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Research Article

Twenty years of gender equality research: A scoping review based on a new semantic indicator

Contributed equally to this work with: Paola Belingheri, Filippo Chiarello, Andrea Fronzetti Colladon, Paola Rovelli

Roles Conceptualization, Formal analysis, Funding acquisition, Visualization, Writing – original draft, Writing – review & editing

Affiliation Dipartimento di Ingegneria dell’Energia, dei Sistemi, del Territorio e delle Costruzioni, Università degli Studi di Pisa, Largo L. Lazzarino, Pisa, Italy

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Visualization, Writing – original draft, Writing – review & editing

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Department of Engineering, University of Perugia, Perugia, Italy, Department of Management, Kozminski University, Warsaw, Poland

Roles Conceptualization, Formal analysis, Funding acquisition, Writing – original draft, Writing – review & editing

Affiliation Faculty of Economics and Management, Centre for Family Business Management, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy

• Paola Belingheri, 
• Filippo Chiarello, 
• Andrea Fronzetti Colladon, 
• Paola Rovelli

• Published: September 21, 2021
• https://doi.org/10.1371/journal.pone.0256474
• Reader Comments

9 Nov 2021: The PLOS ONE Staff (2021) Correction: Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLOS ONE 16(11): e0259930. https://doi.org/10.1371/journal.pone.0259930 View correction

Gender equality is a major problem that places women at a disadvantage thereby stymieing economic growth and societal advancement. In the last two decades, extensive research has been conducted on gender related issues, studying both their antecedents and consequences. However, existing literature reviews fail to provide a comprehensive and clear picture of what has been studied so far, which could guide scholars in their future research. Our paper offers a scoping review of a large portion of the research that has been published over the last 22 years, on gender equality and related issues, with a specific focus on business and economics studies. Combining innovative methods drawn from both network analysis and text mining, we provide a synthesis of 15,465 scientific articles. We identify 27 main research topics, we measure their relevance from a semantic point of view and the relationships among them, highlighting the importance of each topic in the overall gender discourse. We find that prominent research topics mostly relate to women in the workforce–e.g., concerning compensation, role, education, decision-making and career progression. However, some of them are losing momentum, and some other research trends–for example related to female entrepreneurship, leadership and participation in the board of directors–are on the rise. Besides introducing a novel methodology to review broad literature streams, our paper offers a map of the main gender-research trends and presents the most popular and the emerging themes, as well as their intersections, outlining important avenues for future research.

Citation: Belingheri P, Chiarello F, Fronzetti Colladon A, Rovelli P (2021) Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLoS ONE 16(9): e0256474. https://doi.org/10.1371/journal.pone.0256474

Editor: Elisa Ughetto, Politecnico di Torino, ITALY

Received: June 25, 2021; Accepted: August 6, 2021; Published: September 21, 2021

Copyright: © 2021 Belingheri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its supporting information files. The only exception is the text of the abstracts (over 15,000) that we have downloaded from Scopus. These abstracts can be retrieved from Scopus, but we do not have permission to redistribute them.

Funding: P.B and F.C.: Grant of the Department of Energy, Systems, Territory and Construction of the University of Pisa (DESTEC) for the project “Measuring Gender Bias with Semantic Analysis: The Development of an Assessment Tool and its Application in the European Space Industry. P.B., F.C., A.F.C., P.R.: Grant of the Italian Association of Management Engineering (AiIG), “Misure di sostegno ai soci giovani AiIG” 2020, for the project “Gender Equality Through Data Intelligence (GEDI)”. F.C.: EU project ASSETs+ Project (Alliance for Strategic Skills addressing Emerging Technologies in Defence) EAC/A03/2018 - Erasmus+ programme, Sector Skills Alliances, Lot 3: Sector Skills Alliance for implementing a new strategic approach (Blueprint) to sectoral cooperation on skills G.A. NUMBER: 612678-EPP-1-2019-1-IT-EPPKA2-SSA-B.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The persistent gender inequalities that currently exist across the developed and developing world are receiving increasing attention from economists, policymakers, and the general public [e.g., 1 – 3 ]. Economic studies have indicated that women’s education and entry into the workforce contributes to social and economic well-being [e.g., 4 , 5 ], while their exclusion from the labor market and from managerial positions has an impact on overall labor productivity and income per capita [ 6 , 7 ]. The United Nations selected gender equality, with an emphasis on female education, as part of the Millennium Development Goals [ 8 ], and gender equality at-large as one of the 17 Sustainable Development Goals (SDGs) to be achieved by 2030 [ 9 ]. These latter objectives involve not only developing nations, but rather all countries, to achieve economic, social and environmental well-being.

As is the case with many SDGs, gender equality is still far from being achieved and persists across education, access to opportunities, or presence in decision-making positions [ 7 , 10 , 11 ]. As we enter the last decade for the SDGs’ implementation, and while we are battling a global health pandemic, effective and efficient action becomes paramount to reach this ambitious goal.

