This is the third part of an unplanned four-part series—thank you for continuing to forward these newsletters around, and for filling my inbox and DM’s with feedback. I heard from many doctors and scientists about the over-reach they see in terms of justified expertise, which is the focus of this week’s newsletter. I’m going to try to thread a lot of needles here, while bushwhacking through a huge topic—and can easily argue all sides. Very curious for your thoughts in the comments. I’m going to start with authority, move to confidence, discuss credentials, and wrap with expertise.
Before we dive in, I've heard that the first two newsletters cameo’d in slack channels at tech companies and news organizations who are now auditing their shows. (And no, I haven’t heard anything from any of the male podcasters.) If you don’t know what I’m talking about, the first installment is about the dearth of female experts and voices on chart-topping shows hosted by men (“Ending the Manel”), and the second is about the perpetuation of scarcity based thinking when it comes to offering others opportunities (“The Perception (and Reality) of Scarcity”). Both are about patriarchy, and also internalized patriarchy. Next week, we’ll dive into both representation and reputation.
The Quality of Authority
Hi honey! Great job. Make sure they know you’re not a historian, anthropologist, or theologian. Or an academic. Are you going to include references? Make sure you don’t plagiarize. State your privilege! Give Rob and boys a squeeze. Love you!
My mom sent this text after reading an early draft of the introduction to On Our Best Behavior (one of 18 versions, to be exact). The subtext: Know your place, so nobody feels compelled to put you in it. (Check.) Even if many of these are your ideas, where not already directly referenced in the text, make sure to find people to credit them to. (Check.) Start from a defensive crouch and explain all the things you are not, rather than what you are. (Check.) Then establish how what you are disqualifies you from understanding, or connecting with, anyone who represents what you are not. (Check, check. More on this next week.)
Her advice was perfect, really, because it touched a tender spot in me and put a beam of light on exactly why I wanted to write the book, at that time. Under my own name. The irony was not lost on me that I had already ghostwritten a dozen books. I’ve stepped into the shoes of a young, blonde reality TV star; Latina wrestling twins; a seasoned Black male executive; a high-powered white lesbian; and so many more. Somehow, it was easier to speak through the filter of their lives and voices than to speak from the experience of my own. Who am I to say what I know? How am I qualified, and who decides? I’ve struggled to “authorize” myself, quite literally. I am not alone.
(Interesting, the etymology of authority, authorize, and author has nothing to do with power: It comes from augere (Latin), to “originate, increase, promote.” Per the OED, it’s “a person who invents or causes something.”)
Women often don’t feel “authorized” because our culture frequently lets us know we are not. (The OED definition of authority: “the power or right to give orders, make decisions, and enforce obedience.” This isn’t about a lack of confidence—it’s about a wary understanding that the standards for us are different, that we must proceed with caution in softening our approach. That, and we must be doubly sure—ideally armored with credentials—before we raise our hands to engage with the world. We proceed carefully, if at all. We include lots of “weak” language, like “I was just wondering…,” “You’ve probably thought of this…,” “Sorry if this is irrelevant…”
This caveating does not necessarily reflect our inner world—it’s learned behavior to make ourselves more palatable, to make our “authoring,” in its original sense, seem like someone else’s idea. This is all to to make everyone else feel comfortable, and to ensure that our thoughts, solutions, and ideas see the light of day, even if they must be re-stated and claimed by a man.
The Fable of the Confidence Gap
I’m sure you’ve all heard about the widely circulated internal report from Hewlett-Packard in the 2010’s that women will only apply for a job when they’re 100% certain they’re qualified, whereas men will apply if they meet 60% of the qualifications. The reason for this has long been attributed to a gap in confidence, but I’m with Tara Mohr, author of the excellent and ahead-of-its-time book Playing Big, who argues in this piece that it’s not a question of confidence—it’s more a function of a tendency toward compliance and playing by the rules. Women are well trained to stay in our place. (Mohr also cites the McKinsey report that men are hired and promoted based on potential; women on proven track records.) I write a bit about the fake “confidence gap” in On Our Best Behavior in the chapter on PRIDE, and how women don’t lack confidence, just know better than to express it:
Academics and business book gurus state a confidence or ambition gap as one of the primary reasons for the inequity, urging women to dig deeper for self-esteem; to raise their voice; to demand promotions, pay increases, and votes. The problem is with us, it would seem, for lacking the confidence to assert our value. But we all know better—or should know better—than to accept blame for our own oppression: We’ve been well-schooled in what happens to women who go big, who dare to ask for more.
