The glass podium: gender disparities in prestigious ophthalmology conference roles

To analyze gender representation across a hierarchy of speaking roles at major international ophthalmology conferences and quantify disparities in high-prestige invited roles vs merit-based submitted roles.

Annual meetings of 7 international ophthalmology societies (American Academy of Ophthalmology, ASCRS, ESCRS, United Kingdom & Ireland Society of Cataract and Refractive Surgeons, Australian Society of Cataract and Refractive Surgeons, Brazilian Association of Cataract and Refractive Surgery, Irish College of Ophthalmology) from 2019 to 2024.

Retrospective, cross-sectional study.

A total of 40 940 speaker slots were analyzed. Sex was determined using a validated protocol combining API analysis and manual verification. Roles were classified into a 3-tiered hierarchy: tier 1 (high-prestige: named lecturers, keynotes, and awards), tier 2 (invited faculty), and tier 3 (general presenter: submitted papers). Multivariate logistic regression assessed the association between sex and role prestige.

Women held 5397 (36.6%) of tier 3 (submitted) roles but only 45 (25.6%) of tier 1 (high-prestige) roles. In multivariate analysis adjusted for conference and year, women had significantly lower odds of occupying a high-prestige role compared with a submitted role (adjusted odds ratio, 0.59; 95% CI, 0.42-0.84; P = .003). A "glass podium" effect was observed, with women's representation decreasing as role prestige increased.

Despite robust participation in submitted research, women remain underrepresented in the most visible, career-advancing roles. This disparity supports consideration of more objective and structured approaches to speaker invitation and role allocation in invited conference programming.