Closing the gender authorship gap

Since the mid-1960s, slightly more men than women have been present on this planet. In 2022, 4 billion males and 3.95 billion females were living worldwide, implying 50.4% of the world population is male and 49.6% female. By 2050, however, it is expected that the sex ratio will even out and, after 2050, females will outnumber males [1]. Currently, women already outnumber men in the older age groups because of the differences in mortality between men and women, with woman tending to live longer than men.

Although females account for a significant proportion of the patient population, in the past women were excluded from participation in studies. Therefore, research data collected from men were generalized to women, despite the fact that disease symptoms and drug metabolism are different in women and men. The gap in female data resulted in longer times to diagnosis for women than for men, with more frequent misdiagnoses and women more often mistakenly discharged while having a serious medical event [2]. Although this gender gap is improving, it is still present [3].

But what about a gender gap in authorships? In this issue of Endoscopy, Elisabetta Mastrorocco et al. performed a systematic review to assess whether there is a gender gap in the authorship of scientific research in gastrointestinal journals and in the principal investigators [4] of ongoing research.

“I hope that both this editorial and the systematic review written mostly by women will contribute to, stimulate, and encourage men and women to further close the gender authorship gap.”

A total of 4207 articles were included: 2205 US-based and 2002 European-based. First female authorship was found in 33.4% of the articles; senior female authorship in 21.6%. US-based journals showed a statistically significant lower percentage of first female authors, but not of senior female authors. In the analysis of single journals, they found the lowest percentage of first female authors to be in the endoscopy-related journals, namely Gastrointestinal Endoscopy (GIE) at 23% and Endoscopy at 25%. For senior female authorship, the lowest rate was found in Clinical Gastroenterology and Hepatology at 9%, followed by Endoscopy and GIE, at 12.3% and 15%, respectively. There was more likelihood of publications having female authorship in the more clinically oriented topics, like hepatology, inflammatory bowel disease, and upper and lower gastrointestinal disease; however, even in these topics, the percentage of female senior authors remained significantly lower than the percentage of first female authors.

Mastrorocco et al. also found a significant correlation between last and first female authorship. Where the last author was a woman, the first author was female in 51% of publications; when the last author was a man, this percentage came down to 28%. This correlation between last and first female authorship has also been found in other specialties, such as vascular surgery, transplantation surgery, and cardiology [4] [5] [6], while in infectious disease journals, the proportion of female editors appeared to influence the proportions of female last and first authors [7].

Remarkably, in most of the papers that have addressed the gender authorship gap, the first author has been a woman. This may be due to the fact that women recognize this gender gap and want to publish about it, or that the idea became apparent by men and asking women to dive into it to close the gap at the same time.

The positive news is that overall there has been a slight increase in female first and last authorships over recent years, which may be a result of the increase in women in science and medicine. I hope that both this editorial and the systematic review written mostly by women – including first and last female authorship – being published in an endoscopy journal will contribute to, stimulate, and encourage men and women to further close the gender authorship gap.

Publication History

Article published online:
04 April 2024

• References

• 1 United Nations Department of Economic and Social Affairs. World Population Prospects 2022. Accessed March 19, 2024 at: https://population.un.org/wpp
• 2 Nabel EG. Coronary heart disease in women--an ounce of prevention. NEJM 2000; 343: 572-574 DOI: 10.1056/NEJM200008243430809. (PMID: 10954767)
• 3 Merone L, Tsey K, Russell D. et al. Sex inequalities in medical research: a systematic scoping review of the literature. Womens Health Rep (New Rochelle) 2022; 3: 49-59 DOI: 10.1089/whr.2021.0083. (PMID: 35136877)
• 4 DeFilippis EM, Sinnenberg L, Mahmud N. et al. Gender differences in publication authorship during COVID-19: a bibliometric analysis of high-impact cardiology journals. J Am Heart Assoc 2021; 10: e019005
• 5 Faria I, Montalvan A, Kazimi M. et al. Representation of women authorship in the top 5 transplantation journals in the United States. Transplantation 2024; 108: 802-812 DOI: 10.1097/TP.0000000000004844. (PMID: 37917944)
• 6 Buda AM, Pendleton AA, El-Gabri D. et al. Analysis of authorship trends in vascular surgery demonstrates a sticky surgical floor for women. J Vasc Surg 2022; 75: 20-28 DOI: 10.1016/j.jvs.2021.07.228. (PMID: 34450243)
• 7 Last K, Hubsch L, Cevik M. et al. Association between women‘s authorship and women's editorship in infectious diseases journals: a cross-sectional study. Lancet Infect Dis 2022; 22: 1455-1464