Gender Differences in Attitudes Toward Sexual Harassment of Health Care Employees: A Turkish Case Study

Abstract

The purpose of the study was to examine differences in sexual harassment attitudes between male and female labor force in health care organizations. A total of 571 employees working in various health care organizations in Turkey participated in the study. Sexual harassment was measured using 22 items and three-factor structure with constructs “Provocative Behavior,” “Normal Flirtations,” and “Trivial Matter” developed by Turgut. The data were collected using percentage, frequency, mean, standard deviation, independent sample t tests, and multivariate analysis of variance and covariance (MANOVA and MANCOVA). The results of the study revealed that a significant gender difference exists in sexual harassment attitudes with respect to “Provocative Behavior” and “Normal Flirtations” factors, while “Trivial Matter” factor was not statistically significant at the probability level of .05 as part of the sexual harassment scale. After controlling for variables such as age, marital status, monthly income level, education level, profession, institution, length of working time in the organization, and length of time in the health care sector; it was seen that most gender differences remained significant.

Keywords

gender attitudes toward sexual harassment health care employees

Introduction

In recent years, the health care sector has become one of the fastest growing industries in the service sector (Dilber, Bayyurt, Zaim, & Tarim, 2005). Health expenditures have increased with the positive reflection of economic developments, and the health sector in Turkey has begun to develop. The number of health care employees has increased in the past decade in Turkey (International Investors Association, 2012). The health care sector has a critical role with about 871,334 employees in 2016 (Turkish Statistical Institute [TUIK], 2016). According to data acquired from TUIK, labor force participation rate was 72% for males and 32.5% for females in Turkey in 2016. In this context, although the increasing participation of women in the workforce is important in Turkey, their second-class status in the society still prevails (Turgut, 2007). Considering the working conditions and the prejudices regarding women in the health sector, it is difficult for women to come to the position of administrator (Bekata, 2000). Although great progress has been made for women obtaining managerial positions in health care organizations, several gender differences persist. To overcome these barriers, effort must be directed to altering perceptions of organizational power and equal access to promotion (Loo & Thorpe, 1998). This situation is not only seen in the health sector but also experienced in many areas like judicial system in Turkey (Hatipoglu Aydın & Aydın, 2016).

Sexual harassment is a problem that affects the majority of women working outside of their homes (Sbraga & O’donohue, 2000). A growing body of literature shows that harassment takes different forms in different cultures and organizational contexts and may be well interpreted and responded to differently by women from different social backgrounds (Handy, 2006). As the 2016 Human Development Report highlighted, far more women would become active in the labor market and have better wages and positions of influence if the necessary regulations were in place to reduce the workplace harassment against women, to ensure equal wages and hiring practices, and to provide care options for children and older people (United Nations Development Programme [UNDP], 2016). Using the correlations and consequences of sexual harassment of the employees in health care organizations, the aim of this study was to analyze sexual harassment attitudes with respect to gender. These hypothesized differences may be moderated by both a group of select demographic variables of age, marital status, monthly income level, and education level and a group of job-related variables such as profession, institution, length of working time in the organization, and length of time in the health care sector. By taking a select number of variables into consideration, it is hoped that inconsistent findings on gender differences could be minimized and more detailed information could be revealed on gender differences. It makes a great contribution to the sexual harassment literature with respect to theoretical approach and presents a framework for future research in this area.

Conceptual Development

Definition of Sexual Harassment

The definition of sexual harassment includes a range of behaviors such as legally defined harassment, sexist behaviors, and sexual assault (Harris, McDonald, & Sparks, 2018). Sexual harassment is broadly defined as unwelcome verbal or physical sexual overtures that may be made for a condition of employment or otherwise affect one’s job or careers and/or create a hostile or intimidating work environment (Gutek, 2015). The European Commission Code of Practice defines sexual harassment as “unwanted conduct of a sexual nature, or other conduct based on sex affecting the dignity of women and men at work” (Gilbert, Guerrier, & Guy, 1998). Although there is a cross-national variation in the legal definition, sexual harassment is generally defined as a behavior that violates, derogates, demeans, or humiliates an individual based on sex or gender (Lopez, Hodson, & Roscigno, 2009). Sexual harassment is related to both demographic characteristics and the nature of one’s employment (Antecol & Cobb-Clark, 2004).

