By Anne Witz
Introduction
‘Professions’ and ‘patriarchy’,
despite having a splendidly alliterative ring, are two words that are rarely
put together. In the burgeoning literature on women’s employment over the past
decade there has been a relative neglect of the history and nature of women’s
participation in the professions. This book aims to shed some light on this
issue by analysing male and female professional projects in the emerging
medical division of labour. At a substantive level, it examines the relationship
between gender and professionalisation in medicine, mid[1]wifery,
nursing and radiography. At a conceptual level, it twins two concepts, the
rather jaded concept of profession and the newer, fresher concept of
patriarchy. This is, then, a work of sociology and of feminist studies. The
‘sociology of professions’ has a somewhat dated and staid aura about it,
perhaps most associated with fairly turgid and ‘Whiggish’ accounts of
professional men (cf Carr-Saunders and Wilson 1933, Reader 1966). The
traditional sociology of the professions was thoroughly criticised by johnson
(1972) as long ago as the early 1970s for uncritically reproducing at the level
of sociological knowledge professionals’ own definitions of themselves as
possessing distinctive characteristics that marked them off from the ordinary
run of managers, administrators, clerical workers, and the so-called ‘semiprofessionals’
such as radiographers, nurses and physiotherapists. More recently, much
attention has been paid to the relationship between professions and the class
structure, and this focus has led to a radical recasting of sociological approaches
to the study of professions. But within this new critical theory of the
professions, little attention has been paid to the relation between gender and
professionalisation.
It has long been recognised that
there is an important relation between gender and professionalisation, and
indeed this was a focus of analysis in the now displaced functionalist paradigm
of profession (cf Etzioni 1969). However, mainstream sociological renderings of
this relationship have rarely gone beyond a simple equation between gender and
the status, rewards or degree of autonomy enjoyed by practitioners. The overall
trend, even in the newer more critical approaches such as those of Freidson
(1970a,b, 1986) and Rueschemeyer (1986), has been to rely on explanations which
refer to gendered attributes (such as women’s association with ‘caring’ work)
in order to read off the subordinate relation of, say, nursing to medicine.
There are two problems with these existing approaches. One is that they are
static analyses which take the gender of the practitioner as ‘already given’
and resort to untheorised notions of supposed gender-specific attributes, attitudes
and ‘problems’ which women ‘bring to’ professional employment. The other
problem is that they operate with fairly unreconstructed notions of ‘women’s
role’ and have no theory of gender relations beyond a basic, taken-for[1]granted ‘sex role
theory’.
When the focus is on women’s
increasing participation in male[1]dominated
professions, there is a tendency to focus on the problems women have in
adjusting to typically male career patterns, problems which are assumed to be
largely generated by the difficulties of reconciling a career with a family
(Fogarty, Allen and Walters 1981). In short, the ‘dual role’ problematic, which
focuses on conflicts between family and work roles experienced by women and
which was the dominant focus in studies of women’s employment in the 1960s,
lingers on in studies of women in ‘top jobs’. And yet this approach has long
been subject to considerable critique (cf Beechey 1978) for its voluntarism and
neglect of structural factors located within the labour market itself which constrain
and limit women’s employment. Even Crompton and Sanderson’s recent (1989) study
of women in pharmacy and accountancy sneaks a voluntaristic, dual role
explanation by the back door, although their main focus is on patterns of
vertical segregation by sex in occupational labour markets. In short,
sociological studies of women’s professional work are still prey to what
Garnsey (1978) has called ‘the fallacy of the wrong level’, i.e. reading off
women’s position in the hierarchy of professional work from their position in
the family. More seriously, I think it can be argued that both traditional and
critical approaches to the professions continue to reproduce at the level of
sociological knowledge professional men’s own construction of their gendered self-image.
