Purpose: The authors used the Theory of Gendered Organizations (TGO), which posits that gender inequity is built into organization, to explore the lived experience of women with established careers in academic medicine. Methods: Thirty women at one medical center were purposefully sampled and interviewed. Data were inductively analyzed; TGO sensitized analysis of formal expectations of, and informal interactions within, the organization. Results: Women experienced a disjuncture between formal expectations that were intended to be gender-neutral and informal interactions advantaging men, thus demonstrating how the medical center functioned as a gendered organization. Women navigated this gendered organization by advocating for themselves and younger women faculty. Conclusions: TGO elucidates mechanisms that reproduce gender inequity in academic medicine and can inform organizational change.