In one frequently cited study, 156 subjects assessed two fictional CEOs—one man, one woman—who both talked a lot, or a little. Participants expected the powerful man to speak up and rewarded him for dominating the conversation, whereas the woman received backlash for talking more than others. Both the male and female respondents judged the female CEO harshly. What’s especially troubling, to me, is that women know they’ll be penalized for the performance of confidence. When I ask friends if they think they have a confidence problem, they assure me they don’t: They acknowledge that they know they’re better prepared and more competent then most of the men with whom they work, they just know better than to show it.
Reticence to express confidence is borne out in research by Christine Exley and Judd Kessler, who found that even when women knew they performed equally to men, they were loath to profess it: We have been trained not to. And it backfires: One study confirmed that women’s influence is so pegged to warmth and appearing caring and prosocial that the “performance plus confidence equals power and influence” formula that’s so effective for men blows up in women’s faces. The study’s author concludes: “Self-confidence is gender-neutral, the consequences of appearing self-confident are not.” Portraying confidence does not work for women, so telling women to simply be more confident is twisted.
It’s not lost on me that the etymology of confidence comes from con + fidere (Latin): “having full trust.” It’s an etymology that underlines all that women have to lose when we’re pushed to hide or downplay this quality: We deserve to be receptacles of peoples’ faith, as ably as men.
Confidence and expressing expertise are closely intertwined: To say what you know, without fear of censure, or thinking through how it will land takes an awful lot of extra emotional and mental energy for women. After all, as the studies above suggest, women are punished for speaking up, while men are revered. (That said, if we’re going to follow the research thread on who actually has the proven credentials and track record to be in the room and speaking, we should listen to the women more than men! They apparently already have the experience, whereas men are on their way to the experience.)
The Trickiness of Credentials—and When They Matter
Last year, I tried to convince my editor that I should probably spend the next six years getting a PhD.
“Why? What are you planning to do with a PhD?”
This was a question I couldn’t really answer. I don’t want to be an academic, or a psychologist, or pursue any career that requires a doctorate.
“Because maybe it would give me sturdier ground to stand on?”
“Sturdier ground for what exactly?”
This I don’t know, except that a PhD feels both defensive and protective, a way to justify what I have to say, even if it might not actually inform it.
And this is my double-bind: I bow down to academics—and arguably read as much as a PhD candidate, trying to put myself through coursework in my own way—but I have a fair amount of reverse snobbery about institutional pedigrees. And yes, I have a B.A. in English and Fine Art from a Grade A university. Ivy League universities and schools of that ilk have long granted an imprimatur, a stamp of approval that someone has a first-rate mind, and I’m not so sure it’s always deserved: After all, it’s pretty well established that they are not meritocracies. (While I went to school with a lot of impressive geniuses, many people…were not.) These institutions are brands, though, and in the world, this brand gets flexed. I have a lot of mixed feelings about when they’re wielded as shorthand, as a reference point for intelligence, in that way. I’m also concerned when people use them as a bulwark against criticism, or as a snow plow to grant primacy in their field. It feels like a lot of latitude to grant someone who achieved something when they were 18 (though this stands for professors and other affiliated staff as well).
To that end, I could not tell you, save one, where anyone I’ve hired in the last 20 years has gone to college—or if they even graduated. (I know where one of my co-workers went because she was the alumni representative on the board, which required a fair amount of travel.) I don’t care because it’s not particularly relevant to the work that I do: I care instead about the quality of peoples’ ideas, their ability to research, their attention to detail, their interest and enthusiasm in the work, and the breadth of what they read. I’ve always hired off of comprehensive ideas memos, not standardized test scores or educational pedigrees.
