How do you define “professionalism” in the workplace?

That’s a conversation being had among women of color in medicine after a tweet about a Latina doctor being docked for wearing hoop earrings during a practical exam in medical school went viral.

For Briana Christophers, a fourth-year MD-PhD student at the Tri-Institutional MD-PhD Program in New York, the story resonated. “There’s a big movement to police women of color and how they present themselves in medical spaces,” said Christophers, who identifies as Latina. “I think in part it’s as a way of trying to make people who don’t usually fit the mold, fit the mold.”

Christophers remembers being urged to dress in a black or navy suit when interviewing for her PhD programs. So she wore a black suit, but with a lavender blouse, a color that proved to be eye-catching for some, she said.

“It’s actually something I got comments on from various people, because it was unexpected. And some of them were positive, some of them were not,” said Christophers, 26. They were ambiguous statements like, “You don’t usually see someone wearing colors during interviews.”

“Sometimes you don’t know how to interpret those sorts of comments,” Christophers said. “Do you remember because you like the shirt, or because you don’t think I should have done that?”

Briana Christophers in a selfie. (Briana Christophers)
Briana Christophers in a selfie. (Briana Christophers)

The Ohio doctor who posted the original tweet wrote that she ultimately did pass her exam. But the anecdote resonated with thousands of others like Christophers. Some women responded to the tweet by posting photos of themselves wearing hoops in solidarity, along with the hashtag #BigHoopEnergy.

“How you speak, how you present yourself, is very culturally dependent, and to have people who are in a position of power over you getting to dictate whether you’re being a good physician or not based on seemingly superficial attributes I think is dangerous,” Christophers said.

Hoop earrings have long been associated with Latinas of all races, as well as with African American women. Black artists like Nina Simone popularized the earrings in the 1960s and ’70s, fashion editor and author André Leon Talley told the New York Times. They later became a staple earring for a subculture in Los Angeles’s Mexican neighborhoods. In 2017, three Latinas painted “White Girls, take OFF your hoops,” as part of a mural at Pitzer College in Claremont, Calif., after the earrings became increasingly popular outside of Black and Latina communities.

As more women of color enter professional spaces where they have historically been excluded, cultural markers such as hairstyles and clothing may become more common in the workplace. Earlier this year, the Air Force and Army changed their grooming standards to be more inclusive of hairstyles worn by Black women. On the floor of the House of Representatives, Rep. Alexandria Ocasio-Cortez (D-N.Y.) famously wore hoop earrings to her congressional swearing in-ceremony in 2019.

But hoops still stand out in predominantly White spaces, especially in the medical profession, according to many women of color who wear them.

Meanwhile, Hispanic and Black doctors make up just 5.8 percent and 5 percent, respectively, of all active physicians, according to the Association of American Medical Colleges.

For professionals like Alexandra Sims, a pediatrician and researcher in Cincinnati, the hoop earring incident was another example of how women of color feel pressured to compromise being themselves to fit into the workplace.

“What I’ve been thinking about is … all the ways in which society tells marginalized groups, Black and brown people, women, trans people, et cetera, that they don't belong,” Sims said.

Sims said that often leads to daily calculations where she wonders: “Am I too much? Is this too much? Is this earring too big? Is this nail polish color too loud? And how will that be received at work?”

Alexandra Sims in a selfie. (Alexandra Sims)
Alexandra Sims in a selfie. (Alexandra Sims)

Physicians of color may find their credentials questioned based on their appearance alone. In 2018, a Black doctor trying to help a passenger in distress on a Delta flight was repeatedly questioned by flight attendants who doubted that she was really a doctor, despite showing them her medical license. And research has found that doctors of color in U.S. residency programs routinely face racism from fellow doctors and patients.

“At work, wearing my white coat that has my name pretty big on it with a badge that says doctor on it, I still get asked if I’m the environmental services staff,” Sims said. “I think it just demonstrates how deeply ingrained bias, racism and sexism are in society and that we have a lot of work to do to disrupt that.”

Monica Verduzco-Gutierrez, a professor and chair of the department of rehabilitation medicine at University of Texas Health San Antonio, said she doesn’t judge professionalism by what someone wears, but “with the provision of care that you give to patients.”

“Judging someone based on their earrings or their jumpsuit or whatever else that they’re noticing about the student is not an appropriate way to judge the student’s ability to take care of a patient,” said Verduzco-Gutierrez, who clarified that she is not speaking on behalf of the school.

Monica Verduzco-Gutierrez in a selfie. (Monica Verduzco-Gutierrez)
Monica Verduzco-Gutierrez in a selfie. (Monica Verduzco-Gutierrez)

While there are times when as a pediatrician Sims opts not to wear hoop earrings — especially when treating toddlers with inquisitive hands — she also believes those earrings can make some patients feel more comfortable with their doctor. One Stanford University study found that Black men were more likely to engage with Black physicians and agree to preventative medical screenings.

“When I show up at the clinic and see patients and they see a Black woman that looks like their mom … I think that feels super meaningful and maybe has the chance to imprint on that child,” Sims said. “Here’s another example of what a Black woman can be that’s beyond the messaging that we’re given.”

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