Scholars have dedicated a massive effort towards understanding gender equality, its determinants, its consequences for women and society, and the appropriate actions and policies to advance women’s equality. Many topics have been covered, ranging from women’s education and human capital [ 12 , 13 ] and their role in society [e.g., 14 , 15 ], to their appointment in firms’ top ranked positions [e.g., 16 , 17 ] and performance implications [e.g., 18 , 19 ]. Despite some attempts, extant literature reviews provide a narrow view on these issues, restricted to specific topics–e.g., female students’ presence in STEM fields [ 20 ], educational gender inequality [ 5 ], the gender pay gap [ 21 ], the glass ceiling effect [ 22 ], leadership [ 23 ], entrepreneurship [ 24 ], women’s presence on the board of directors [ 25 , 26 ], diversity management [ 27 ], gender stereotypes in advertisement [ 28 ], or specific professions [ 29 ]. A comprehensive view on gender-related research, taking stock of key findings and under-studied topics is thus lacking.

Extant literature has also highlighted that gender issues, and their economic and social ramifications, are complex topics that involve a large number of possible antecedents and outcomes [ 7 ]. Indeed, gender equality actions are most effective when implemented in unison with other SDGs (e.g., with SDG 8, see [ 30 ]) in a synergetic perspective [ 10 ]. Many bodies of literature (e.g., business, economics, development studies, sociology and psychology) approach the problem of achieving gender equality from different perspectives–often addressing specific and narrow aspects. This sometimes leads to a lack of clarity about how different issues, circumstances, and solutions may be related in precipitating or mitigating gender inequality or its effects. As the number of papers grows at an increasing pace, this issue is exacerbated and there is a need to step back and survey the body of gender equality literature as a whole. There is also a need to examine synergies between different topics and approaches, as well as gaps in our understanding of how different problems and solutions work together. Considering the important topic of women’s economic and social empowerment, this paper aims to fill this gap by answering the following research question: what are the most relevant findings in the literature on gender equality and how do they relate to each other ?

To do so, we conduct a scoping review [ 31 ], providing a synthesis of 15,465 articles dealing with gender equity related issues published in the last twenty-two years, covering both the periods of the MDGs and the SDGs (i.e., 2000 to mid 2021) in all the journals indexed in the Academic Journal Guide’s 2018 ranking of business and economics journals. Given the huge amount of research conducted on the topic, we adopt an innovative methodology, which relies on social network analysis and text mining. These techniques are increasingly adopted when surveying large bodies of text. Recently, they were applied to perform analysis of online gender communication differences [ 32 ] and gender behaviors in online technology communities [ 33 ], to identify and classify sexual harassment instances in academia [ 34 ], and to evaluate the gender inclusivity of disaster management policies [ 35 ].

Applied to the title, abstracts and keywords of the articles in our sample, this methodology allows us to identify a set of 27 recurrent topics within which we automatically classify the papers. Introducing additional novelty, by means of the Semantic Brand Score (SBS) indicator [ 36 ] and the SBS BI app [ 37 ], we assess the importance of each topic in the overall gender equality discourse and its relationships with the other topics, as well as trends over time, with a more accurate description than that offered by traditional literature reviews relying solely on the number of papers presented in each topic.

This methodology, applied to gender equality research spanning the past twenty-two years, enables two key contributions. First, we extract the main message that each document is conveying and how this is connected to other themes in literature, providing a rich picture of the topics that are at the center of the discourse, as well as of the emerging topics. Second, by examining the semantic relationship between topics and how tightly their discourses are linked, we can identify the key relationships and connections between different topics. This semi-automatic methodology is also highly reproducible with minimum effort.

This literature review is organized as follows. In the next section, we present how we selected relevant papers and how we analyzed them through text mining and social network analysis. We then illustrate the importance of 27 selected research topics, measured by means of the SBS indicator. In the results section, we present an overview of the literature based on the SBS results–followed by an in-depth narrative analysis of the top 10 topics (i.e., those with the highest SBS) and their connections. Subsequently, we highlight a series of under-studied connections between the topics where there is potential for future research. Through this analysis, we build a map of the main gender-research trends in the last twenty-two years–presenting the most popular themes. We conclude by highlighting key areas on which research should focused in the future.

Our aim is to map a broad topic, gender equality research, that has been approached through a host of different angles and through different disciplines. Scoping reviews are the most appropriate as they provide the freedom to map different themes and identify literature gaps, thereby guiding the recommendation of new research agendas [ 38 ].

Several practical approaches have been proposed to identify and assess the underlying topics of a specific field using big data [ 39 – 41 ], but many of them fail without proper paper retrieval and text preprocessing. This is specifically true for a research field such as the gender-related one, which comprises the work of scholars from different backgrounds. In this section, we illustrate a novel approach for the analysis of scientific (gender-related) papers that relies on methods and tools of social network analysis and text mining. Our procedure has four main steps: (1) data collection, (2) text preprocessing, (3) keywords extraction and classification, and (4) evaluation of semantic importance and image.

Data collection

In this study, we analyze 22 years of literature on gender-related research. Following established practice for scoping reviews [ 42 ], our data collection consisted of two main steps, which we summarize here below.

Firstly, we retrieved from the Scopus database all the articles written in English that contained the term “gender” in their title, abstract or keywords and were published in a journal listed in the Academic Journal Guide 2018 ranking of the Chartered Association of Business Schools (CABS) ( https://charteredabs.org/wp-content/uploads/2018/03/AJG2018-Methodology.pdf ), considering the time period from Jan 2000 to May 2021. We used this information considering that abstracts, titles and keywords represent the most informative part of a paper, while using the full-text would increase the signal-to-noise ratio for information extraction. Indeed, these textual elements already demonstrated to be reliable sources of information for the task of domain lexicon extraction [ 43 , 44 ]. We chose Scopus as source of literature because of its popularity, its update rate, and because it offers an API to ease the querying process. Indeed, while it does not allow to retrieve the full text of scientific articles, the Scopus API offers access to titles, abstracts, citation information and metadata for all its indexed scholarly journals. Moreover, we decided to focus on the journals listed in the AJG 2018 ranking because we were interested in reviewing business and economics related gender studies only. The AJG is indeed widely used by universities and business schools as a reference point for journal and research rigor and quality. This first step, executed in June 2021, returned more than 55,000 papers.