While it might not be so relevant for service journalism, I do think that educational pedigree and accreditation matters acutely when it comes to health and other life and death matters—with some caveats. Because pedigree and accreditation is not enough. Experience probably matters more. That, and a certain humility: The best physicians, therapists, and scientists seem to acknowledge all that they don’t know or might be missing; they seem to be more interested in asking good questions than knowing all the answers; they seem to be curious and collaborative rather than authoritative.
And physicians and scientists, for better or worse, also tend to be highly specialized. It’s easy to make the argument that doctors who are too focused or specialized can sometimes lose sight of the whole—treating symptoms rather than identifying systemic root causes can be a downside in the West—but the reality is that this is solved by an excellent primary care physician who can quarterback and coordinate treatment, pulling a dream team together.
I understand that this doesn’t always happen, and that we all hold the fantasy of Dr. House in our heads: The medical genius who is fluent in all systems, no medical mystery too complex or hard to solve. (BTW, "Diagnostic Medicine” is not a real board certification.) The reality is that physicians specialize (and earn board certification) and provide patient care in their area of expertise, racking up experience and anecdotal evidence over decades of study and then practice. This has a tremendous amount of value.
When is Expertise Legitimate, and When is it Overreach?
I spent my childhood in doctor’s offices and watching procedures at the hospital (obviously pre-HIPAA!). I typed my dad’s medical dictation, I worked for a cardiologist, watched gastroenterologists perform colonoscopies, and spent two summers delivering trays in the hospital, where I learned a lot about hair nets and hierarchies in medicine. My dad, now retired, is a pulmonologist—he did his residency at the Mayo Clinic before moving to Montana and setting up a private practice. He did a lot of intensive care, so I spent many hours waiting for him in the ER or at the nurse’s station in the ICU, and he was also primary care doctor for many of his older patients, guiding them through protracted and long chronic diseases, like emphysema. My dad knows a lot about the body, but he specifically knows about the lungs: And that’s where he stays. When friends asked for an opinion about another system of the body, he would generally demur, unless he had utmost confidence in the facts. To this day, he won’t even offer me general health advice, referring me back to my gastroenterologist or my OB/GYN—sometimes he’ll take my questions to his network to confer. In my experience of working for and around a fair number of doctors—and interviewing hundreds of them over the years—good ones know their zone, and who to call when they feel they’re out of the bounds of their competency.
The invention of celebrity doctors and scientists, of media personalities who are translate research and dispense health advice to the public is a new thing. I don’t know for sure, but I’d imagine it’s a concept that was pioneered by America’s first TV physician, Dr. Oz, a cardiothoracic surgeon who eventually…went completely off the rails. His own show debuted in 2009, when Dr. Google was also a nascent idea, and the lay public had little access to this type of information outside of general interest books and their own doctor’s offices. It certainly primed us to take in information from anyone who seems both credible and platformed.
The wealth and breadth of information available thrills me—again, with caveats. Two summers ago, when I was in the midst of a medical mystery, I diagnosed myself with eight conditions online (ultimately, I had lymphocytic colitis, diagnosed by my gastro via colonoscopy, which is now well-managed). I know we’ve all had the experience of the late night internet deep-dive where we convince ourselves we could totally play a doctor on TV. While there are many wrong turns, there is no doubt—particularly for women, that an expansion of information and conversation (including from other women sharing their experiences and resources) is net positive in a big way.
I think, if I’m honest, that this is also why these wellness bros also get under my skin. Wellness felt like a sacred space for women to exchange information and validate our intuition about our health—in a world that wasn’t exactly built for us. Women weren’t legally required to be included in all NIH clinical research until 1993, we’re routinely under-treated and under-medicated, and still frequently told by our doctors that our symptoms are just in our heads. We’ve been looking for and making our own alternative conversation for decades: Now, to watch this space be entirely co-opted and capitalized by bros who preach a gospel of bio-hacking, optimizing life through controlling all inputs, and age denial via longevity medicine (even though they don’t seem to be enjoying the lives they already have all that much), feels a bit like salt in the wound. Do men need to take over everything? The traditional medical system was already hand-built to their specifications.