Scholars investigated the causes behind sexual harassment, and various models have been suggested explaining the reasons of sexual harassment. One of them is the biological model which states that sexual harassment occurs because of the sexual attraction between men and women and stems from males’ strong sexual needs. Another explanation is that sexual harassment is a consequence of unequal power and status distribution in the workplace. As men possess power over women and have higher status in the organizations, they see the right to demand from the lower status (Turgut, 2007). Organizational theory has traditionally played a prominent role in sexual harassment research. According to this, numerous organizational factors such as aspects of power and inequality, policies or organizational climate, and so on explain the likelihood of sexually abusive behaviors (M. B. D. Nielsen et al., 2017).

Sexual harassment, both implicit and overt, restricts the productivity, recognition, funding, advancement, earnings, retention, and continuation of women in their fields (Byington & Lee, 2015; National Institutes of Health, 2014). Sexual harassment contributes to declines in productivity and is associated with higher stress. The consequences for women who experience sexual harassment are not only professional. These women are also at risk of adverse health outcomes with health effects compounded for minorities, including sexual minorities (National Academies of Sciences, Engineering, and Medicine, 2014). The study carried out by Street, Gradus, Stafford, and Kelly (2007) investigated gender differences in the experiences of sexual harassment during military service, and it was seen that the negative mental health symptoms were associated with these experiences. Another study carried out by Harnois and Bastos (2018) examined discrimination, harassment, and gendered health inequalities and found that among women, but not men, perceptions of sexual harassment were associated with poor physical health. On the other side, M. B. Nielsen, Bjørkelo, Notelaers, and Einarsen (2010) studied sexual harassment and the findings showed that sexual harassment was significantly related to mental problems and low job satisfaction among men and women.

Sexual Harassment Experiences With Respect to Gender

Inequitable attitudes toward employees may result in behaviors known as “sexual harassment” in the workplace (Sbraga & O’donohue, 2000). The term “sexual harassment” has since been adopted by women in many other countries where it is used to characterize their experiences, to ensure recognition of these forms of conduct, and to have them prevented (McCann, 2005). Schütte et al. (2014) found that women were more likely to be exposed to emotional demands such as demands for hiding emotions, low degree of freedom, low quality of leadership, sexual harassment, bullying, discrimination, and low job promotion, whereas men were more likely to be exposed to quantitative demands such as demands for responsibility, low predictability, low meaning of work, low role clarity, low social support, long and asocial hours, night work, job insecurity, and work–life imbalance.

Fineran (2002) studied adolescents’ experiences with sexual harassment and results revealed that there are differences in the experience of sexual harassment by gender. Girls reported being significantly more upset and threatened by the sexual harassment they experienced at work. Vartia and Hyyti (2002) studied gender differences in facing and experiencing workplace bullying and found that female victims had been subjects of sexual harassment more often than their male colleagues. Moreover, according to the study by Street et al. (2007), women reported a higher frequency of sexual harassment. On the other side, harassment and victimization among male employees were studied in a sample of 460 industrial employees, supervisors, and managers by Einarsen and Raknes (1997). The results indicated that aggression and harassment are significant problems in this organizational setting. On a weekly basis, 7% of the men reported being subjected to at least one of the following behaviors from coworkers or supervisors: ridicule and humiliation, teasing, verbal abuse, rumors and gossips spread about themselves, offending remarks, recurring reminders on blunders, hostility or silence when joining a conversation, or devaluing of one’s effort and work. As many as 22% reported being subjected to one or more of these acts at least monthly. Komaromy, Bindman, Haber, and Sande (1993) studied sexual harassment in medical training and found that about one man in five (11 of 49) reported having been harassed. Unlike women, men noted more affairs during residency than during medical school and about half of the harassers were other men. Waldo, Berdahl, and Fitzgerald (1998) investigated the relative frequency and type of men’s experiences of potential sexually harassing behaviors, including 378 males (aged 40-44 years) from a large utility company, 209 males (aged 40-44 years) from a university campus, and 420 males (aged 35-39 years) from a food processing plant. Results indicate that men experience potential sexually harassing behaviors from other men more often than they do from women; however, men in all samples reported relatively few negative reactions to these experiences. Gruber and Fineran (2008) compared the impact of sexual harassment victimization on the mental and physical health of adolescents. Their findings showed that boys experienced bullying slightly more than girls, and girls were harassed a little more often than males.

