Sexual harassment and workplace safety among female doctors: the hidden toll in Sri Lanka.

Data on sexual harassment in medicine is limited in South Asia, and formal mechanisms for reporting and redress remain underdeveloped in the region. We aimed to describe workplace sexual harassment among female doctors, associated factors, survivor experiences and perceptions of physical and sexual safety in the workplace in Sri Lanka. We conducted a cross-sectional study among Sri Lankan female doctors with at least 6 months of work experience. Data were collected using an anonymous online questionnaire from September to October 2024, administered via mailing lists of professional medical bodies and closed social media network groups of female doctors on Facebook and WhatsApp. We used SPSS V.23 for quantitative data analysis and narratively described free text responses in the sections titled 'Other: please specify'. The number of completed responses was 377. Of the study participants, 58.6% (n=221) reported having experienced sexual harassment in the workplace at some point in their career. Rape was reported by 1.32% (n=5). Significant associations were seen between workplace sexual harassment and junior position and not having children (p<0.05). Only a few had filed formal complaints (0.9%, n=2). Reasons cited for lack of action were fear of not being taken seriously (63%), fear of tarnishing the reputation of self (54%) and fear of the perpetrator (37.8%). Perceived psychological responses included anger (80%), disappointment (50.6%) and shame (44.3%). Suicidal thoughts affected 2.7%, while 0.4% had attempted suicide. The majority responded 'yes' (33.4%) or 'maybe' (43.8%) to the question related to perception of lack of physical or sexual safety in the workplace. The most common reasons for feeling unsafe were lack of adequate privacy in on-call rooms, bathrooms and changing rooms (63.1%), inadequate safety measures such as lack of locks or proper doors (54.2%) and unavailability of chaperones when handling male patients (30.1%). Workplace sexual harassment is common but under-reported among female doctors in Sri Lanka and could result in adverse psychological effects. Apart from sociocultural enablers, there are modifiable environmental factors that are associated with it, and it is imperative that administrators take these factors into account for the improvement of workplace safety.