Gender-Based Differences in X Usage Among Orthopedic Surgeons at Top-Ranked US Hospitals: Cross-Sectional Analysis

Gender disparities in academic medicine persist, particularly in male-dominated fields such as orthopedic surgery. Social media platforms are reshaping academic communication, although data describing gender differences in use and engagement are limited.

This study aims to examine gender differences by X (formerly known as Twitter) use among orthopedic surgeons, including variations in engagement, content, and influence.

This cross-sectional study evaluated publicly available data from the 2023 US News and World Report top 20 hospitals for orthopedic surgery. Demographic data, apparent gender (binary), and public X data were collected.

Of 1327 orthopedic surgeons, 25% (332/1327) were on X. X users were more likely to hold leadership roles (P<.001), higher faculty appointments (P<.001), and additional advanced degrees (P=.007). Women X users (vs men) were less likely to be full professors (12% vs 20%; P=.04). While women (vs men) had similar numbers of followers, following, and posts (P>.05), women liked more posts (median 242 vs 35, P=.006). On thematic analysis of biographical content, women were more likely to mention being a parent, spouse, or their hobbies and interests (24.4% vs 12.1%; P=.048).

Orthopedic surgeons on X were more likely to have higher academic rank, leadership titles, and dual degrees, although gender disparities persisted with women X users harboring lower rates of full professorship. Women orthopedic surgeons were more actively engaged with other posts on X. The motivation behind these trends is worthy of further study.