Mensuration and Mitigation of Gender-Based Disparity in Aesthetic Academia: How Can We Do Better?

Abstract

Introduction: Females have long been underrepresented in all surgical disciplines, particularly plastic surgery. In this study, we sought to characterize the state of gender parity in aesthetic surgery academia by comparing gender authorship ratios in published literature as well as a comparison of the current number of practicing female and male plastic surgeons. Materials and Methods: We conducted a retrospective study of peer-reviewed publications relating to Aesthetic/Cosmetic surgery from the Journal of Plastic and Reconstructive Surgery (PRS) and Annals of Plastic Surgery (APS) from January 2009 to December 2020. Title of publication, senior and first authors’ names were extracted and gender of the first and senior authors was assigned by a gender determination application. First author:senior ratios were determined and recorded as follows- Male:Male (M:M), Female:Male (F:M), Male:Female (M:F), and Female:Female (F:F). Temporal trends of practicing plastic surgeons stratified by gender from 2009-2020 was obtained from the ACGME. Univariate, Multivariable logistic regression and Spearman’s rank correlation tests were used as appropriate. Results: We included 1025 articles. Sixteen percent (n= 169) of first authors and 20% (n= 202) of senior authors were female. Obtained ratios include 46 F:F, 156 F:M, 123 M:F, and 700 M:M. There was a positive correlation between increasing year and number of female surgeons r(3) =.99, p = 0.01. In multivariable logistic regression, female senior authorship (OR 1.60; 95% CI, 1.083- 2.343; p <0.0001) and publication year (OR 1.54; 95% CI, 1.119-2.129; p <0.0001) were independently associated with female first authorship. Conclusion: Compared to male first authors, female senior authors were more than one and half times as likely to include a female first author. To achieve gender parity in aesthetic academic surgery, men should mentor and include more female first authors.