How does gender affect work rewards for professionals in a state-run economy? Using surveys from physicians in Estonia in 1991, the authors first found that the gender of the physician did not affect the level of formal rewards. However, because the state allocated formal rewards on the basis of professional purity, which was negatively correlated with feminization, specialties that had the greatest proportion of women also had the lowest formal rewards. These findings contrast with the authors' findings for the level of informal "black market" rewards. Women were less likely to receive informal rewards than men, especially if they worked in subfields high in professional purity. The authors conclude that the link between professional purity and feminization is critical in explaining pay differences informal work rewards while gender itself is the critical factor in explaining informal reward differences.