Impact of Representation on Gender Stereotypes and Discrimination for Women Surgeons in Ukraine

Women physicians remain underrepresented in surgical specialties and leadership roles, highlighting the need to address persistent barriers to equality and professional development. We aimed to explore challenges faced by female surgeons in Ukraine, focusing on how representation and leadership influence experiences of discrimination, stereotypes, and career advancement.

We conducted a cross-sectional study using a web-based self-administered anonymous survey among Ukrainian female surgical residents and attendings (January-February 2024). The survey included items on demographics, training, operative autonomy, and workplace experiences. Descriptive statistics and multivariable logistic regression were used to identify factors associated with gender-related challenges.

The survey was accessed 492 times and 340 responses were included: 218 from female attendings (64.1%) and 122 from residents (35.9%). Overall, 17.1% (n = 59) reported being the only woman surgeon at their hospitals and 34.4% (n = 117) were the only female resident. Additionally, 56.8% (n = 193) reported no women in surgical leadership and 43.8% (n = 149) lacked a mentor. Bias and discrimination were widespread: 48.5% (n = 165) reported gender stereotypes, 80.0% (n = 272)-explicit discriminatory comments, 59.1% (n = 201)-primarily assisting in surgeries, and 68.5% (n = 233)-lack of patient trust in surgical competence. Over half (54.4%, n = 188) experienced sexual harassment or objectification by colleagues, with no significant variation by years of practice. In multivariable analysis, hospitals with 8-20 (OR 0.24 and 95% CI: 0.08-0.73) and > 20 (OR 0.21 and 95% CI: 0.06-0.71) female attendings had lower odds of discriminatory comments. Misidentification as nurses and assistants by patients was less likely in hospitals with > 20 attendings (OR 0.14 and 95% CI: 0.02-0.81). Presence of women surgeons in leadership was associated with lower odds of workplace gender stereotypes (OR 0.51 and 95% CI: 0.32-0.84) and sexual harassment (OR 0.58 and 95% CI: 0.36-0.94). Having a mentor (OR 3.71 and 95% CI: 2.03-6.80) and being an attending (OR 3.89 and 95% CI: 1.99-7.60) were linked to reporting similar operative autonomy as men surgeons. Hospital type, capacity, and number of female surgical residents were not significant factors.

Representation of women in surgical attending and leadership roles is associated with fewer workplace gender-related challenges. However, barriers, such as limited operative autonomy and lack of mentorship, remain. Targeted reforms are needed to build more equitable surgical environments in Ukraine.