Guarding Against Implicit Bias: Attractiveness. Harrison L. Love, Richard B. Gunderman. Journal of the American College of Radiology, October 29, 2020. https://doi.org/10.1016/j.jacr.2020.10.004
Abstract: Most of the literature on implicit bias naturally focuses on negative stereotypes: categories such as race and gender that lead to discrimination against some candidates in job interview invitations, offers of employment, and promotions. Examples of implicit bias abound; for example, girls are often assumed to be less capable than boys in engineering and math, and parents rate these abilities in their daughters lower than in their sons, even when they perform equally in school [ 1 ].
Yet not all implicit biases are negative, and in fact some traits foster positive unfairness, advantaging some candidates over others. One such trait is physical attractiveness. Recognizing and compensating for this form of bias is equally important for members of the radiology profession.
ATTRACTIVENESS
Some traits tend to be viewed as attractive across all cultures. Amongthese are facial symmetry, clear complexion, and a narrow waistline [2].Other features tend to apply to particular genders. For example, men tend to be attracted to women who appear young and have full breasts and lips. Women tend to be attracted tomen who are taller than they are andwho have broad shoulders. Viewers appraise such features at a subliminallevel, gauging attractiveness afterviewing a photograph for only 1/100thof a second [2].There is evidence that the prefer-ence for attractiveness is innate [3]. Forexample, 1-year-old infants play longerand more intensely, experience lessdistress, and even appear to exhibitmore pleasure when playing withattractive people. Even infants asyoung as 2 months old gaze longer atattractive faces than unattractive ones.The corollary of attractiveness bias is abias against the unattractive [4].Hence it is no surprise that mostpeople take care of how they appear toothers, relying to some degree on attire,cosmetics, and grooming to create a morefavorable impression. Very few peoplewould willingly show up for a job inter-view appearing as they do the momentthey climb out of bed in the morning.That attractiveness should beappealing is a bit tautological, but manytheorists have speculated that it mayserve as an indicator of geneticfitness [5].For example, body build may offer cluesabout health, and general appearancemay serve as an indicator ofsocioeconomic status, both which maybe desirable to prospective mates.Somehaveargued,forexample,thatthe male preference for youth reflects aconcern with reproductivefitness, whilethe traits preferred by women serve asindicators of the capacity to offer protec-tion and provide resources. Even at theneurologic level, viewing the faces ofattractive people has been shown to acti-vate areas of the brain associated withreward [6].
ATTRACTIVENESS BIAS
As this bias toward attractiveness appliesacross genders, ages, and sexual orientations [6], there is ample evidence that it manifests in the workplace [7]. For example, such individuals are morelikely to be interviewed and hired, andthey tend to earn higher wages than individuals judged to be unattractive. Attractive wait staff in restaurants havebeen shown to receive higher tips,regardless of the quality of service theyprovide.And such effects appear not to beaccounted for by other traits; forexample, even when self-confidence istaken into account, attractive individualsretain an advantage in compensation.Likewise, studies in the legal professionhave shown that physically attractive defendants tend to receive more favor-able judgments. Such effects are likely toredound to the detriment of the biased.The underlying reasons for such bia-ses are complex, but it appears thatattractive people are, on balance, perceived by others to be friendlier, healthier, more intelligent, more competent, more generous, and more trustworthy than unattractive people, who tend to beperceived as duller, more introverted, and less generous and trustworthy. There is also reason to think that thebias toward physical attractiveness is at least somewhat unfair. Forexample, some studies suggest that the skill andproductivity of workers is not correlated with their attractiveness [6]. Likewise, here is little evidencethata ttractivepeople are more likely than others to becooperative, generous, or trustworthy.
ATTRACTIVENESS BIAS INRADIOLOGY
The association between attractivenessand academic performance is especiallygermane to radiologists who are select-ing candidates for residency, fellowship,and post-training employment oppor-tunities. There appear to be strongpositive correlations between attractive-ness and such characteristics as perceivedintelligence, perceived academic perfor-mance, and perceived conscientiousness.However, there is no strong positivecorrelation between attractiveness andactual academic performance [4].Attractiveness influences what actu-ally happens in contexts such as schoolsand workplaces. Attractive students aremore likely to get into university becausethey are deemed more intelligent andconscientious. They are also likely toreceive better grades. Likewise, moreattractive people are more likely to gethired and be retained. And salariesappear to be 10% to 15% higher forindividuals deemed to be attractive,which is similar to wage differentialsassociated with gender and race.In some contexts, the implicit biastoward attractiveness may not even beunfair. Consider, for example, lines ofwork such as modeling and acting, inwhich the attractiveness of workers is likelyto enhance sales of products and tickets.
COUNTERACTINGATTRACTIVENESS BIAS
How should radiologists and otherradiology personnel who seek to eval-uate candidates, learners, and colleaguesfairly approach the problem of the pos-itive bias toward physical attractiveness?One part of the solution may be simplyto recognize that such biases exist.Knowing that they are biased to-ward attractive candidates, committeescharged with residency and fellowshipselection, searching and screening forjob candidates, and promotion andtenure can consciously question thedegree to which their deliberations arebiased by attractiveness. Where suchbiases are identified, attempts can bemade to compensate for them.Another way to reduce the effects ofattractiveness bias is to take the physicalappearance of those being evaluated outof the equation. In some cases, candi-date photographs can be excluded fromassessment. During interviews, evalua-tors can be blinded, for example byproviding one or more members of aselection committee with only the audiocomponent of an interview.It is worth noting that the currentcoronavirus pandemic and other situations in which mask wearing is appropriate may play some role in mitigating attractiveness bias. If part of a candi-date’s face is covered when a photo-graph is taken or during a remote or in-person interview, the potential for facialattractiveness is diminished.Some have even suggested that arti-ficial intelligence might play a role inmitigating attractiveness bias. As suchbias is to some degree subjective, perhapscomputers could provide a more objec-tive assessment of candidates. Yet therecent travails of facial recognition tech-nology serve as an important reminderthat even seemingly objective computers may harborbiases based on theirpro-gramming and the data sets they havebeen tasked to learn from.In thefinal analysis, the challenge of implicit bias toward physical <attractiveness is not one that can beeliminated but must instead be managed. To begin with, we need toacknowledge that such biases exist.Moreover, we must recognize that in many situations, it is unfair to allowour expectations and evaluations to beshaped by how a person looks. Finally, we need to do our best toensure that such biases do not undulyinfluence our decision making, allow-ing traits that are only skin deep toobscure our perception of far moreimportant personal attributes such asintelligence, character, and experience,which in the long run are likelier topredict performance.
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