In the second step–because a look at the papers showed very sparse results, many of which were not in line with the topic of this literature review (e.g., papers dealing with health care or medical issues, where the word gender indicates the gender of the patients)–we applied further inclusion criteria to make the sample more focused on the topic of this literature review (i.e., women’s gender equality issues). Specifically, we only retained those papers mentioning, in their title and/or abstract, both gender-related keywords (e.g., daughter, female, mother) and keywords referring to bias and equality issues (e.g., equality, bias, diversity, inclusion). After text pre-processing (see next section), keywords were first identified from a frequency-weighted list of words found in the titles, abstracts and keywords in the initial list of papers, extracted through text mining (following the same approach as [ 43 ]). They were selected by two of the co-authors independently, following respectively a bottom up and a top-down approach. The bottom-up approach consisted of examining the words found in the frequency-weighted list and classifying those related to gender and equality. The top-down approach consisted in searching in the word list for notable gender and equality-related words. Table 1 reports the sets of keywords we considered, together with some examples of words that were used to search for their presence in the dataset (a full list is provided in the S1 Text ). At end of this second step, we obtained a final sample of 15,465 relevant papers.

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https://doi.org/10.1371/journal.pone.0256474.t001

Text processing and keyword extraction

Text preprocessing aims at structuring text into a form that can be analyzed by statistical models. In the present section, we describe the preprocessing steps we applied to paper titles and abstracts, which, as explained below, partially follow a standard text preprocessing pipeline [ 45 ]. These activities have been performed using the R package udpipe [ 46 ].

The first step is n-gram extraction (i.e., a sequence of words from a given text sample) to identify which n-grams are important in the analysis, since domain-specific lexicons are often composed by bi-grams and tri-grams [ 47 ]. Multi-word extraction is usually implemented with statistics and linguistic rules, thus using the statistical properties of n-grams or machine learning approaches [ 48 ]. However, for the present paper, we used Scopus metadata in order to have a more effective and efficient n-grams collection approach [ 49 ]. We used the keywords of each paper in order to tag n-grams with their associated keywords automatically. Using this greedy approach, it was possible to collect all the keywords listed by the authors of the papers. From this list, we extracted only keywords composed by two, three and four words, we removed all the acronyms and rare keywords (i.e., appearing in less than 1% of papers), and we clustered keywords showing a high orthographic similarity–measured using a Levenshtein distance [ 50 ] lower than 2, considering these groups of keywords as representing same concepts, but expressed with different spelling. After tagging the n-grams in the abstracts, we followed a common data preparation pipeline that consists of the following steps: (i) tokenization, that splits the text into tokens (i.e., single words and previously tagged multi-words); (ii) removal of stop-words (i.e. those words that add little meaning to the text, usually being very common and short functional words–such as “and”, “or”, or “of”); (iii) parts-of-speech tagging, that is providing information concerning the morphological role of a word and its morphosyntactic context (e.g., if the token is a determiner, the next token is a noun or an adjective with very high confidence, [ 51 ]); and (iv) lemmatization, which consists in substituting each word with its dictionary form (or lemma). The output of the latter step allows grouping together the inflected forms of a word. For example, the verbs “am”, “are”, and “is” have the shared lemma “be”, or the nouns “cat” and “cats” both share the lemma “cat”. We preferred lemmatization over stemming [ 52 ] in order to obtain more interpretable results.

In addition, we identified a further set of keywords (with respect to those listed in the “keywords” field) by applying a series of automatic words unification and removal steps, as suggested in past research [ 53 , 54 ]. We removed: sparse terms (i.e., occurring in less than 0.1% of all documents), common terms (i.e., occurring in more than 10% of all documents) and retained only nouns and adjectives. It is relevant to notice that no document was lost due to these steps. We then used the TF-IDF function [ 55 ] to produce a new list of keywords. We additionally tested other approaches for the identification and clustering of keywords–such as TextRank [ 56 ] or Latent Dirichlet Allocation [ 57 ]–without obtaining more informative results.

Classification of research topics

To guide the literature analysis, two experts met regularly to examine the sample of collected papers and to identify the main topics and trends in gender research. Initially, they conducted brainstorming sessions on the topics they expected to find, due to their knowledge of the literature. This led to an initial list of topics. Subsequently, the experts worked independently, also supported by the keywords in paper titles and abstracts extracted with the procedure described above.

Considering all this information, each expert identified and clustered relevant keywords into topics. At the end of the process, the two assignments were compared and exhibited a 92% agreement. Another meeting was held to discuss discordant cases and reach a consensus. This resulted in a list of 27 topics, briefly introduced in Table 2 and subsequently detailed in the following sections.

https://doi.org/10.1371/journal.pone.0256474.t002

Evaluation of semantic importance

Working on the lemmatized corpus of the 15,465 papers included in our sample, we proceeded with the evaluation of semantic importance trends for each topic and with the analysis of their connections and prevalent textual associations. To this aim, we used the Semantic Brand Score indicator [ 36 ], calculated through the SBS BI webapp [ 37 ] that also produced a brand image report for each topic. For this study we relied on the computing resources of the ENEA/CRESCO infrastructure [ 58 ].