Although women experience sexual harassment more often than men and are also harassed for reasons that are sex-specific and that reflect power differentials between the sexes, the fact that specific harassment policies and more general work contexts reduce harassment victimization for both women and men should be a consideration for organizations and/or corporations when making important decisions about general and specific policies and procedures (Mueller, De Coster, & Estes, 2001).

Attitudes of Different Genders Toward Sexual Harassment

Gender issue is an important structure in the organizations. Moreover, gender differences influence attitudes toward sexual harassment. Males perceive more situations as being sexual or potentially sexual and, thus, view sexually harassing behavior as normal or appropriate. For example, they may see sexual harassment as a normal flirtation between men and women (Foulis & McCabe, 1997). Perry, Kulik, and Schmidtke (1997) reported that if women do not actively respond to sexual harassment, the harassment may persist and their personal and professional lives may suffer.

There are various findings about sexual harassment and gender-related issues. According to some studies (Foulis & McCabe, 1997; Kenig & Ryan, 1986; Kennedy & Gorzalka, 2002; LaRocca & Kromrey, 1999; Mazer & Percival, 1989; Reilly, Lott, Caldwell, & DeLuca, 1992; Reilly, Lott, & Gallogly, 1986; Russell & Trigg, 2004; Sakallı-Uğurlu, Salman, & Turgut, 2010; Shechory Bitton & Ben Shaul, 2013; Sheffey & Tindale, 1992; Tang, Yik, Cheung, Choi, & Au, 1995; Williams & Cyr, 1992), significant gender differences exist in males’ and females’ perceptions and in their tolerance level of sexual harassment.

For instance, Reilly et al. (1986) examined sexual harassment among university students and found that men and women differed significantly in the tolerance for sexual harassment inventory, with men more tolerant of sexual harassment than women. In another study conducted by Kenig and Ryan (1986), it was found that women consistently tend to have lower levels of tolerance than men. The study done by Mazer and Percival (1989) revealed that men have more discriminatory and traditional sex role attitudes than women, while Sexual Harassment Attitude Scale (SHAS) scores indicate that they also have more tolerant and accepting attitudes toward sexual harassment than women. Similarly, Williams and Cyr (1992) found that males and females differ in their perceptions of sexual harassment particularly when a female target makes prior commitments to having a friendly relationship. Females rated the perpetrator’s behavior as more sexually harassing than males. The study conducted by Sheffey and Tindale (1992) investigated perceptions of sexual harassment in the workplace and found that ambiguous behaviors are perceived as being more sexually harassing in male-dominated and mixed settings than in female-dominated settings. Women identified behaviors significantly more harassing in traditional, nontraditional, and integrated work settings than their male peers. Reilly et al. (1992) studied tolerance for sexual harassment related to self-reported sexual victimization using a sample of college women and men and found that men were more tolerant of sexual harassment. Tang et al. (1995) studied sexual harassment and found that individuals’ intolerance toward sexual harassment was related to the support they receive in terms of gender equality and flexible gender roles. Compared with men, women had broader definitions of sexual harassment and were less tolerant of these behaviors. Foulis and McCabe (1997) defined sexual harassment as factors affecting attitudes and perceptions and found that males were more tolerant of sexual harassment which suggests that males are socialized to be the sexual aggressors and to perceive situations as being more sexual than females. In another study, LaRocca and Kromrey (1999) examined sexual harassment of male and female students as well as perceptions of perpetrator and character traits of the victim. Results indicated that female students perceived the scenario more sexually harassing than male students. Kennedy and Gorzalka (2002) investigated potential differences in attitudes toward coercive and noncoercive sexual behavior. According to the results of the study, men were more likely to be tolerant of sexual harassment than women on almost all items presented and women differed significantly from men on 14 of the items. Russell and Trigg (2004) examined the effect of gender in terms of tolerance for sexual harassment and found that women were significantly less tolerant of harassment than men were. Sakallı-Uğurlu, Salman, and Turgut (2010) studied predictors of Turkish women’s and men’s attitudes toward sexual harassment using provocative behaviors and trivial matter subscales and found that men scored higher in both subscales, suggesting that men are more tolerant of sexual harassment. Another study done by Shechory Bitton and Ben Shaul (2013) investigated the role of sex in determining attitudes toward sexual harassment and perceptions of sexual harassment, and the findings point to significant sex differences in the perception of behaviors as sexual harassment. Women were less tolerant of sexual harassment regardless of the victim’s sex.

