Prospective analyses of sex/gender-related publication decisions in general  medical journals: editorial rejection of population-based women's reproductive  physiology

Dharani Kalidasan; Azita Goshtasebi; Joan Chrisler; Helen L Brown; Jerilynn C Prior

doi:10.1136/bmjopen-2021-057854

Prospective analyses of sex/gender-related publication decisions in general medical journals: editorial rejection of population-based women's reproductive physiology

Kalidasan D, Goshtasebi A, Chrisler J, Brown HL, Prior JC

Published February 25, 2022 BMJ Open, 12(2), e057854

DOI 10.1136/bmjopen-2021-057854 PMID 35217542 PMC PMC8883282

RRM Academy Synopsis

Men were 84% of senior authors in ten issues of five journals

A prospective review of 74 research articles in ten issues of five top medical journals found that men were the senior author on 84% of the papers. The issues held no women's health studies outside disease topics. The issues studied followed desk rejections of two women's reproductive manuscripts at five journals.

Key Findings

Of 797 articles in ten issues, 74 original research articles were analyzed. The issues followed rejection of two women's reproductive manuscripts at five journals.
Men were 84% of senior authors and 69% of first authors. Women were first author on 31% (range 21–46) and senior author on 16% (range 8–21).
Women's health was the overall focus of 12% of the 74 articles, mostly pregnancy-related conditions and breast cancer. No normal-function article related to women or women's reproduction.
Diseases or their treatment were the focus of 50 of 74 articles (68%).
Eight of ten rejection emails came from women, usually in lower ranked roles. None came from an Editor-in-Chief. One of the ten letters included any review.

Interpretation

The authors used content analysis: they counted author gender and topics in published articles and noted who signed the rejection letters. The sample is small at 74 articles. Author gender came from public profiles, and for 11 authors (15%) from first names alone, which the authors say carries a higher chance of error. The authors state they cannot know how many men's manuscripts on reproductive topics were rejected without review. The senior author of this paper was senior author on one of the two rejected manuscripts and first author on the other. The design describes patterns and cannot show why any manuscript was rejected.

RRM Context

One rejected manuscript reported ovulatory disturbances in 24%–37% of women with normal-length cycles, among over 3000 women. RRM clinicians treat ovulation as a vital sign. The authors propose a sex/gender champion on editorial boards, a committee for author appeals, and gender parity in double-blind peer review.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To assess whether editorial desk rejection at general medical journals (without peer review) of two clinical research manuscripts may relate to author gender or women's physiology topics. Given evidence for bias related to women in science and medicine, and editorial board attitudes, our hypothesis was that submissions by women authors, on women's reproductive, non-disease topics received differential editorial assessment.

Design

A prospective investigation of publications, author gender and topics in general medical journals in two issues following the editorial rejections of two clinical research manuscripts by five major English-language general medical journals. The rejected manuscripts (subsequently published in lower impact journals) described research funded by national granting bodies, in population-based samples, authored by well-published women scientists at accredited institutions and describing innovative women's reproductive physiology results.

Setting

Tertiary academic medical centre.

Main Outcome Measures

All clinical research published in the two issues following rejection date by each of the five major general medical journals were examined for first/senior author gender. The publication topic was assessed for its gendered population relevance, whether disease or physiology focused, and its funding. Rejection letters assessed editor gender and status.

Results

Women were underrepresented as original research authors; men were 84% of senior and 69% of first authors. There were no, non-disease focused publications relating to women's health, although most topics were relevant to both genders. The majority (80%) of rejection letters appeared to be written by junior-ranked women editors.

Conclusion

Sex/gender accountability is necessary for clinical research-based editorial decisions by major general medical journals. Suggestions to improve gender equity in general medical journal publication: (1) an editorial board sex/gender champion with power to advocate for manuscripts that are well-performed research of relevance to women's health/physiology; (2) an editorial rejection adjudication committee to review author challenges; and (3) gender parity in double-blind peer review.

Dharani Kalidasan, Azita Goshtasebi, Joan Chrisler, Helen L Brown, Jerilynn C Prior

D Kalidasan, A Goshtasebi, J Chrisler, H Brown, J Prior

PMID 35217542 35217542 DOI 10.1136/bmjopen-2021-057854 10.1136/bmjopen-2021-057854 Kalidasan et al. 2022, Kalidasan 2022

Prospective analyses of sex/gender-related publication decisions in general medical journals: editorial rejection of population-based women's reproductive physiology

Men were 84% of senior authors in ten issues of five journals

Key Findings

Interpretation

RRM Context

Abstract

By this author

Energy intake and appetite in laboratory and free-living conditions may be consistent across menstrual cycle phases

MON-154 Breast areolar diameter in healthy menstruating women—a single cycle cross-sectional study of associations with body size and ovulatory characteristics

SAT-128 Prospective 1-year Menstrual CycleBreast Tenderness and Swelling Experiences—data from healthy regularly cycling women initially proven normally ovulatory on two consecutive cycles

SUN-109 Feasibility of Cyclic Progesterone and Spironolactone for PCOS-specific Health-Related Quality of Life—a six-month, Phase II, single arm, single center, open-label study

Related research

Reflecting sex, social class and race inequalities in reproduction? Study of the gender representations conveyed by 38 fertility centre websites in 8 European countries