The Semantic Brand Score (SBS) is a measure of semantic importance that combines methods of social network analysis and text mining. It is usually applied for the analysis of (big) textual data to evaluate the importance of one or more brands, names, words, or sets of keywords [ 36 ]. Indeed, the concept of “brand” is intended in a flexible way and goes beyond products or commercial brands. In this study, we evaluate the SBS time-trends of the keywords defining the research topics discussed in the previous section. Semantic importance comprises the three dimensions of topic prevalence, diversity and connectivity. Prevalence measures how frequently a research topic is used in the discourse. The more a topic is mentioned by scientific articles, the more the research community will be aware of it, with possible increase of future studies; this construct is partly related to that of brand awareness [ 59 ]. This effect is even stronger, considering that we are analyzing the title, abstract and keywords of the papers, i.e. the parts that have the highest visibility. A very important characteristic of the SBS is that it considers the relationships among words in a text. Topic importance is not just a matter of how frequently a topic is mentioned, but also of the associations a topic has in the text. Specifically, texts are transformed into networks of co-occurring words, and relationships are studied through social network analysis [ 60 ]. This step is necessary to calculate the other two dimensions of our semantic importance indicator. Accordingly, a social network of words is generated for each time period considered in the analysis–i.e., a graph made of n nodes (words) and E edges weighted by co-occurrence frequency, with W being the set of edge weights. The keywords representing each topic were clustered into single nodes.

The construct of diversity relates to that of brand image [ 59 ], in the sense that it considers the richness and distinctiveness of textual (topic) associations. Considering the above-mentioned networks, we calculated diversity using the distinctiveness centrality metric–as in the formula presented by Fronzetti Colladon and Naldi [ 61 ].

Lastly, connectivity was measured as the weighted betweenness centrality [ 62 , 63 ] of each research topic node. We used the formula presented by Wasserman and Faust [ 60 ]. The dimension of connectivity represents the “brokerage power” of each research topic–i.e., how much it can serve as a bridge to connect other terms (and ultimately topics) in the discourse [ 36 ].

The SBS is the final composite indicator obtained by summing the standardized scores of prevalence, diversity and connectivity. Standardization was carried out considering all the words in the corpus, for each specific timeframe.

This methodology, applied to a large and heterogeneous body of text, enables to automatically identify two important sets of information that add value to the literature review. Firstly, the relevance of each topic in literature is measured through a composite indicator of semantic importance, rather than simply looking at word frequencies. This provides a much richer picture of the topics that are at the center of the discourse, as well as of the topics that are emerging in the literature. Secondly, it enables to examine the extent of the semantic relationship between topics, looking at how tightly their discourses are linked. In a field such as gender equality, where many topics are closely linked to each other and present overlaps in issues and solutions, this methodology offers a novel perspective with respect to traditional literature reviews. In addition, it ensures reproducibility over time and the possibility to semi-automatically update the analysis, as new papers become available.

Overview of main topics

In terms of descriptive textual statistics, our corpus is made of 15,465 text documents, consisting of a total of 2,685,893 lemmatized tokens (words) and 32,279 types. As a result, the type-token ratio is 1.2%. The number of hapaxes is 12,141, with a hapax-token ratio of 37.61%.

Fig 1 shows the list of 27 topics by decreasing SBS. The most researched topic is compensation , exceeding all others in prevalence, diversity, and connectivity. This means it is not only mentioned more often than other topics, but it is also connected to a greater number of other topics and is central to the discourse on gender equality. The next four topics are, in order of SBS, role , education , decision-making , and career progression . These topics, except for education , all concern women in the workforce. Between these first five topics and the following ones there is a clear drop in SBS scores. In particular, the topics that follow have a lower connectivity than the first five. They are hiring , performance , behavior , organization , and human capital . Again, except for behavior and human capital , the other three topics are purely related to women in the workforce. After another drop-off, the following topics deal prevalently with women in society. This trend highlights that research on gender in business journals has so far mainly paid attention to the conditions that women experience in business contexts, while also devoting some attention to women in society.

https://doi.org/10.1371/journal.pone.0256474.g001

Fig 2 shows the SBS time series of the top 10 topics. While there has been a general increase in the number of Scopus-indexed publications in the last decade, we notice that some SBS trends remain steady, or even decrease. In particular, we observe that the main topic of the last twenty-two years, compensation , is losing momentum. Since 2016, it has been surpassed by decision-making , education and role , which may indicate that literature is increasingly attempting to identify root causes of compensation inequalities. Moreover, in the last two years, the topics of hiring , performance , and organization are experiencing the largest importance increase.

https://doi.org/10.1371/journal.pone.0256474.g002

Fig 3 shows the SBS time trends of the remaining 17 topics (i.e., those not in the top 10). As we can see from the graph, there are some that maintain a steady trend–such as reputation , management , networks and governance , which also seem to have little importance. More relevant topics with average stationary trends (except for the last two years) are culture , family , and parenting . The feminine topic is among the most important here, and one of those that exhibit the larger variations over time (similarly to leadership ). On the other hand, the are some topics that, even if not among the most important, show increasing SBS trends; therefore, they could be considered as emerging topics and could become popular in the near future. These are entrepreneurship , leadership , board of directors , and sustainability . These emerging topics are also interesting to anticipate future trends in gender equality research that are conducive to overall equality in society.

