While I was reading this, I remembered something a doctor friend of mine told me once. He's a psychiatrist not a surgeon, and he was telling me a story about some of the surgical residents in his training cohort. "They're like high school football stars," he said, "only smarter, which makes them even more full of themselves."

He was talking about surgeon culture, and he explained it in a way that really sounds like the patriarchal dominance hierarchy. Surgeons see themselves at the very top of the medical pyramid. Getting accepted into a surgical residency is perhaps more difficult than for most residencies. Surgeons have to be (like all doctors) at the high end of the intelligence bell curve, but they are also have to be physically extraordinary. Surgery demands extreme physical dexterity and physical endurance. So, surgeons are something like athletes, or at least (said my psychiatrist friend) that's how they often see themselves.

He told me that hazing and other negative harassment behaviors are common among surgical residents as a form of establishing a pecking order — and that fully trained surgeons often laugh or wink at the behavior, sometimes participating in it themselves.

So, I guess it's not all that surprising that a field like that would be very hostile to women, who presumably are expected to fit in with the general ethos.

That's like the rest of society, of course, but magnified given disproportionate toxic-masculine representation, or at least that's my hypothesis.