Gender Authorship Trends Among Craniofacial Publications: A 20-Year Analysis

Abstract

This study aims to identify gender disparities within the subspecialty of craniofacial surgery as women surgeons remain underrepresented in academia and leadership, arenas heavily dictated by research productivity. All craniofacial articles published in 3 major research journals from 2000 to 2020 were reviewed and evaluated in 5-year increments. Information regarding author gender, authorship distribution, geographic origin, and publication type was collected. ANOVA, χ2, and logistic regression modeling were used for analysis. In total, there were 3684 articles with 15 206 total authors—3128 (20.6%) were women, including 665 (21.3%) first authors, 1980 (63.2%) middle authors, and 487 (15.7%) senior authors. Mean women authorship increased significantly from 2000 to 2020 (0.33 vs 1.22 P < .001) with corresponding significant increases in first and senior authorship (8.63% vs 27.02; 5.65% vs 16.13%; P < .001). Statistically significant trends across time were observed for first and senior authorships ( P < .001). Women were more likely to publish original publications as first and senior authors (OR: 1.83, P < .001; OR: 1.37, P = .0012). Women were less likely to publish editorial articles (OR 0.6, P < .001). The United States ranked third in publication output by female first authors but was behind all regions except Africa for output by female senior authors. Although female authorship has increased significantly over the last 2 decades, women remain a minority within the craniofacial literature. Further research is needed to elicit the root of these disparities.

Assessment of Sex Diversity Among Craniofacial Academic Faculty

“…A study by Wang et al5 examining 2 decades of sex authorship trends in craniofacial literature found that women remain a minority among craniofacial publication authorship. It has been emphasized that women in surgery are asked to hold multiple administrative roles that can take away from academic productivity and may carry less weight in consideration of promotion 16.…”

“…Only 20.6% of all authors in craniofacial journals from 2000 to 2020 were female. 5 Disparities also exist between sexes with regard to the proportion of females publishing and receiving invitations for podium presentations at national meetings, with just 10.9% of all speakers at the American Society of Plastic Surgeons meeting being female. 2,6 Although there is an increase in female medical students pursuing plastic surgery, it does not seem to relate to the amount of females going into academia.…”

“…Although diversity at the fellowship levels has increased, there is still a lack of diversity in research productivity, an important benchmark for academia and leadership. Only 20.6% of all authors in craniofacial journals from 2000 to 2020 were female 5. Disparities also exist between sexes with regard to the proportion of females publishing and receiving invitations for podium presentations at national meetings, with just 10.9% of all speakers at the American Society of Plastic Surgeons meeting being female 2,6…”

Article Factors Influencing Gender Disparities in Senior Authorship of Plastic Surgery Publications

“…To our knowledge, no prior studies have evaluated how sex of the senior author has changed across time with respect to study type, subspecialty, or geography. 16,[22][23][24] Original research, such as clinical trials or basic science studies, are associated with more academic prestige than literature reviews or case reports. Typically, collecting original data requires more time and/or funding (eg, laboratory space and research fellows), and these resources have historically been more available to men in academia.…”

“…[25][26][27][28] Thus, interrogating inequality in study type may reveal exacerbations of the academic gap. With respect to subspecialty within plastic surgery, women have had a greater representation in articles related to the breast and burn surgery 16 but reduced representation in those focused on craniofacial 16,24 and aesthetic 23 surgery. These trends in authorship may reflect clinical practice, as there are typically fewer female faculty within the craniofacial and aesthetic subspecialties.…”