https://doi.org/10.1371/journal.pone.0256474.g003

In addition to the SBS score of the different topics, the network of terms they are associated to enables to gauge the extent to which their images (textual associations) overlap or differ ( Fig 4 ).

https://doi.org/10.1371/journal.pone.0256474.g004

There is a central cluster of topics with high similarity, which are all connected with women in the workforce. The cluster includes topics such as organization , decision-making , performance , hiring , human capital , education and compensation . In addition, the topic of well-being is found within this cluster, suggesting that women’s equality in the workforce is associated to well-being considerations. The emerging topics of entrepreneurship and leadership are also closely connected with each other, possibly implying that leadership is a much-researched quality in female entrepreneurship. Topics that are relatively more distant include personality , politics , feminine , empowerment , management , board of directors , reputation , governance , parenting , masculine and network .

The following sections describe the top 10 topics and their main associations in literature (see Table 3 ), while providing a brief overview of the emerging topics.

https://doi.org/10.1371/journal.pone.0256474.t003

Compensation.

The topic of compensation is related to the topics of role , hiring , education and career progression , however, also sees a very high association with the words gap and inequality . Indeed, a well-known debate in degrowth economics centers around whether and how to adequately compensate women for their childbearing, childrearing, caregiver and household work [e.g., 30 ].

Even in paid work, women continue being offered lower compensations than their male counterparts who have the same job or cover the same role [ 64 – 67 ]. This severe inequality has been widely studied by scholars over the last twenty-two years. Dealing with this topic, some specific roles have been addressed. Specifically, research highlighted differences in compensation between female and male CEOs [e.g., 68 ], top executives [e.g., 69 ], and boards’ directors [e.g., 70 ]. Scholars investigated the determinants of these gaps, such as the gender composition of the board [e.g., 71 – 73 ] or women’s individual characteristics [e.g., 71 , 74 ].

Among these individual characteristics, education plays a relevant role [ 75 ]. Education is indeed presented as the solution for women, not only to achieve top executive roles, but also to reduce wage inequality [e.g., 76 , 77 ]. Past research has highlighted education influences on gender wage gaps, specifically referring to gender differences in skills [e.g., 78 ], college majors [e.g., 79 ], and college selectivity [e.g., 80 ].

Finally, the wage gap issue is strictly interrelated with hiring –e.g., looking at whether being a mother affects hiring and compensation [e.g., 65 , 81 ] or relating compensation to unemployment [e.g., 82 ]–and career progression –for instance looking at meritocracy [ 83 , 84 ] or the characteristics of the boss for whom women work [e.g., 85 ].

The roles covered by women have been deeply investigated. Scholars have focused on the role of women in their families and the society as a whole [e.g., 14 , 15 ], and, more widely, in business contexts [e.g., 18 , 81 ]. Indeed, despite still lagging behind their male counterparts [e.g., 86 , 87 ], in the last decade there has been an increase in top ranked positions achieved by women [e.g., 88 , 89 ]. Following this phenomenon, scholars have posed greater attention towards the presence of women in the board of directors [e.g., 16 , 18 , 90 , 91 ], given the increasing pressure to appoint female directors that firms, especially listed ones, have experienced. Other scholars have focused on the presence of women covering the role of CEO [e.g., 17 , 92 ] or being part of the top management team [e.g., 93 ]. Irrespectively of the level of analysis, all these studies tried to uncover the antecedents of women’s presence among top managers [e.g., 92 , 94 ] and the consequences of having a them involved in the firm’s decision-making –e.g., on performance [e.g., 19 , 95 , 96 ], risk [e.g., 97 , 98 ], and corporate social responsibility [e.g., 99 , 100 ].

Besides studying the difficulties and discriminations faced by women in getting a job [ 81 , 101 ], and, more specifically in the hiring , appointment, or career progression to these apical roles [e.g., 70 , 83 ], the majority of research of women’s roles dealt with compensation issues. Specifically, scholars highlight the pay-gap that still exists between women and men, both in general [e.g., 64 , 65 ], as well as referring to boards’ directors [e.g., 70 , 102 ], CEOs and executives [e.g., 69 , 103 , 104 ].

Finally, other scholars focused on the behavior of women when dealing with business. In this sense, particular attention has been paid to leadership and entrepreneurial behaviors. The former quite overlaps with dealing with the roles mentioned above, but also includes aspects such as leaders being stereotyped as masculine [e.g., 105 ], the need for greater exposure to female leaders to reduce biases [e.g., 106 ], or female leaders acting as queen bees [e.g., 107 ]. Regarding entrepreneurship , scholars mainly investigated women’s entrepreneurial entry [e.g., 108 , 109 ], differences between female and male entrepreneurs in the evaluations and funding received from investors [e.g., 110 , 111 ], and their performance gap [e.g., 112 , 113 ].

Education has long been recognized as key to social advancement and economic stability [ 114 ], for job progression and also a barrier to gender equality, especially in STEM-related fields. Research on education and gender equality is mostly linked with the topics of compensation , human capital , career progression , hiring , parenting and decision-making .