On the other side, Bursik (1992) found no significant gender differences in the perception of sexual harassment and hypothesized that the gender role groups would differ in their perceptions of sexual harassment. Although gender role may play a minor role in the interpretive process, it does not appear to be a major contributing factor in terms of individual differences in the perception of harassment. Head, Sorensen, and Pincus (1995) found that the respondent’s gender does not cause a perceptual bias regarding defining sexual harassment. From this evaluation, our study intends to test the following hypothesis:

Hypothesis (H1): Female employees are less tolerant of sexual harassment according to each of the three constructs than men.

Hypothesis (H2): Male employees are less tolerant of sexual harassment according to each of the three constructs than women.

As seen from the literature review on the topic, there are various findings about gender differences on sexual harassment attitudes. It is evident that differences can exist between male and female employees in their sexual harassment perceptions and tolerance levels. These differ from country to country and from organization to organization with some variation. Although sexual harassment has been examined in different organizations by the researchers, little research has been conducted among employees who work at health care organizations in Turkey. Based on the previous studies, the general hypothesis of this study is whether there are differences in sexual harassment attitudes in health care organizations between female and male employees or not. This current study contributes to the rich literature on sexual harassment in two ways. First, data used in the study were acquired from health care organizations. Second, other demographic variables such as age, marital status, monthly income, education, and a select list of organizational variables such as position and length of time in the health care organization were used to examine the existing differences between the two gender groups in their sexual harassment attitudes. Using research findings, we can not only reach sexual harassment attitudes but also develop a viewpoint for other countries and cultures.

Method

Data and Sampling

The study was conducted among employees who work at health care organizations in Ankara, Turkey, from September 2017 through February 2018. As health care organizations tend to have a large number of employees, these organizations were selected to populate the sample with “enough” employees. The study used a proportional stratified random sampling based on the number of health care organizations and their total number of employees. Based on this information, the total survey population is estimated as 871,334 (according to the TUIK (2016) Data). This figure was treated as the limit of the universe, and following the sample size calculation as suggested by Yamane (2001), the appropriate sample size turned out to be 383. Initially, based on the size of the health care organization, an appropriate number of questionnaires was sent to the managers of organizations. The managers of these organizations distributed questionnaires to the employees and collected them. In total, 967 questionnaires were distributed. The questionnaire was completed by the employees who work in several health care organizations. After a waiting period of 6 months, 571 usable questionnaires were generated and they provided a response rate of almost 59%.

The total number of the health workforce in Turkey was separated into two groups as men and women to find the answer to the question in line with the research, and the sample was selected from these groups using the stratified random sampling method. According to the results of the normality tests, the data set showed normal distribution, and for this reason, parametric tests were used in the analysis. To prevent potential language problems, the questionnaire was translated into Turkish using the back-translation method by the research team.

The survey questionnaire consisted of two parts. The first part of the survey included some statements about characteristics of the employees working in the health care organizations. It is thought that the gender of the participants will affect their attitudes toward sexual harassment. Moreover, when other variables such as age, marital status, monthly income level, education level, profession, institution, length of time in the organization, and length of time in the health care sector have been controlled, it is seen that gender still affects their attitudes toward sexual harassment.

The second part of the survey covered questions about employees’ attitudes toward sexual harassment. SHAS, which was originally developed by Turgut and Salman (2006), was used in the study (Turgut, 2007). Attitudes toward sexual harassment were measured with 22 items, and all the items were measured on a scale of 1 to 5 (1 = strongly disagree and 5 = strongly agree). Based on the literature, the three-factor structure defined Factor 1 as “Provocative Behavior,” Factor 2 as “Normal Flirtations,” and Factor 3 as “Trivial Matter.” In this study, three-factor scale was used and responses to 22 items were captured using 5-point Likert-type scales varying from 1 = strongly disagree to 5 = strongly agree. High scores showed higher levels of tolerance for sexual harassment.

