International Women’s Day (IWD) was established in 1911 as part of the suffrage movement and is celebrated on 8 March every year worldwide. IWD is an excellent opportunity to reflect on women in anaesthesia and related specialities. In this editorial, I provide a current perspective on women in anaesthesia research, including their role in authorship, reviewing, editing, invited speaking, and leadership, and suggest some activities that can be done to increase the inclusion and visibility of women in academic anaesthesia. THE ANAESTHESIA WORKFORCE Women and girls have excelled in secondary and tertiary education for decades and are highly represented among the best students. In many countries worldwide – including India – more than 50% of medical school graduates are women.1 Anaesthesia is a popular speciality for people of all genders, and in many countries, men maintain only a slim majority over women as a proportion of anaesthesia trainees. Following these scholarly academic strides, the ‘pipeline’ fractures and narrows down, with fewer and fewer women securing full-time academic appointments, achieving promotion and assuming leadership roles. Even the idea of a ‘pipeline’ is gendered because it is based on a typical male trajectory that does not accommodate career interruptions and part-time work associated with childbirth and care of older relatives. AUTHORSHIP Authorship is the most widely recognised metric for scholarly output and a key performance indicator for promotion and grant applications. The underrepresentation of women as authors of original research papers, review articles, and editorials has been well documented.2 In five high-impact anaesthesia journals published in 2008–18, the proportion of woman-authored original research articles increased from 37% in 2008 to 46% in 2018.3 An interesting contrast was seen in the two prominent Indian anaesthesia journals in 2023–4, where women were first authors of 53% and corresponding authors of 51% of original research papers.4 This may be due to women anaesthesiologists preferencing employment in medical colleges over private practice in India. However, women were first authors of only 13% and last authors of only 11% of editorials. Editorials are usually commissioned by journal editors, and editorial writers are usually well-known senior academicians or reviewers. A bias towards men as editorial writers is well described in other fields of medicine.5 REVIEWING Peer review is one of the cornerstones of research integrity and one of the key responsibilities of an academic anaesthesiologist. Although researchers can volunteer to undertake peer review, the ultimate choice of reviewers belongs to the editorial team. Current evidence suggests that this choice is biased because women are considerably under-represented as reviewers.6 For example, over a 2-year period (2016–7), 23% of reviewers for a prominent anaesthesia journal were women and they provided 18% of the reviews. Although the speed of reviewing was similar between men and women reviewers, the authors could not determine whether men were more likely to accept review invitations than women. During the same period, 36% of manuscripts had a woman as a first and/or corresponding author.7 There was no association between the gender of authors and reviewers in this study. EDITING Editors and editors-in-chief are in powerful positions to shape the literature and influence the careers of academic anaesthetists. It is well documented that women are under-represented in editing roles in anaesthesia journals. Although there has been progress over the last decade,8 in 2025, 82% of anaesthesiology journal editors-in-chief and 74% of editors were men.9 Interestingly, there was a strong association between the representation of women on editorial boards and the publication of articles authored by women.9 SPEAKING Speaking at meetings is a great way for researchers to publicise their research and enhance their track record. Meetings also provide substantial networking opportunities that may foster future research collaborations, and reviewer and editorial invitations. The various speaking roles at scientific meetings include original research presentations (usually by application), review lectures, and keynote orations (usually by invitation). Women are historically under-represented as lecturers and keynotes because they are not invited and/or because they must decline due to caregiver responsibilities at home.10 LEADERSHIP Inequity in academic anaesthesia is most evident at the level of senior leadership, where women remain under-represented as full professors, heads of hospital units, and chairs of university departments.11 Among many potential reasons, including career interruptions, part-time work, unequal pay, and biases related to promotion, the expectation that women adopt a traditionally masculine style of leadership may place an undue burden on them and detract from their success.12 SOLUTIONS Real change will occur only when women and men work as partners in caring for children and older relatives rather than the current scenario where men act as enablers or helpers of women. This long-term societal change depends on Governments enacting legislation that promotes equal opportunity; prevents discrimination, bullying, and harassment at work; and makes adequate provision for parental leave. It also depends on the enthusiastic participation of all sectors in society. While I believe that the onus for change should be largely on society and medical organisations, women in academic anaesthesiology should be proactive about their academic careers. This self-driven approach builds visibility and resilience in the field of academic anaesthesiology. In the meantime, academic anaesthesiologists (both male and female) can consider the following actions to improve the lot of women in research: Consider the gender composition of your research group When you put together a team to do a research project or establish a research program, ensure that your team is gender-balanced. Think about how women can be included as chief investigators on grant applications and whether a woman should be first and/or corresponding author of the main manuscript. Ensure that emerging women researchers are appropriately mentored and connected with women in research networks. Writing and submitting your manuscript When you write up your results or submit a review article or editorial, refer to the work of women as well as men researchers. When you suggest potential reviewers, aim for at least 50% of your suggestions to be women. Reviewing submitted manuscripts Volunteer to review manuscripts for reputable journals. When you are invited to review for a journal, ensure that authors follow guidelines about reporting of sex and gender and consider sex/gender in sub-groups analyses. Suggest women as editorial writers. Join an editorial board Encourage women to join journal editorial boards. Ensure that women have enough information and training about the processes, obligations, and rewards of being an editor. Only work with journals that support diversity, inclusion, and equity. Ensure equity in conference programmes If you are organising a conference, ‘take the pledge’ to include 50:50 men and women on the programme – from the original research presentations through to the keynote orations.13 If you are invited to speak at a conference, enquire about gender equity and insist on adequate inclusion of women before you agree to participate. Reflect, learn, and grow Continuous leadership development is vital for all doctors at all levels of training and consultant practice.14 Evidence-based leadership models and international experts are widely available and should be considered. Take any opportunities that arise to learn about leadership, volunteer for leadership opportunities, reflect on your attitudes towards equity, learn about your own biases and how other organisations and nations deal with these issues, and become an advocate for women in academic anaesthesiology. CONCLUSIONS The journey towards equity and inclusion for women in anaesthesia research will be a long one, and resilience and compromise will be required by women and men. My hope is that women and men work collegially and in good faith to achieve this goal. Study data availability Not applicable. Disclosure of use of artificial intelligence (AI)-assistive or generative tools Not used. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
K B Leslie (Sun,) studied this question.