Education contributes to a higher human capital [ 115 ] and constitutes an investment on the part of women towards their future. In this context, literature points to the gender gap in educational attainment, and the consequences for women from a social, economic, personal and professional standpoint. Women are found to have less access to formal education and information, especially in emerging countries, which in turn may cause them to lose social and economic opportunities [e.g., 12 , 116 – 119 ]. Education in local and rural communities is also paramount to communicate the benefits of female empowerment , contributing to overall societal well-being [e.g., 120 ].

Once women access education, the image they have of the world and their place in society (i.e., habitus) affects their education performance [ 13 ] and is passed on to their children. These situations reinforce gender stereotypes, which become self-fulfilling prophecies that may negatively affect female students’ performance by lowering their confidence and heightening their anxiety [ 121 , 122 ]. Besides formal education, also the information that women are exposed to on a daily basis contributes to their human capital . Digital inequalities, for instance, stems from men spending more time online and acquiring higher digital skills than women [ 123 ].

Education is also a factor that should boost employability of candidates and thus hiring , career progression and compensation , however the relationship between these factors is not straightforward [ 115 ]. First, educational choices ( decision-making ) are influenced by variables such as self-efficacy and the presence of barriers, irrespectively of the career opportunities they offer, especially in STEM [ 124 ]. This brings additional difficulties to women’s enrollment and persistence in scientific and technical fields of study due to stereotypes and biases [ 125 , 126 ]. Moreover, access to education does not automatically translate into job opportunities for women and minority groups [ 127 , 128 ] or into female access to managerial positions [ 129 ].

Finally, parenting is reported as an antecedent of education [e.g., 130 ], with much of the literature focusing on the role of parents’ education on the opportunities afforded to children to enroll in education [ 131 – 134 ] and the role of parenting in their offspring’s perception of study fields and attitudes towards learning [ 135 – 138 ]. Parental education is also a predictor of the other related topics, namely human capital and compensation [ 139 ].

Decision-making.

This literature mainly points to the fact that women are thought to make decisions differently than men. Women have indeed different priorities, such as they care more about people’s well-being, working with people or helping others, rather than maximizing their personal (or their firm’s) gain [ 140 ]. In other words, women typically present more communal than agentic behaviors, which are instead more frequent among men [ 141 ]. These different attitude, behavior and preferences in turn affect the decisions they make [e.g., 142 ] and the decision-making of the firm in which they work [e.g., 143 ].

At the individual level, gender affects, for instance, career aspirations [e.g., 144 ] and choices [e.g., 142 , 145 ], or the decision of creating a venture [e.g., 108 , 109 , 146 ]. Moreover, in everyday life, women and men make different decisions regarding partners [e.g., 147 ], childcare [e.g., 148 ], education [e.g., 149 ], attention to the environment [e.g., 150 ] and politics [e.g., 151 ].

At the firm level, scholars highlighted, for example, how the presence of women in the board affects corporate decisions [e.g., 152 , 153 ], that female CEOs are more conservative in accounting decisions [e.g., 154 ], or that female CFOs tend to make more conservative decisions regarding the firm’s financial reporting [e.g., 155 ]. Nevertheless, firm level research also investigated decisions that, influenced by gender bias, affect women, such as those pertaining hiring [e.g., 156 , 157 ], compensation [e.g., 73 , 158 ], or the empowerment of women once appointed [ 159 ].

Career progression.

Once women have entered the workforce, the key aspect to achieve gender equality becomes career progression , including efforts toward overcoming the glass ceiling. Indeed, according to the SBS analysis, career progression is highly related to words such as work, social issues and equality. The topic with which it has the highest semantic overlap is role , followed by decision-making , hiring , education , compensation , leadership , human capital , and family .

Career progression implies an advancement in the hierarchical ladder of the firm, assigning managerial roles to women. Coherently, much of the literature has focused on identifying rationales for a greater female participation in the top management team and board of directors [e.g., 95 ] as well as the best criteria to ensure that the decision-makers promote the most valuable employees irrespectively of their individual characteristics, such as gender [e.g., 84 ]. The link between career progression , role and compensation is often provided in practice by performance appraisal exercises, frequently rooted in a culture of meritocracy that guides bonuses, salary increases and promotions. However, performance appraisals can actually mask gender-biased decisions where women are held to higher standards than their male colleagues [e.g., 83 , 84 , 95 , 160 , 161 ]. Women often have less opportunities to gain leadership experience and are less visible than their male colleagues, which constitute barriers to career advancement [e.g., 162 ]. Therefore, transparency and accountability, together with procedures that discourage discretionary choices, are paramount to achieve a fair career progression [e.g., 84 ], together with the relaxation of strict job boundaries in favor of cross-functional and self-directed tasks [e.g., 163 ].

In addition, a series of stereotypes about the type of leadership characteristics that are required for top management positions, which fit better with typical male and agentic attributes, are another key barrier to career advancement for women [e.g., 92 , 160 ].

Hiring is the entrance gateway for women into the workforce. Therefore, it is related to other workforce topics such as compensation , role , career progression , decision-making , human capital , performance , organization and education .

A first stream of literature focuses on the process leading up to candidates’ job applications, demonstrating that bias exists before positions are even opened, and it is perpetuated both by men and women through networking and gatekeeping practices [e.g., 164 , 165 ].

