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Female Leaders in Paramedicine: Sharing the Hive or a Sting in Their Tale?


Literature surrounding the topic of gender and ambulance services has been historically scarce and has focused more on discrimination and even such subjects as whether women are physically able to life and carry patients, drive vehicles and deal with the emotions associated with emergency care. In more recent times however, gender discrimination and stereotypes are becoming more subtle. Whilst this is positive as it signals an improving picture, it is becoming increasingly difficult to identify behaviours and constructs that are detrimental to women.

There was a recent conversation on social media that focussed on women in research roles, with the intent to highlight and celebrate the work female researchers in all fields were undertaking, and their contributions to healthcare and science. Despite the overwhelming positivity of the thread, we were dismayed to see a portion of women actively message against this celebration. This opposition was not against the binary celebration of gender in research (which was, perhaps a downside of this thread), but directed at other women in research roles. The message was clear: there’s no space for more women here.

Sadly, such overt negative preference for same-gendered colleagues is not new. If direct experience of this has been avoided at during school or adolescence, we’ll have no doubt observed the phenomenon in films (Mean Girls) or television programmes (Pretty Little Liars, Glee). Yet, a Queen Bee is not something we considered to exist in our small corner of healthcare, in paramedicine. Considered rife within the business environment, and accepted within sociology, a ‘Queen Bee’ refers to a woman in a leadership position who has undoubtedly worked hard to attain that position. Queen bee syndrome, therefore, refers to women in such authoritative positions who hinder the advancement of other women in that sector, viewing them as direct competitors. In the workplace (as in school or college), queen bees will view or treat subordinators more critically if they are female. Though perhaps another term more accurately reflects the women we encountered: ‘loophole women’. Found in a similar way to the queen bee, this describes the instance when women who are successful in a male-dominated field oppose other women attaining similar levels of success as, should it be attained at scale, would detract from their own status or importance (1). Neither phenomenon is without evidence. In their survey of women holding senior positions, Derks et al (2) found that women displayed queen bee behaviour to advance their own career paths, by reinforcing cultural stigmas of gender to fit in with their male counterparts in the workplace. By distancing themselves from women they viewed as ‘weaker’, queen bees were able to demonstrate more masculine qualities, stereotypically seen as more professional and valuable by their male peers – thus legitimising their right to be in their role.

We see this perception reinforced in imagery too, in both the wider media and especially in relation to prehospital critical care teams. For example, women are expected to be both kind and warm to fulfil societal expectations but also fierce and tough to fulfil what is expected of them as leaders (3). Ask yourself how often you see posed pictures of critical care teams. Are clinicians stood there smiling with approachable body language (being warm and kind)? Or are they stood there frowning, arms folded, looking very serious with dramatic lighting and stormy skies in the background? This kind of imagery, whilst it demonstrates the seriousness of the work, may affect the types of behaviours that are perceived to be required for a career in such a role that scarcely requires such body language.

In apicology, the queen bee is the dominant reproductive female and usually the mother of most of the bees in the hive. Yet, she is not the central organiser within the hive. Although the worker bees will protect her fiercely (she is, of course, a one-woman baby-bee factory), the hive society is not hierarchical, and it relies on the contribution of every bee in that society. It is this decentralisation of the hive community that makes it able to undertake and coordinate problem-solving tasks, such as attacks on peksy Pooh-bears who wish to steal honey or swarms to find new homes. Indeed, when a queen bee looks to up-sticks and find a new home, it is the collective grasp of bees that keep them together in a nest, and it is their altruistic nature (swarm intelligence) of sharing the load that keeps the nest together regardless of rain, wind or bears. They are, without doubt, stronger together. Perhaps the queen bees who occupy our profession could learn a lot from Madame Apis melifera.

It is becoming widely accepted that women have a moral duty to elevate other women behind them, rather than pulling the ladder up. Perhaps this is becoming a (rather useful) gender stereotype too. The presence of women in senior positions increasing opportunity for other women has been observed in ‘big business’ but less is known about empowerment of other women, especially in relation to paramedicine (4). Whilst each year, around International Women’s Day there are positive articles and ‘tweets’ celebrating women in paramedicine, we need a constant focus on this area. Especially as younger generations of women entering the profession may be less alert to the double binds and expectations, especially as some of these women will have grown up in an improved landscape. A local network or even an international one would improve this attention but until then, we are all responsible for making our everyday focus better for the women who come after us.

For now, Queen Bees and Loophole women still exist in our relatively small corner of healthcare – being the female exceptions (‘role models’) in a field where men still hold a majority of power positions. But if you are the exception that proves the rule, and the rule is that women are inferior, you haven’t made any progress at all as a role model for other women. The power of Women in Canadian Paramedicine lies in its capacity to bring together women and transform women’s consciousness at the deepest possible level. Through encouraging conversations, sharing experiences and being a vehicle for change, we have the opportunity to build and grow a nest, each of us holding onto another, each of us bringing each other up. We need this – to create change and even the gender roles within paramedicine, we are only stronger if we work together.

Global Medic 20210400


  1. Bird C, Briller SW. Born female; The high cost of keeping women down.
  1. Derks B, Ellemers N, Van Laar C, De Groot K. Do sexist organizational cultures create the Queen Bee?. British Journal of Social Psychology. 2011 Sep;50(3):519-35.
  1. Zheng W, Kark R, Meister A. How women manage the gendered norms of leadership. Harvard Business Review. 2018 Nov 28
  1. Dezső CL, Ross DG, Uribe J. Is there an implicit quota on women in top management? A large‐sample statistical analysis. Strategic Management Journal. 2016 Jan;37(1):98-115
Alexandra Ulrich

Alexandra Ulrich

Alex is an Advanced Paramedic Practitioner in Critical Care for the London Ambulance Service NHS Trust and a Senior Lecturer in Paramedic Science at the University of Hertfordshire.

Georgette Eaton

Georgette Eaton

Georgette is the Clinical Practice Development Manager for Advanced Paramedic Practitioners (Urgent Care) in London Ambulance Service NHS Trust and is reading for a DPhil in Evidence Based Healthcare at the University of Oxford.

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Women in Paramedicine

Women in Paramedicine

Women in Paramedicine is compromised of dozens of women in the paramedical field across Canada. Since 2019, they have been sharing their research, point of view, thoughts, and strength to Canadian Paramedicine through their voice and words.

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