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ResearchJan 20, 2023

'You cannot be what you cannot see': why women need equity in research and writing journal papers

Women must have equal prominence with their male counterparts in terms of conducting research and authorship in journals covering the physiotherapy and sports and exercise fields.

Changes are vital because women need to see relatable role models in key leadership positions if they are to feel confident about realising their potential, according to an article published earlier this month (11 January) by the British Journal of Sports Medicine.

The authors warn that that a failure to alter the status quo – in which men have always taken the lead in a disproportionate number of studies and papers – risks dampening women’s ambition to attain prominent positions. As they point out: ‘You cannot be what you cannot see’.

Photo Credit: Shutterstock
It's time to end discrimination in physiotherapy/sport and exercise medicine research


Little change in 10 years 

The article’s lead author is physiotherapist Sallie M Cowan, from the School of Allied Health, Human Services and Sport at La Trobe University in Victoria. Dr Cowan and her colleagues – all of whom are based in Australia and Canada – analysed articles published in four publications – the British Journal of Sports Medicine, Journal of Orthopaedic and Sports Physical Therapy, Physical Therapy in Sport and International Journal of Sports Physical Therapy – in a bid to uncover any underlying sex/gender imbalances.

They scrutinised thousands of papers labelled as ‘research’ or ‘editorial/opinion’ that appeared in 2008/2009 and 10 years later (2018/2019) to identify the number of women and men listed as being a first and last author (positions that reflect the importance of the author’s contribution and/or seniority).

Though the results showed that more women authors were listed as lead or final author in the more recent two-year tranche, the increase was fairly marginal, the authors note.

‘Compared with 2008/2009, the proportion of women as first and last authors was 3.6 per cent (33.0 per cent compared with 29.4 per cent) and 4.8 per cent (33.2 per cent compared with 27.4 per cent) higher respectively in 2018/2019.’

 For too long, we have tolerated gender/sex discrimination in sport and exercise medicine/physiotherapy research – now is the time for actions to redress the gender/sex gap [Sallie M Cowan et al]

Concern over ratio of women participants

The authors note that the proportion of women participating in original studies ‘remained largely unchanged over the 10-year period’. In addition, only 10 per cent of all the participants who took part in the studies were female.

‘Our study indicates that having more women in leading author positions (ie, first and last) was associated with greater inclusion of women participants. Increasing women’s leadership of research may deliver a simple means to increase the representation of women participants in sport and exercise medicine/physiotherapy research. This, and other strategies with potential to increase women research participants are required.’

Gender parity among graduates not replicated elsewhere

Dr Cowan and her colleagues point out that the gender parity that now exists among graduates in the medical and allied health fields has not transferred to academic leadership positions.

‘Women are under-represented in publications, grant funding, leadership roles, conference keynotes and as panel members compared with men. Under-representation of women in leadership denies women important role models – you cannot be what you cannot see.’

Limitations: sex and gender 'conflated'

In a section looking at their study’s limitations, the authors note that many of the articles’ authors conflated ‘sex’ and ‘gender’ and did state whether they asked the participants to identify based on their biology or sociocultural identity.

They ‘implore’ researchers to understand the terms and accurately and appropriately collect and report data relating to sex and/or gender, and provide non-binary options). ‘As such, some of our gender/sex assessments may have been incorrect,’ they add. 

Conclusion: time to address the 'gender/sex gap'

Dr Cowan and her colleagues conclude: ‘Women are under-represented in leadership positions in sport and exercise medicine/physiotherapy journals, and women participants are understudied.

‘Further, there has been little change in women author representation and in the number of women participants included in research between 2008/2009 and 2018/2019. It is time for funders, academic journals, universities and research leads to take bold actions to address these inequities, which have wide-ranging and enduring consequences.

The add: ‘For too long, we have tolerated gender/sex discrimination in sport and exercise medicine/physiotherapy research – now is the time for actions to redress the gender/sex gap.’

To read the full version of the article, titled Sport and exercise medicine/physiotherapy publishing has a gender/sex equity problem: we need action now! Visit: https://bjsm.bmj.com/content/early/2023/01/11/bjsports-2022-106055?s=03

Author: Ian A McMillan
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