The hiring process itself is also subject to biases [ 166 ], for example gender-congruity bias that leads to men being preferred candidates in male-dominated sectors [e.g., 167 ], women being hired in positions with higher risk of failure [e.g., 168 ] and limited transparency and accountability afforded by written processes and procedures [e.g., 164 ] that all contribute to ascriptive inequality. In addition, providing incentives for evaluators to hire women may actually work to this end; however, this is not the case when supporting female candidates endangers higher-ranking male ones [ 169 ].

Another interesting perspective, instead, looks at top management teams’ composition and the effects on hiring practices, indicating that firms with more women in top management are less likely to lay off staff [e.g., 152 ].

Performance.

Several scholars posed their attention towards women’s performance, its consequences [e.g., 170 , 171 ] and the implications of having women in decision-making positions [e.g., 18 , 19 ].

At the individual level, research focused on differences in educational and academic performance between women and men, especially referring to the gender gap in STEM fields [e.g., 171 ]. The presence of stereotype threats–that is the expectation that the members of a social group (e.g., women) “must deal with the possibility of being judged or treated stereotypically, or of doing something that would confirm the stereotype” [ 172 ]–affects women’s interested in STEM [e.g., 173 ], as well as their cognitive ability tests, penalizing them [e.g., 174 ]. A stronger gender identification enhances this gap [e.g., 175 ], whereas mentoring and role models can be used as solutions to this problem [e.g., 121 ]. Despite the negative effect of stereotype threats on girls’ performance [ 176 ], female and male students perform equally in mathematics and related subjects [e.g., 177 ]. Moreover, while individuals’ performance at school and university generally affects their achievements and the field in which they end up working, evidence reveals that performance in math or other scientific subjects does not explain why fewer women enter STEM working fields; rather this gap depends on other aspects, such as culture, past working experiences, or self-efficacy [e.g., 170 ]. Finally, scholars have highlighted the penalization that women face for their positive performance, for instance when they succeed in traditionally male areas [e.g., 178 ]. This penalization is explained by the violation of gender-stereotypic prescriptions [e.g., 179 , 180 ], that is having women well performing in agentic areas, which are typical associated to men. Performance penalization can thus be overcome by clearly conveying communal characteristics and behaviors [ 178 ].

Evidence has been provided on how the involvement of women in boards of directors and decision-making positions affects firms’ performance. Nevertheless, results are mixed, with some studies showing positive effects on financial [ 19 , 181 , 182 ] and corporate social performance [ 99 , 182 , 183 ]. Other studies maintain a negative association [e.g., 18 ], and other again mixed [e.g., 184 ] or non-significant association [e.g., 185 ]. Also with respect to the presence of a female CEO, mixed results emerged so far, with some researches demonstrating a positive effect on firm’s performance [e.g., 96 , 186 ], while other obtaining only a limited evidence of this relationship [e.g., 103 ] or a negative one [e.g., 187 ].

Finally, some studies have investigated whether and how women’s performance affects their hiring [e.g., 101 ] and career progression [e.g., 83 , 160 ]. For instance, academic performance leads to different returns in hiring for women and men. Specifically, high-achieving men are called back significantly more often than high-achieving women, which are penalized when they have a major in mathematics; this result depends on employers’ gendered standards for applicants [e.g., 101 ]. Once appointed, performance ratings are more strongly related to promotions for women than men, and promoted women typically show higher past performance ratings than those of promoted men. This suggesting that women are subject to stricter standards for promotion [e.g., 160 ].

Behavioral aspects related to gender follow two main streams of literature. The first examines female personality and behavior in the workplace, and their alignment with cultural expectations or stereotypes [e.g., 188 ] as well as their impacts on equality. There is a common bias that depicts women as less agentic than males. Certain characteristics, such as those more congruent with male behaviors–e.g., self-promotion [e.g., 189 ], negotiation skills [e.g., 190 ] and general agentic behavior [e.g., 191 ]–, are less accepted in women. However, characteristics such as individualism in women have been found to promote greater gender equality in society [ 192 ]. In addition, behaviors such as display of emotions [e.g., 193 ], which are stereotypically female, work against women’s acceptance in the workplace, requiring women to carefully moderate their behavior to avoid exclusion. A counter-intuitive result is that women and minorities, which are more marginalized in the workplace, tend to be better problem-solvers in innovation competitions due to their different knowledge bases [ 194 ].

The other side of the coin is examined in a parallel literature stream on behavior towards women in the workplace. As a result of biases, prejudices and stereotypes, women may experience adverse behavior from their colleagues, such as incivility and harassment, which undermine their well-being [e.g., 195 , 196 ]. Biases that go beyond gender, such as for overweight people, are also more strongly applied to women [ 197 ].

Organization.

The role of women and gender bias in organizations has been studied from different perspectives, which mirror those presented in detail in the following sections. Specifically, most research highlighted the stereotypical view of leaders [e.g., 105 ] and the roles played by women within firms, for instance referring to presence in the board of directors [e.g., 18 , 90 , 91 ], appointment as CEOs [e.g., 16 ], or top executives [e.g., 93 ].

Scholars have investigated antecedents and consequences of the presence of women in these apical roles. On the one side they looked at hiring and career progression [e.g., 83 , 92 , 160 , 168 , 198 ], finding women typically disadvantaged with respect to their male counterparts. On the other side, they studied women’s leadership styles and influence on the firm’s decision-making [e.g., 152 , 154 , 155 , 199 ], with implications for performance [e.g., 18 , 19 , 96 ].

