Progress and Gaps: Two Decades of Female Authorship in High-Impact Otolaryngology Journals.

OBJECTIVE: To evaluate longitudinal trends in female authorship in high-impact otolaryngology journals and assess changes in representation across first and last author positions over a 20-year period. STUDY DESIGN: Cross-sectional bibliometric analysis. SETTING: Three high-impact otolaryngology journals: JAMA Otolaryngology-Head & Neck Surgery, The Laryngoscope, and Otolaryngology-Head and Neck Surgery. METHODS: Research articles published in 2004 and 2024 were identified. First and last author genders were determined using publicly available sources. Descriptive statistics and proportional comparisons were performed to compare gender distribution across authorship positions and time points. RESULTS: A total of 3733 authors across 1948 original articles were analyzed. Overall female authorship increased from 15.5% in 2004 to 33.5% in 2024 (P < .001). Female first authorship more than doubled from 15.9% to 39.9% (P < .001), while female last authorship rose more modestly from 15.6% to 26.4% (P < .001). CONCLUSION: Female authorship in otolaryngology has grown substantially over the past 2 decades, reflecting progress in early-career scholarly participation. However, persistent underrepresentation in senior authorship positions highlights enduring barriers to academic advancement. Continued efforts to improve mentorship, sponsorship, and equitable promotion practices are essential to achieving gender equity in otolaryngology scholarship.