Factor 1, “Provocative Behaviors,” includes 10 items and suggests that sexual harassment is what women provoke by the way they dress or behave. Example items include “Most women who are sexually insulted by a man provoke his behavior by the way they talk, act or dress,” “Most men are sexually teased by many of the women with whom they interact at work or at school,” “An attractive person has to expect sexual advances and should learn how to handle them,” and “Encouraging a supervisor’s sexual interest is frequently used by women to get better grades or to improve their work situations.” Cronbach’s alpha for the complete instrument was .91, which is deemed acceptable.

Factor 2, consisting of six items, reflected perceptions of sexual harassment as “Normal Flirtations” and as being a natural result of the sexual interaction between men and women. Examples from this factor are “Innocent flirtations make the workday or school day interesting,” “It is only natural for a man to make sexual advances to a woman he finds attractive,” and “It is not a problem to touch people from the other sex, with whom there is no intimate relationship.” Cronbach’s alpha for the complete instrument was .92, which is deemed acceptable.

Factor 3, consisting of six items, is the dimension of perceptions which reflect sexual harassment as a form of discrimination and hostility toward women. Example items include “Sexual harassment is a very serious social problem,” “Sexual harassment is a concept that women make up,” and “Sexual intimidation is a serious social problem.” Cronbach’s alpha for the complete instrument was .93, which is deemed acceptable.

Analysis of Data

The first part of the data analysis procedure includes descriptive analysis. The characteristics of the respondents revealed that male and female participants accounted for 51.6% and 48.4% of the sample, respectively. The marital status distribution of the respondents showed that married employees accounted for 73.49% and single employees for 26.6% of the sample. The distribution of the employees’ ages was as follows: 18 to 30 years old (24.6%), 31 to 40 years old (33.3%), 41 to 50 years old (27.5%), and 50 and over (14.6%). In addition, when the educational level of the employees was examined, it was seen that 10% was primary school graduate, 21.1% was high school graduate, 11.3% had associate degree, 44.7% had bachelor’s degree, and 12.9% had postgraduate degree.

According to the t-test results (Table 1), the “Provocative Behavior” and “Normal Flirtations” factors as part of the sexual harassment scale were statistically significant at .05 probability level between female and male employees. From “Provocative Behavior” factor (male = 3.3545, female = 2.3107, p < .05) and “Normal Flirtations” factor (male = 2.9982, female = 2.7926, p < .05), males scored higher in “Provocative Behavior” and “Normal Flirtations” than their female counterparts. These findings revealed that significant gender differences exist in the employees’ attitudes toward sexual harassment with respect to “Provocative Behavior” and “Normal Flirtations” dimensions. In other words, female employees’ attitudes toward sexual harassment are more negative than males, namely, they are less tolerant. However, it is also found that there are no significant differences between female and male employees with respect to the “Trivial Matter” factor of the scale. Although there is no significant difference between male and female on their “Trivial Matter” perceptions, women scored higher (female = 4.1024, p < .05) than men (male = 4.0795, p < 0.05) on this subscale.

Table 1.

Gender Differences in Attitudes Toward Sexual Harassment Factors.

Sexual Harassment Factors	Female	Male	t Value	Sig.
Provocative Behavior	2.3107	3.3545	−13.907	.000
Normal Flirtations	2.7926	2.9982	−4.529	.000
Trivial Matter	4.1024	4.0795	0.903	.367

Note. Scale ratings: 1= strongly disagree; 2 = disagree; 3 = undecided/neutral; 4 = agree; 5 = strongly agree.

In this study, multivariate analysis of variance (MANOVA) was performed to investigate gender differences in sexual harassment attitudes. MANOVA is a generalization of analysis of variance (ANOVA) to a situation in which there are several dependent variables. MANOVA emphasizes the mean differences and statistical significance of the differences among groups. Discriminant analysis emphasizes the prediction of group membership and the dimensions on which groups differ (Tabachnick & Fidell, 2013).

