Diverse OT: Being a male OT in a profusely female OT world.
Occupational therapy is a balancing act, but are the profession’s minority male OTs walking the high wire alone?
For the latest article in our diverseOT series we focus on male occupational therapists (OTs). Veteran Rob Padwick reflects on 20 years of professional performance and participation, mainly among women.
It takes a certain type of person to be an occupational therapist.
“When I started as an OT – in fact, even before I became qualified 20 years ago - it was obvious that it was a female-dominated profession,” occupational therapist Rob Padwick, 59, recalls.
“Beginning my course at Southampton University, there were only five male OTs in 95 students.
“By the time we got to the end of our first year, one female had left, and the five male OTs were reduced to three.”
All three males went on to graduate in 2001; a single example of men staying the occupational therapy course but one that begs the question: why don’t more?
Rob has several suggestions, including hindrance to attitudinal change due to the historical dominance of women in the profession.
But, of greater relevance, Rob believes: “It takes a certain type of person to be an occupational therapist.”
He said: “Whether you’re male or female, you need to have incredible intuition, and you need to be really empathetic.
“You need to be very, very good at listening and very nurturing, and I think some people are simply not.”
Rob also pointed to restrictive rates of pay during the early stages of an occupational therapy career.
“In the early days, supporting a partner and children on the typical salary, it’s not always easy to see how you can provide for them.
“In that way, I don’t think the profession attracts men whose role is a main provider.”
No man’s land
Rob has frequently been the only male OT, or one of few, in his professional experience during the past two decades, which include:
- His current role as Clinical Lead at an assisted living technology company, Beanbag Care.
- Senior OT for locum agencies and Salisbury NHS Trust’s Wessex Rehabilitation Centre.
- Clinical Development Manager for Medequip Assistive Technology.
So, what’s it like starting a new job in a gender minority?
In many ways, you feel in the beginning that you are different, but you feel different in a good way because they want you there.
“In my experience, female OTs love having a male OT around,” Rob said, “and I don’t think that’s exceptional for occupational therapy.
“A balance of sexes is good within a team to get the banter and the camaraderie. The friendships are different when you have a mixed group.
“The dynamic and perspectives change.”
Yet, no matter how welcome Rob has felt in this female-dominated profession, he still hopes there will be more male OTs swelling the ranks soon.
“Within a professional group, like OTs, because you are nearly always the only male OT within a department, you look for another male therapist to have a friendship with,” he said.
“You kind of need that bond of sharing male-specific issues, of which there are many.
“If you only have a woman to talk to within your team, then you’re sharing job-specific questions that are non-specific for your sex and your identity.
“I think, as a therapist, you need to share some matters with somebody who can understand them.
“I would no sooner choose to talk about some issues with my wife than I would talk to a female work colleague.
“Sometimes, it’s just being with another bloke that matters, being able to offload some of those gender-specific issues you’re faced with on a day-to-day basis.”
“That could be, for example, an older female patient flirting with you because you’re a male therapist (yes, it happens!), or perhaps it could be a male patient rejecting you because he wants a female therapist.
“Until the balance is more equal, it will remain challenging.”
As all OTs will agree, facilitating a patient’s or client’s right to choose their therapist is crucial to achieving positive outcomes.
And for Rob, this takes on greater significance in his work with elderly patients whose gender identity values and beliefs may reflect those of a different generation.
You don’t want to push yourself on to being their therapist when their feelings are that they don’t want you there.
By way of example, he referred to an occupational therapy assessment of an individual’s ability to wash and dress – a common clinical process he, nevertheless, declines to perform.
“To carry out that assessment of a female patient,” he said, “I’m watching her take her clothes off and wash, and I am writing a report about her ability to do that.
“But I feel out of place, not because I’m not willing to do it, but I feel instinctively sensitive about her body and her embarrassment.
“And even if she wants me to be the therapist and is willing and happy for me to provide that assessment, I don’t feel right doing it.
“And I don’t feel right doing that for her sake. I feel it’s unfair and unreasonable, and I instinctively want a female colleague to step into my place.
“I also think, because of the older patients I like working with, that an elderly man, nine times out of ten, would instinctively want a woman to carry out that assessment.
“That’s very old school, and I’m sure, for my generation and my kids’ generation, that’s changed. A lot of men now would be perfectly happy for a man to carry out that assessment.
“But I have refused to carry out washing and dressing assessments for women from the very beginning of my career.
“I use different ways for my patients to evidence, sequence and plan the process without embarrassment.”
So, what ways does Rob suggest might be used to ease more men into occupational therapy?
“A lot of people still don’t know what occupational therapy is,” he said. “I only became aware of it because I had an accident and was in the hospital.
“A lot of us only learn about it as we get older, particularly when an older relative needs OT input to help them maintain independence.
“So, it has to do with education and knowledge in school and awareness of the variety of work and the career opportunities.
I’ve been able to excel as an OT. I’ve had so many opportunities because, as a male, you’re an exception which means you attract more attention.
Men make up just eight per cent of the UK’s total OT workforce. 
The Royal College of Occupational Therapy’s #ChooseOT mission aims to address this and other inequalities to make the profession as diverse as the people it serves.
More RCOT information about career pathways into occupational therapy here: https://chooseot.co.uk/