A sociological analysis of gender and professions which incorporates a more
sophisticated conceptualisation of the ways in which gender is itself both
socially constructed and a structuring principle is long overdue. The concept
of patriarchy is introduced in this analysis of gender and professionalisation
in order to structurally ground the category ‘gender’ by locating it firmly
within power relations of male dominance and female subordination. Of course,
‘patriarchy’ has been a much debated concept, even within feminist studies,
since its reemergence as a key concept of second-wave feminism. It has proved
at one and the same time a powerful critical tool and a problematic one,
tending as it sometimes does to slide into universalism, a historicism and
ethnocentrism. The formerly more restricted use of the term to refer to the
power of the male head of household (the ‘power of the father’) describes a
particular, historically specific form of male dominance. But the concept of
patriarchy is now used by con[1]temporary feminist
scholars more broadly to refer to gender relations in which men are dominant
and women subordinate. It therefore describes a societal-wide system of social
relations of male dominance (cf Millett 1972, Hartmann 1979, 1981), not simply
those in the family/household. Indeed, an extremely important element of the
development of this broader, gender concept of patriarchy has been to establish
that patterns of male dominance in modern society do not rest solely on the
unequal distribution of power in the family (cf Walby 1986, 1989, 1990a, and
1990b, Hartmann 1979, 1981). It is this broader, gender concept of patriarchy
which I use in this analysis of professions and patriarchy, because I believe
that, despite the protestations of its critics (Bradley 1989, Crompton and
Sanderson 1989, Barret 1987, Acker 1989, Row-botham 1981), it is able to capture
the highly complex and shifting nature of gender relations, teasing out the
synchronic links between gender relations in various sites of social relations
(such as the family, labour market and state), as well as the diachronic shifts
in the structure of patriarchy, where the common motif is ‘from private to
public patriarchy’ (Hernes 1987, Borchorst and Siim 1987, Walby 1990a, 1990b).
In Part I the concepts of
‘patriarchy’ and ‘professions’ are addressed. Chapter 1 discusses ‘dual
systems’ theorists and explores their contributions to an analysis of women’s
position in the labour market. These writers all offer superior accounts to
those offered by human capital theorists (Mincer 1980), dual and segmented
labour market theorists (Doeringer and Piore 1971, Barron and Norris 1976,
Gordon, Edwards and Reich 1982), and Marxist approaches, both those that rely
on the concept of an ideology of masculinism (Barrett 1987) and those that work
within the ‘labour process’ framework (Braverman 1974, Beechey 1978, 1986,
Bradley 1989, Glucksman 1990, Liff 1986, Milkman 1984). The origins and
persistence of job segregation by sex in the labour market or labour process
are, I believe, best explained within a dual systems framework which explores
the intersection between two structuring principles, those of patriarchy and
those of capitalism, as the work by Hartmann (1979), Cockburn (1983, 1985,
1986a, 1988), Savage (1985, 1987, 1988a,b), Walby (1986, 1988b, 1990),
Mark-Lawson and Witz (1988, 1990), Lown (1990) and Summerfield (1984)
demonstrates. I shall, however insist that it is essential to work with a
historically sensitive concept of patriarchy.
But the dual systems thesis has
been substantiated largely with reference to manual occupations, such as coal
miners, engineers, printers, cotton textile workers, and fairly routine forms
of non-manual work such as clerical work. It has also been substantiated in
cases where male workers are organised into trade unions, rather than in
industries and occupations where there is weak union organisation, although
this does not provide sufficient grounds to undermine the explanatory potential
of dual systems theory, as Glucksman (1990) has recently claimed it does. By
comparison, there has been a relative neglect by dual systems theorists of
those occupations currently seen as comprising the ‘service class’ (Goldthorpe
1982, 1987, Abercrombie and Urry 1983). Yet the work of Crompton (1986) and
Crompton and Sanderson (1989) clearly establishes the importance of forms of
vertical occupational segregation by sex in the service class. We need to
consider whether the concepts of ‘exclusion’, and its corollary ‘segregation’,
which are used in analyses of how organised, working-class men have delimited
and constrained working-class women’s participation in paid work, are adequate
to the task of analysing processes generating job segregation by sex in
professional work. Do we need to complement these with other concepts if we are
to understand the specific form assumed by patriarchal practices in
professionalising occupations? What are the similarities and differences
between the stances and strategies adopted by men in professional organisations
and in trade unions? These are some of the issues that are raised in this book.
