Everyone loses when the opinions of qualified women are not heard. The BMJ Gender Diversity Group shares how you can help us improve the gender balance of expert voices in The BMJ
The covid-19 pandemic has surfaced many distressing truths about ingrained structural and systemic bias across society, from horrific racial injustice to disproportionate economic impacts on women. Medicine and academia are no exception. Emblematic of this structural bias is the extent to which men dominate both public and academic discourse about covid-19 and decisions about how to handle the pandemic.
Women are underrepresented in discourse and decision making about the pandemic
Most healthcare workers are women but few appear as experts in medical journals, on television news, or in the popular press. Even fewer are in the rooms where decisions are made. According to Women in Global Health, women make up only 20% of the WHO Emergency Committee on covid-19 and 16% of the WHO-China joint mission on covid-19, despite women accounting for 70% of the global health workforce on clinical frontlines.
The picture is no better at a national policy level if Italy, the US, and UK—three countries with among the current highest numbers of covid-19 deaths—are anything to go by. There are no women on the Italian scientific committee dealing with the pandemic, and 80% of those on its covid management team are men. Only 10% of the members of the US coronavirus task force are women. The UK’s influential Scientific Advisory Group for Emergencies (SAGE) and covid-19 response committees are also heavily male, with just 15 (22%) women among the 69 named members in the main SAGE group (two participants are unnamed). As a recent article in BMJ Global Health examining 24 national coronavirus task forces concluded, “From the available data on Covid-19 decision-making entities, female representation is particularly paltry,” with just three having either gender parity or more female than male members.
A similar imbalance can be seen in the media. An analysis of experts appearing on UK news programmes since the start of the pandemic by City University’s Expert Women Project reported a three year high in the number of male experts in March 2020, with 2.7 male pundits appearing for every woman.
Even covid-19 research is dominated by men
The bias against women persists beyond policy making and commentary into covid-19 research. Even before covid, we knew that, despite increasing numbers of women in academia, men persistently publish more than women across the course of their careers. Women actually publish as many papers as men on a yearly basis but are much more likely to drop out of academia or have shorter careers.
The causes of this “productivity puzzle” are under debate. Structural biases within science and academia are clearly contributory, but social factors such as women’s greater domestic and family responsibilities are likely to play their part. With the pandemic exacerbating the disparity in these responsibilities, as described in this analysis in the Observer newspaper in the UK, is it any surprise that we are seeing an effect on women’s professional outputs, including signals that research submissions from women have decreased across the board?
Journals are part of the problem
Across BMJ’s 70 specialty journals there is a pre-existing inequity: 39% of all publications in 2019 across these journals had a female first author (53% male, 8% unknown).
This has worsened since the onset of covid, where for covid-19 related articles published in 2020, the proportion of female first authors was lower (26% female, 60% male, 14% unknown). Many of these articles are editorials (20% of all BMJ specialty journals’ covid-19 publications) and 82% of these had male first authors.
First authorship of 161 research papers published in The BMJ in 2019 was predominantly male (61% male, 37% female, 1% unknown) and has remained so for the 13 articles on covid-19 published in 2020 (62% male, 38% female). However, first authorship of the 174 editorials published in 2019 was more equitable (52% male, 48% female) but female first authorship has dipped slightly (44% female) for the 25 editorials on covid-19 in 2020 as we strived to find female editorialists in the pandemic.
This internal audit (limited by being based only on first authorship) may indicate how the pandemic is stifling both the foregrounding of women’s voices and their research output. In a rapidly changing pandemic, editors are under pressure to produce high quality content fast. Journal editors who need reviewers or editorialists may fall prey to biases that reinforce rather than challenge existing inequalities: we turn to the seeming safety of “tried and true” experts who are available to meet tight deadlines, as opposed to spending our time and resources seeking out less prominent, and available voices. In other words, unless mitigations are consciously put in place, a crisis creates conditions favouring male experts and authors.
Help us change things
Are there so few women whose voices are worth hearing? We don’t think so. We are conscious that we need to do better. We are committed to seeking out women experts, commentators, and authors, and to encourage all editors to speak up when the same male voices are being suggested by default. We have searched our reviewer and author databases for women with relevant expertise so that we have a rapid source of women experts. We want to create opportunities for women to contribute to the covid-19 discourse.
We know that women are not as quick as men to suggest themselves as experts, and not as likely to accept invitations to air their opinions. But we are committed to improving the gender balance of expert voices in The BMJ, and you can help. Are you a woman with expertise relevant to the pandemic, or do you know someone who is? Please join our reviewer database so we can add you to our expert list. Pitch us your ideas for editorials, analysis, or education articles. Send us your research.
Everyone loses when the opinions of qualified women are not heard and women are not involved in decision making. For journals, the quality of our content suffers when we don’t include a full and diverse range of expert voices. From a global health perspective, overlooking the entire talent pool has been likened to fighting covid-19 with one hand tied behind our back. Important perspectives are missed and there’s a risk that inequalities are perpetuated or worsened. As UN secretary-general António Guterres put it in a speech about women and power in February: “Only through the equal participation of women can we benefit from the intelligence, expertise and insights of all of humanity.”
You can register as a reviewer for The BMJ via our online editorial office (https://mc.manuscriptcentral.com/bmj). Be sure to add keywords and special interests that will identify you as an expert on covid-19 related topics so that you will show up when editors search for experts. Please also consider registering as a reviewer for our specialty journals.
Cat Chatfield (research integrity editor at The BMJ), Richard Hurley (features and debates editor at The BMJ), Navjoyt Ladher (head of education for The BMJ), Elizabeth Loder (head of research for The BMJ), Mark Richards (transfer editor at BMJ), and Sara Schroter (senior researcher at The BMJ) on behalf of The BMJ Gender Diversity Group.