In the study, gender was used as an independent variable. “Provocative Behavior,” “Normal Flirtations,” and “Trivial Matter” were used as dependent variables. There was a statistically significant difference between the female and male employees according to the combined dependent variables: F = 70.205, p = .000; Wilk’s Λ = .71; $η_{p}^{2}$ = .28. When the results for the dependent variables were considered separately, a statistical difference was found in two dimensions, namely, provocative behavior and normal flirtations, using a Bonferroni-adjusted alpha level of .37 (Provocative Behavior: F = 193.354, p = .000, $η_{p}^{2}$ = .26). An inspection of the mean scores indicated that males scored higher (M = 3.3545, SD = 0.96) in provocative behavior than females (M = 2.3107, SD =0.76). An inspection of the mean scores indicated that males scored higher (M = 2.9982, SD = 0.54) in normal flirtations than females (M = 2.7926, SD = 0.50).

Gender differences in attitudes toward sexual harassment, considering other characteristics

In this study, multivariate analysis of covariance (MANCOVA) was performed to investigate gender differences in sexual harassment attitudes. MANCOVA is the multivariate extension of ANCOVA (analysis of covariance). MANCOVA asks whether there are statistically significant mean differences among groups after adjusting the newly created dependent variables for differences on one or more covariates. For example, pretreatment subjects are pretested on test anxiety, minor stress anxiety, and free floating anxiety. When pretest scores are used as covariates, MANCOVA asks whether mean anxiety on the composite score differs among the treatment groups, after adjusting for preexisting differences in the three types of anxieties (Tabachnick & Fidell, 2013).

MANCOVA was employed to test gender differences while controlling for other variables such as age, marital status, monthly income level, education level, profession, institution, length of time in this organization, and length of time in the health care sector. This analysis reveals that gender differences in sexual harassment attitudes (i.e., multivariate main effect) existed after controlling for covariates (see Table 2). After considering marital status, the mean score of “Normal Flirtations” factor showed a significant change between male and female respondents. Furthermore, monthly income level (TL) showed differences between male and female respondents in “Provocative Behavior” factor, and institutions showed differences between male and female respondents in “Trivial Matter.” When the length of time in the health care sector was controlled, the mean score of “Provocative Behavior” and “Normal Flirtations” factors showed a significant change between male and female respondents.

Table 2.

Gender Differences on Sexual Harassment Factors Controlling for Other Variables.

Item Controlled	Provocative Behavior (F, p)	Normal Flirtations (F, p)	Trivial Matter (F, p)
Age	1.817 (.178)	0.438 (.578)	0.091 (.763)
Marital status	1.420 (.234)	5.855 (.016)*	0.580 (.447)
Monthly income level (TL)	14.779 (.000)*	0.067 (.797)	0.206 (.650)
Educational level	1.034 (.310)	0.856 (.355)	1.675 (.196)
Profession	0.025 (.875)	1.677 (.196)	0.596 (.441)
Institution	2.908 (.089)	0.278 (.598)	47.026 (.000)*
Length of time in this organization	2.197 (.139)	0.251 (.617)	1.594 (.207)
Length of time in health care sector	210.132 (.000)*	21.927 (.000)*	0.028 (.868)

Note. Significance levels are indicated in parentheses (*p < .05).

Conclusion and Discussion

The concept of sexual harassment has been important in the workplace recently. It is a common problem which is, whether at school, in a factory, or in a health care facility, thought to be a factor affecting the business life negatively. Therefore, this study investigated the gender differences in sexual harassment attitudes of the health care employees. To realize this aim, 571 employees participated in the study in several health care organizations in Ankara, Turkey.

Gender differences were first compared using independent t tests, and the study indicated that there are no significant differences between female and male employees with respect to the “Trivial Matter” factor of the scale. Moreover, findings showed that “Provocative Behavior” and “Normal Flirtations” factors as part of the sexual harassment scale were statistically significant at .05 probability level between female and male employees. Males scored higher in “Provocative Behavior” and “Normal Flirtations” than their female counterparts, and female employees’ attitudes toward sexual harassment were more negative than males. In other words, female employees were less tolerant. The finding of this study is also consistent with past researches (Foulis & McCabe, 1997; Kenig & Ryan, 1986; Kennedy & Gorzalka, 2002; Mazer & Percival, 1989; Reilly et al., 1992; Reilly et al., 1986; Russell & Trigg, 2004; Sakallı-Uğurlu, Salman, & Turgut, 2010; Shechory Bitton & Ben Shaul, 2013; Tang et al., 1995) related to gender differences in attitudes toward sexual harassment of the health care employees.