However, the generic concept of profession is also an implicitly gendered one
and we need, first of all, to move onto a less androcentric terrain within
which to locate discussions of professions and patriarchy. This issue is
explored in Chapter 2. I shall argue that the first step is to abandon any
generic concept of profession and redefine the sociology of the professions as
the sociological history of occupations as individual, empirical and above all
historical cases rather than as specimens of a more fixed, general concept (cf
Freidson 1983). The term ‘professional project’ is introduced to establish the
concrete and historically bounded character of profession. The second step is
to conceptualise these projects as strategies of occupational closure, which
aim for an occupational monopoly over the provision of certain skills and
competencies in a market for services. It is neo-Weberian writers who have used
the concept of closure to analyse professionalisation (cf Parkin 1979, Parry
and Parry 1976) and chart the links between these and processes of class
formation in modern capitalism. What remains to be done, however, is to develop
the conceptual framework for an analysis of gender and the closure strategies
adopted by professionalising occupations. So, in Chapter 2, I critically
develop and refine the conceptual tools of neo-Weberian closure the[1]ory in order to
unpick the specifically gendered dimensions of closure practices in
professionalising occupations. These are exclusionary, inclusionary,
demarcationary and dual closure strategies.
It is important to gender the
agents of closure strategies and distinguish between male and female
professional projects. Indeed, the very fact that women have engaged in professional
projects has been generally neglected in the sociological literature. Gender
clearly makes a difference to both the form and the outcome of professional
projects. Finally, these gendered projects need to be grounded within the structural
and historical matrix of patriarchy as well as capitalism. The remaining
chapters that make up Part II explore and develop the concepts of closure and
arguments about professions and patriarchy developed in these first two
chapters. It is the relation between gender and closure which concerns me and
it is causal processes link[1]ing these which I
seek to identify. I look at therelation between gender and medical
professionalisation through an analysis of women’s struggle to enter the modern
medical profession in the 1860s and 1870s. Medical men used gendered
exclusionary strategies to main[1]tain a male monopoly
of registered medical practice in the years immediately following the passage
of the 1858 Medical (Registration) Act. Aspiring women doctors, in their turn,
replied with an inclusion[1]ary strategy. In
Chapter 4 I examine inter-occupational relations between medical men and female
midwives during the latter half of the nineteenth century, using the concept of
demarcation to unpick medical men’s stances in relation to midwives, and dual
closure to describe midwives’ own strategic responses to their tenuous and
unregulated position in the emerging medical division of labour. In this and
the following chapter on nurses’ campaign for a system of state-sponsored
registration, I elaborate on the concept of ‘dual closure’ and argue that
female professional projects typically assumed this form. Finally, in Chapter
6, I examine the mixed-gender occupation of radiography during the 1920s and
1930s, a period when it underwent an inexorable process of feminisation. I look
at how male radiographers failed to exclude women from formalised routes of
access to radiography and, conversely, how women gained and maintained access
to radiography training and practice. The concept of gendered internal
demarcation is introduced to highlight how processes of vertical segregation
within an occupational labour market emerge. In addition, this chapter on
radiography and the chapter on the occupational politics of nurse registration
both examine the complex interrelation between gender, professionalisation and
employer strategies.
Inevitably, because I have chosen
to focus specifically on the relation between gender and the occupational
politics of closure that have characterised professional projects, there are
various facets of professionalisation which remain unexamined, but not because
they are unimportant. For example, there are those which would be of interest
to Foucauldian scholars exploring the relation between power, knowledge and
gender. Indeed, I think there are some interesting ways in which a focus on
‘discursive strategies’ can be used to illuminate the gendering process at
work, such as in the recent work of Pringle (1989) who explores the shifting
discursive construction of the secretary over the course of the twentieth
century, and the sexualisation of power relations within bureaucratic
hierarchies. The concept of dis[1]course seems to me to
provide a bridge between hitherto different, and conflicting, explanations of
gender divisions in the workplace, between those which used the concept of
‘ideology’ and others which have adopted a more materialist focus on
patriarchal practices. At points in my analysis, I do refer to ‘discursive
strategies’, and now think these are more important than I used to.
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