Shortly after I was 14 I went for tea with my Great Aunt. I had long black hair (I was a goth for over a decade) and when I went into her house and we were away from the street she started to berate me: my hair was down, it wasn’t up, it wasn’t dressed. I was 14 now, I was a woman, what would people think if I wore my hair down. People would question what kind of woman I was, how would I get a husband? who would look after me? If I didn’t dress properly, learn to cook and clean and behave properly no one would want me.

Needless to say, this probably had the opposite of any intended effect  I pointed out that I would wear my hair how I wished and that I didn’t ‘need a man to take care of me’ and that I ‘was jolly well able to take care of myself’. Thus was my first introduction to how the way I dressed would be used to judge both me, and my current and future potential for success. This was only emphasised further at my girls school, where being a goth was treated as a one way street to failure at life, rather than a means of self expression. Like applying black lipstick or having black hair would immediately consign me to the rubbish heap of life. I continued to wear black lipstick and have black hair far into my 20’s in part to prove that their expectations were nonsense. 

Imagine my surprise then to find, when working at a council as my first job post university, to hear one of the inspiring female leaders there spending her time preaching a similar message. I remember her so clearly 20 years later, even though I don’t remember her name. She was very senior in the council and was on her way to Westminster to speak. I noticed that she always wore trouser suits with small shoulder pads and so I asked her whether she wore them as she felt more comfortable or empowered in them. She replied she didn’t even like them, but she’d long ago learnt that she had to dress like the men in order to succeed or be taken seriously. No long hair, no skirts, you must have makeup but it must be natural etc.

That’s politics you say, in healthcare we meet patients from all walks of life and therefore we should be able to represent ourselves and reflect back at them that same sense of diversity………….Well that is what I’ve always thought too. Until I went on my first senior leadership course run by the King’s Fund. Now this course was so hilarious in so many ways that at some point I will write a separate blog entitled ‘Taking a walk with the wheel of my life’ but for now let me share that it was the worst £9000 I have ever spent.

The course was called the Athena programme and was specifically aimed at women in senior leadership positions in healthcare. The first three day retreat involved many horrors that occurred within a monastery with no phone reception or Internet access. On the second evening there there was a three hour session on dressing for success. As part of this I was made to endure an extensive slide presentation showing that successful female leaders all wear ‘a uniform’. The uniform being a box jacket, skirt suit, chunky statement necklace and a broach. They included a picture of Margaret Thatcher and the epitome of ‘the uniform’. At this point I should have collected my things and left but as £9000 is a lot of money and I have a thing for certificates, so I stuck it out for the whole 4 modules over a year.

Why am I so offended by this?

The fact that I go by Girlymicro has probably not passed you by. In 2012 when I setting up my twitter account the name was fairly deliberately chosen. I was surrounded by successful men but I hadn’t really met any senior women that I could access for mentorship (thankfully that has now changed and I know loads). I was saddened by the continuous messaging that I needed to be someone other than who I was if I ever wanted to succeed. It wasn’t good enough to be smart, it wasn’t good enough to be driven, it wasn’t good enough to succeed at the tick boxes, instead I had to look the right way to have doors opened for me. This went one of two ways, I could be ‘the pretty one’ where doors could be opened as I was appealing to men, or I could be ‘one of the guys’ where I was accepted because I tried to be one of them, look like one of them, behave or talk like one of them.

Well sadly most days you’re lucky if I get out of bed and brush my hair, so I was never going to be one of the pretty ones. That said I don’t wear trousers, I like kooky shoes and maxi dresses, I’m not being caught dead wearing a statement necklace and you don’t have enough money to make me cut my hair.  I am not therefore ever going to be one of the guys. So where did that leave someone like me? Destined to be pretty much invisible as I didn’t fit the mould? Screw that, it left me making a deliberate decision to try to break that mould by just being me, as publicly as possible. Choosing Girlymicro as my twitter handle was the first step in this journey.

Does this mean I’m saying wear what you want?

Let’s get this one out of the way, I’m not advocating you turn up to clinic naked or in a bikini.  What I am saying is that you can be both respectful and wear clothes that represent who you are as a person rather than being forced to conform to a standard set by ‘others’.

I really believe that dress is one of those things where we use it judge whether people fit our cultural norms. If someone doesn’t fit then no matter how good they are at the role it will always be a challenge. I’ve lost count of the number of times it’s been made clear to me that if I only fit in more, played the game more that I would go further. Dress is just one example of how this is acted out in a way that it easy to assess.

Why is all of this important?

All of this matters because we don’t sit in isolation from our patients, or from our students.  We are the people that stand in front of them. This may be why you tell me that I need to dress a certain way, but is it really?

Is dressing a certain way actually only a reflection of an older version of healthcare where it was about clinician authority? If we are moving towards a model of healthcare that is more based in co-creation isn’t it actually more important that our patients and trainees see diversity and representation in us that reflects them?

I think this is also especially important when we’re talking about progression and recruitment. If people can’t see themselves in a position they will often discount the fact that it is for them. Dressing in ‘the uniform’ isn’t just exclusive in terms of making in and out crowds visible. It also requires privilege.  None of those clothing items are cheap, most of them would have been incredibly inaccessible to me until I was on a consultant salary. To be honest even now I’m on a consultant salary there are things I would rather spend my money on. Why are we making a job that is already difficult to access and viewed as inaccessible even harder, by requiring you have have money to merely fit in.

My other question is whether this reflects our diversity and inclusion aspirations? Where do braids fit into this or choosing to wear a hijab? What about those people who have alopecia or are allergic to make up? If we are serious about representation and moving towards a more inclusive working environment should we be setting implicit standards which require others to change who they are in order to conform if they wish to succeed? What kind of message are we sending about what we require to work with us, if we are saying you have to leave who you are at the entry of where you work.

Wear what empowers you!

I am always going to be the kind of person who looks like they’ve walked through a hedge on the way to work and if I manage 3 hours without dropping food or drink down myself it’s probably because I haven’t found time to have either. This is what I’ve landed on however. I will wear things that empower me. Some days that means I may wear a jacket, sometimes that means I will wear an inspirational slogan and sometimes it just means that I will wear something comfortable that will get me through the day.

I will also not judge the clothing of those who work around or for me. If you are wearing jeans in the lab I do not care. The only place you will receive judgement from me on the matter of dress is if you are working on a clinical unit and are covered with bangles and other things that mean you are increasing transmission risk to others. Even my ‘you do you’ attitude has limits when it comes to patient safety.

I want to finish however with a story that shows that you don’t need to conform to be a success. Many of you will know Dr Kerrie Davies. If you don’t she’s a truly inspirational woman, and don’t just believe me, she won last years Healthcare Scientist of the year award from the CSO, so people who are waaaaaay more senior and brighter than me agree.

I met Kerrie when we were both trainee Clinical Scientists over 10 years ago. Since then she’s won million pound grants, been a Lead Scientific Advisor for the UKHSA during the COVID-19 pandemic and been awarded a PhD. All with blue hair! Kerrie expresses who she is and is unapologetic about it, whilst simultaneously being both a super bright and empathetic leader. All I can say is that we should all ‘be more Kerrie’ and the world would be a better place.

Whilst you think about your outfit for tomorrow and how you are going to start wearing something that will help you be just a little bit more you, I’m off to have a serious think about whether I could pull off blue hair.

All opinions in this blog are my own.