Trends and disparities in female authorship in surgical publications: A large-scale bibliometric study using natural...

Gender disparities in academic surgery persist, particularly in authorship positions that signal leadership, mentorship, and scholarly influence. Comprehensive global analyses across surgical specialties remain limited. This study examined gender representation among first and last (senior) authors across surgical subspecialties, countries, and continents using natural language processing applied to bibliometric data.

In a cross-sectional bibliometric study of surgical publications indexed in MEDLINE (January 1, 2015, to December 31, 2024), articles were drawn from 30 high-impact journals across 15 subspecialties. Natural language processing tools inferred author gender and country of affiliation. After excluding entries with missing or unclassifiable data, 112,841 articles were analyzed. The main outcome was proportion of female first and last authors by specialty, region, article type, and journal. Secondary measures included temporal trends, Gender Parity Index (GPI), and results of χ² and trend analyses.

Of 112,727 articles, 32,909 (29.2%) had female first authors, and 22,505 (19.9%) had female last authors. Female first authorship increased from 26.1% in 2015 to 34.1% in 2024, and female last authorship increased from 17.8% to 22.8% (both P < .001). Obstetrics/gynecology (59.8%), pediatric surgery (42.5%), and transplant surgery (39.4%) had the highest female first authorship, whereas cardiothoracic surgery (17.6%) and neurosurgery (18.9%) had the lowest. Representation also varied by country (Australia 32.1% vs Japan 10.1%) and article type (editorials 34.6% vs technical reports 14.3%). Differences by specialty, region, and article type were significant (P < .001).

Despite modest progress, substantial gender disparities remain, especially in senior roles, technical specialties, and high-prestige article types. Targeted initiatives are needed to promote equity in surgical research and leadership worldwide.