But I digress.
In the age of social media, anyone can be anything—and when you sprinkle a little “science-ese” on top of it, you have a captive audience. (I’m also guilty of believing people who “sound smart” and are using words I don’t understand—because it’s intimidating to the lay people, I wish doctors and scientists would use plain English more for this reason, i.e., you don’t have to say pneumothorax, you can say “punctured or collapsed lung.”) But as we wade through this information, this is where it’s on us, as consumers, to use our discernment about who we’re tuning into, where they have legitimate expertise, and where they are frankly…out of their lane. It’s also important to recognize that there’s a difference between theoretical information (lab and study results), experiential insight (decades of patient care), and anecdotal observations (one-off, or surprising events that shouldn’t be written off because they’re rare).
I also feel that Meta needs a policy here: It’s time for them to acknowledge that no, they’re not just a “platform,” they’re an edited algorithm that profits off…freaking people out and/or stoking high emotional reactions. They’ve hinted that they recognize this by way of the news that came out the other week that they’ll no longer promote news or activist content. I would argue that instead of shadow banning news, they should reconsider how they offer credentials. In lieu of a standard blue check, they should provide a distinguishing mark for press who meet and clear a journalistic bar, in the same way press credentials are assessed and delivered in the wider world. And Meta and their ilk should also require proof of credentials for people who are offering health advice to the public under the moniker of “Dr.” Instead of “@drfillintheblanks” I want to know whether someone is an M.D. (and their corresponding board certifications), a D.O. (and their corresponding board certifications), an N.D., a doctor of Chinese medicine (DAc), a PhD, a PsycD, a doctor of chiropractic, a doctor of pharmacology, an Ayurvedic doctor, and so on. All of these designations say a lot about someone’s sensibility, worldview, training, and expertise. (For example, N.D.’s do way more nutrition in their training, but do not, say, perform open heart surgery.) Many practitioners do not currently clarify. Meta should have a process for evaluating and substantiating credentials. Maybe that’s an unpopular opinion, but in the age of medical misinformation, it feels like it would be a social good. Yes, this would require a significant investment on Meta’s part, but considering how we’ve lined their pockets, I’d argue we more than deserve this level of consideration and care.
So to keep this on theme, and bring it back to the male podcasters who kicked off this email series, yes, I think these men—despite their credentials—are frequently over their skis. They’re certainly more than equipped to speak to their area of specialty: Huberman has a PhD in neuroscience, with a lab focused on the optic nerve; Attia did his residency in general surgery, though he now bills himself as a longevity physician (I could be wrong, but he does not seem to be board certified?). They’re obviously also very well equipped to interview other doctors and scientists. With all that said, I don’t understand why they continually center themselves as experts on…everything. Why do they need to do this? Why would Huberman, for example, think that he should solo host a two hour episode on…oral care. Per the show notes of this recent episode, he cites five DDS, including three women—not sure why he didn’t have them on to speak to their own work? And more pointedly: Why does a neuroscientist explaining how to remineralize teeth go down so easily with us?
Cicrcling back to the beginning of this newsletter—authority and confidence—it’s hard to find examples of women who feel comfortable speaking as experts about everything, and are celebrated for doing so. (If you know some, please drop them in the comments—based on my DM’s, many doctors and scientists are irate about the overreach though don’t want to publicly take them on, and I know there’s a cottage industry devoted to disputing some of the claims they make.)
Honestly, I don’t have an axe to grind with these guys (so please don’t come at me Huberman bros). And I don’t think they represent most male doctors and scientists in their ease with embodying expertise across the board, but they are currently the most visible example of a strong cultural instinct that we need to look at.