This finding is also consistent with the MANOVA, in which the independent variable was gender and three delineated factors were dependent variables. When the results for the dependent variables were considered separately, there were statistical differences in two dimensions, namely, “Provocative Behavior” and “Normal Flirtations,” with an alpha level of .37 using Bonferroni correction.

Finally, MANCOVA was used to test gender differences while controlling for other variables; such as age, marital status, monthly income level, education level, profession, institution, length of time in this organization, and length of time in the health care sector. This analysis reveals that gender differences on sexual harassment attitudes (i.e., multivariate main effect) existed after controlling for these covariates.

Employees have different attitudes toward sexual harassment with respect to gender. Common explanations for the differences in sexual harassment attitudes may be stemming from females’ and males’ different characteristics, expectations, and responsibilities. Socially assigned gender roles of women, including the responsibility for doing the housework and childcare/eldercare and the norms of patriarchal society, play an influential role in shaping women’s decision to enter the labor market (Erarslan & Aycan, 2017). Women may develop different psychological contracts with organizations than men. They may be more committed and satisfied with work when they perceive that their organization offers policies that are consonant with the family role in comparison with men (Scandura & Lankau, 1997). When companies promote female and family friendly policies, such as strong policies against sexual harassment and policies encouraging equal opportunity for women, an environment will be created where talented women, and the most talented people, regardless of the gender, attain top management positions (Crampton & Mishra, 1999).

The results of the study provide information on male and female employees’ attitudes toward sexual harassment in Turkish culture. Another explanation for the differences in sexual harassment attitudes may be cultural influence; however, it is more relevant and it requires more attention. In the area of sexual offenses, for example, perceptions and understanding may be quite different—and cultural differences play a major role. Therefore, modifying cultural beliefs requires a prolonged and deliberate effort, which involves not only the workplace but also the entire society (Di Martino, Hoel, & Cooper, 2003). Some studies have pointed out cultural differences in perceived sexual harassment. In feminine cultures, like in Norway, women have reported significantly fewer incidents of unwanted sexual behavior than women from masculine cultures, such as the United States (cited in Vartia & Hyyti, 2002). Folgero and Fjeldstad (1995) examined cultural norms and sexual harassment in service organizations, and the authors argue that a major reason for this is the particular cultural norms in service organizations: Employees are not allowed to perceive themselves as victims of sexual harassment. In view of the general morality of the Turkish society, it is based on the belief that a woman can be accused of talking about sexual harassment or hesitating to complain (Bekata, 2000).

Although some organizations have recognized women as valuable additions to the workforce and have instituted changes to retain them, a great deal of men has done their best to prevent women from succeeding (Baumgartner & Schneider, 2010). Moreover, many organizations have established policies and procedures to deal with sexual harassment while few complaints are reported. Some have suggested that the lack of complaints is due to the absence of a problem, or the timidity or fearfulness of victims (Riger, 1991).

From a theoretical implication perspective, it is clear from the findings of the study that examining the gender differences on attitudes of sexual harassment while controlling for relevant variables would help contextualize the place of the study and make findings more useful in health care organizations. On the other side, the findings of this study have several practical implications. To decrease and prevent sexual harassment is an important point, and therefore, it is strongly recommended for organization managers to use these findings. Moreover, education plans, programs, and strategies can be designed for women to understand the structure of sexual harassment. Regarding the study limitations, this study was conducted among health care employees in Ankara, Turkey. Therefore, future research needs to examine the model in different contexts, such as different cities or countries and with participants who have different characteristics. Future research that would extend the current study is recommended.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Derya Kara, PhD, is an associate professor in the Faculty of Economics and Administrative Sciences, Ankara Hacı Bayram Veli University. She graduated in 2002 from Gazi University. She received her PhD degree from Gazi University. She has extensive experience in the travel and tourism field, human resource management, health care, and tourism management. Her current research interests are in the areas of human resource management with respect to gender in service organizations. She teaches courses on human research management, health tourism, and gender. She has published numerous articles on the national and international journals. She has also received a number of awards on the research field.

Şükrü Anil Toygar, PhD, is a assistant professor in the Healthcare Management Department, Faculty of Health Sciences, Selçuk University. He recieved his PhD in Healthcare Management from Gazi University. He works on policy analysis, occupational health and disease, and health policy. He teaches courses on leadership, health policy, and management. He has published numerous articles on the national and international journals.

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