by Craig Klugman, Ph.D.

Over the last few days, a number of recordings have come to light showing Republican Presidential Nominee Donald Trump saying lewd, lascivious, and down right crass statements about women. His response was “It’s just locker room talk.” The problem, Mr. Trump is that words do matter and what we say when we think no one is watching is an insight into our true selves and what we really think.

This issue is quite salient in the culture of medicine. In many of the inner sanctums of medicine, such as the operating room, locker room talk is a regular occurrence. Many physicians with whom I have spoken tell stories of doctors making fun of patients bodies, checking out patient’s genitalia, commenting on weight or body shape, denigrating a patient’s race or sex. Several cases of patients accidentally and deliberately recording their surgery demonstrate this phenomena. This is not the rare occurrence, this is part of the OR culture. Doctors say that they are simply blowing off steam and dealing with the unusual stress and high stakes that exist in the OR. Is this simply blowing off steam? Or is it an expression of disrespect of patients? Or is it a display of one’s true inner beliefs in a situation where one feels safe, in control, and free of being judged by others (because one is in a high position of power)?

The locker room, according to sociologist Timothy Jon Curry is a place of masculinity where male dominance is displayed in a bastion of male privilege. Curry says this is often the site of objectifying women in an aggressive and violent manner and denigrating LGBT persons. By claiming “locker room talk,” Trump is saying that such behavior and thought is acceptable.

Surgery and the OR is a bastion of machismo. Surgery is still a male dominated discipline. The OR is a locker room environment by Curry’s definition. The problem is not only the harm that comes to patients from potentially hearing such talk, or the harm to co-workers from being subjected to such talk, but that these medical leaders (a) tolerate such talk, (b) perpetuate such talk, and (c) may be showing their real feelings. Even if they are just taking part of the “locker room culture” by “being one of the guys” and not truly believing what is being said, these words do hurt and do influence others. What about the resident or medical student who hears these ideas and absorbs the concept that this toxic talk is acceptable and normal in medicine? That people say such words and hear them without challenge is a tacit acceptance of them and a perpetuation of structural violence that has repercussions in larger world. It is nothing short of discriminatory behavior.

We should also realize that the banter Mr. Trump and some physicians dismiss as just chatting does not happen in all locker rooms. I’ve been going to a gym for over 25 years now and have never heard this kind of talk. Other athletes and coaches have never heard such talk nor would they tolerate it. This kind of locker room talk is an excuse not a norm.

So Mr. Trump, words do matter. And yes doctor, such banter in the OR is not acceptable. It’s time for all of us to speak up and not accept the excuse for hate language that “it’s just locker room talk.”