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TRENDS IN AUTHOR GENDER AMONG DIVERSITY STUDIES IN PLASTIC SURGERY LITERATURE
Valeria Bustos, MD1, Nerone Douglas, MSc2, Elizabeth Moroni, MD, MHA2, Samyd Bustos, MD2, Bernard T. Lee, MD, MBA, MPH1, Carolyn De La Cruz, MD, FACS2.
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School., Boston, MA, USA, 2Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

PURPOSE: Diversity in plastic surgery is a topic garnering increasing attention in the literature. However, little is known regarding the diversity of the authors of these papers. Despite the increasing number of women in the field of plastic surgery, there is still a deficit in the number of women plastic surgeons in positions of leadership. These positions have long been held by white men of the profession, which additionally has an indirect effect on the representation among publications in the literature. Therefore, this study aims to evaluate gender trends among diversity studies published in Plastic Surgery journals, in order to analyze the trend of women within the field transitioning into leadership roles ultimately increasing representation in the literature.
METHODS: The current literature was queried through PubMed with the search terms "Plastic Surgery" AND "Diversity." All papers from the search were compiled, screened based on the inclusion criteria that the article was within the realm of plastic surgery and focused on a specific aspect of diversity. All articles which met inclusion criteria were included. Names of all authors were collected. The likely gender was adjudicated by using the NamSor Software which predicts gender based on name input. If software-calibrated gender probability was less than 80% certainty, an internet search was conducted by two independent reviewers to corroborate the authorís gender.
RESULTS: A total of 208 papers were identified with our search strategy. Of these, 74 met inclusion criteria. The majority of studies (94.6%) were conducted in the United States. Twenty-two (29.7%) studies pertained to gender diversity. The prevalence of papers related to gender diversity has increased in more recent years, with no papers published prior to 2010, four between 2011 and 2018, and 18 from 2019 to 2021. When considering all papers on diversity, authorship (including first authorship and senior authorship) showed male predominance. Overall, women represented 42.2% of total authors, 39.2% of first authors, and 36.5% of senior authors. In the 22 gender diversity-related papers, authorship showed female predominance, as females comprised 58.8% of authors. Of those, women represented 59.1% of both first authors and senior authors. Overall, authorship on the topic of diversity (and specifically gender diversity) is increasing for both men and women, most notably over the past three years.
CONCLUSION: The prevalence of publications related to diversity, specifically gender diversity, in plastic surgery is increasing over time, as is the number of female authors. While female authorship predominates in papers related to gender diversity, parity is yet to be achieved in papers related to diversity outside of gender diversity. This increase in publications on gender diversity by women in the field also highlights the shift in the increasing number of women into the field of plastic surgery and into positions of leadership.


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