To close the loop, it’s also abundantly clear to me that this topic carries a lot of my own anxiety, my own baggage to unpack around expertise, authority, and whether I can reasonably claim any for myself. I bet some of you can relate. Besides the personal piece, there’s definitely cultural and social work for all of us. One simple exercise is to notice when you’re inclined to judge a woman more harshly than a man for speaking, or whether you listen to men more graciously when they expound on their expertise (real or professed). Ask yourself if the information would go down as easy if you were hearing it from a woman. It’s an interesting exercise. Just last week I was listening to a conversation between two therapists—a man and a woman—and I caught myself willing her to stop talking so much. (I checked the transcript and yes, she spoke significantly more than him, but my irritation toward her was…something else. I doubt I would have noted it if he had been dominating, which is often, per the social science, how these things go in the public domain.)
As for solving the invisible bar of expertise, and when it’s been met and exceeded, I’m not sure where to land—as mentioned, it’s easy enough to argue both sides. But there’s no chance of creating equality if women abide by the rules while men pretend like there aren’t any rules at all. I don’t think women should be forced to bend their integrity to catch up, but it sucks to always lose.
Women are already so self-silencing, and so muzzled when it comes to saying what they know, gaps won’t be closed if we self-restrict even more. But as it is now, we are woefully out of balance: Women’s voices need to come up, men’s voices need to be dialed down. This will require courage on the part of women, and sacrifice on the part of men—and support and a willingness to change our listening patterns from all of us.
Thanks for reading this far, I know it was a long one.
THE LATEST FROM THE PODCAST:
2/22: The Basics of Spiral Dynamics with Nicole Churchill
Apple | Spotify | Transcript
2/15: On being “Basic” with Kate Kennedy
Apple | Spotify | Transcript
2/8: On maintaining sexual desire with Emily Nagoski PhD
Apple | Spotify | Transcript
2/1: On the essential nature of relational conflict with John & Julie Gottman, PhDs
Apple | Spotify | Transcript
1/25: On our fat-phobic culture with Kate Manne
Apple | Spotify | Transcript
1/18: On growing ourselves up with Aliza Pressman, PhD
Apple | Spotify | Transcript
1/11: On being with each other’s pain with Rabbi Sharon Brous
Apple | Spotify | Transcript
THE LATEST POSTS:
The Perception (and Reality) of Scarcity: Part Two
Ending the “Manel”: Doing this Requires Understanding Ourselves
My Baby-Thin Skin: The Shame of “Disappointing” People and Our Doubled Selves
What Size Are Your Shoes? And More Pointedly, is Your Life Governed by Fear?
If You Build It, They Will Come: Maybe?
Entering the Wilderness: Embracing All that’s Not Human
Accepting Responsibility: Growing Up is Hard
What Motivates Change? Hint: Not Harshness, and Likely Not Fear
“I’d Rather Be Whole Than Good.”: Welcome to my Carl Jung Era
Contemplating the I-Ching: A Q&A With Jungian Therapist Satya Doyle Byock
I’ve Given Up Hope for a Better Past: A Conversation with Rabbi Steve Leder
Self-Help Needs a Rebrand: We Should Call it Personal Responsibility
Full archive HERE
My New York Times bestselling book—On Our Best Behavior: The Seven Deadly Sins and the Price Women Pay to be Good—is out now.
There are so many valuable, interesting points in this article. There's no need to say "Thanks for reading this far, I know it was a long one," when we, the readers are the ones saying "Thank you" for conceiving and articulating this beautiful, rich, and helpful material.
Thank you so much, Elise. I do believe that you've already earned your PhD---in several disciplines!! Everything you mention in this post resonates. So many emotions surface. What also comes up for me are questions about nuance and perspective in this world where authority and expertise have become so black and white. Could any of a woman's conditioned reluctance about claiming expertise or authority also stem from a deeper wisdom that all subjects must continue to evolve? That as soon as we proclaim authority over a certain domain, we stagnate? What I appreciate about your work is that you're curious and you so eloquently converse with those who have earned credibility in their field. And you do so from a space of very well-informed wonder. Maybe that is a standard of excellence and core competency we should all aspire to emulate. Sending you love and gratitude. 💗