and cost of living is sky high. I shudder at the thought of what would have happened to us financially if he had been out of work and my salary was relied upon.

In terms of female health, let’s not forget that scientific and medical research often excludes females as participants because our changing oestrogen levels can be seen to affect results. This has meant that in general, health advice and research focuses on and benefits male health.

Perhaps the profession could include teaching about female health issues throughout the lifespan to support us to look after ourselves and identify symptoms early? That is one way to look after the current workforce that is (currently) mainly women.

These diseases are not the diseases of the elderly, they are the diseases of women – that along with caring responsibilities, menopause and lack of career prospects may be affecting our own attrition rates.

I’m not sure what the answer is to all of these things raised but I do think it’s important that we all work together as fellow humans for the benefit of us all – the hard-working professionals and the patients. Perhaps as part of our mission to recruit more men into the profession we should also be asking ourselves why it is that so many women want to become SLTs?