Human capital.

Human capital is a transverse topic that touches upon many different aspects of female gender equality. As such, it has the most associations with other topics, starting with education as mentioned above, with career-related topics such as role , decision-making , hiring , career progression , performance , compensation , leadership and organization . Another topic with which there is a close connection is behavior . In general, human capital is approached both from the education standpoint but also from the perspective of social capital.

The behavioral aspect in human capital comprises research related to gender differences for example in cultural and religious beliefs that influence women’s attitudes and perceptions towards STEM subjects [ 142 , 200 – 202 ], towards employment [ 203 ] or towards environmental issues [ 150 , 204 ]. These cultural differences also emerge in the context of globalization which may accelerate gender equality in the workforce [ 205 , 206 ]. Gender differences also appear in behaviors such as motivation [ 207 ], and in negotiation [ 190 ], and have repercussions on women’s decision-making related to their careers. The so-called gender equality paradox sees women in countries with lower gender equality more likely to pursue studies and careers in STEM fields, whereas the gap in STEM enrollment widens as countries achieve greater equality in society [ 171 ].

Career progression is modeled by literature as a choice-process where personal preferences, culture and decision-making affect the chosen path and the outcomes. Some literature highlights how women tend to self-select into different professions than men, often due to stereotypes rather than actual ability to perform in these professions [ 142 , 144 ]. These stereotypes also affect the perceptions of female performance or the amount of human capital required to equal male performance [ 110 , 193 , 208 ], particularly for mothers [ 81 ]. It is therefore often assumed that women are better suited to less visible and less leadership -oriented roles [ 209 ]. Women also express differing preferences towards work-family balance, which affect whether and how they pursue human capital gains [ 210 ], and ultimately their career progression and salary .

On the other hand, men are often unaware of gendered processes and behaviors that they carry forward in their interactions and decision-making [ 211 , 212 ]. Therefore, initiatives aimed at increasing managers’ human capital –by raising awareness of gender disparities in their organizations and engaging them in diversity promotion–are essential steps to counter gender bias and segregation [ 213 ].

Emerging topics: Leadership and entrepreneurship

Among the emerging topics, the most pervasive one is women reaching leadership positions in the workforce and in society. This is still a rare occurrence for two main types of factors, on the one hand, bias and discrimination make it harder for women to access leadership positions [e.g., 214 – 216 ], on the other hand, the competitive nature and high pressure associated with leadership positions, coupled with the lack of women currently represented, reduce women’s desire to achieve them [e.g., 209 , 217 ]. Women are more effective leaders when they have access to education, resources and a diverse environment with representation [e.g., 218 , 219 ].

One sector where there is potential for women to carve out a leadership role is entrepreneurship . Although at the start of the millennium the discourse on entrepreneurship was found to be “discriminatory, gender-biased, ethnocentrically determined and ideologically controlled” [ 220 ], an increasing body of literature is studying how to stimulate female entrepreneurship as an alternative pathway to wealth, leadership and empowerment [e.g., 221 ]. Many barriers exist for women to access entrepreneurship, including the institutional and legal environment, social and cultural factors, access to knowledge and resources, and individual behavior [e.g., 222 , 223 ]. Education has been found to raise women’s entrepreneurial intentions [e.g., 224 ], although this effect is smaller than for men [e.g., 109 ]. In addition, increasing self-efficacy and risk-taking behavior constitute important success factors [e.g., 225 ].

Finally, the topic of sustainability is worth mentioning, as it is the primary objective of the SDGs and is closely associated with societal well-being. As society grapples with the effects of climate change and increasing depletion of natural resources, a narrative has emerged on women and their greater link to the environment [ 226 ]. Studies in developed countries have found some support for women leaders’ attention to sustainability issues in firms [e.g., 227 – 229 ], and smaller resource consumption by women [ 230 ]. At the same time, women will likely be more affected by the consequences of climate change [e.g., 230 ] but often lack the decision-making power to influence local decision-making on resource management and environmental policies [e.g., 231 ].

Research gaps and conclusions

Research on gender equality has advanced rapidly in the past decades, with a steady increase in publications, both in mainstream topics related to women in education and the workforce, and in emerging topics. Through a novel approach combining methods of text mining and social network analysis, we examined a comprehensive body of literature comprising 15,465 papers published between 2000 and mid 2021 on topics related to gender equality. We identified a set of 27 topics addressed by the literature and examined their connections.

At the highest level of abstraction, it is worth noting that papers abound on the identification of issues related to gender inequalities and imbalances in the workforce and in society. Literature has thoroughly examined the (unconscious) biases, barriers, stereotypes, and discriminatory behaviors that women are facing as a result of their gender. Instead, there are much fewer papers that discuss or demonstrate effective solutions to overcome gender bias [e.g., 121 , 143 , 145 , 163 , 194 , 213 , 232 ]. This is partly due to the relative ease in studying the status quo, as opposed to studying changes in the status quo. However, we observed a shift in the more recent years towards solution seeking in this domain, which we strongly encourage future researchers to focus on. In the future, we may focus on collecting and mapping pro-active contributions to gender studies, using additional Natural Language Processing techniques, able to measure the sentiment of scientific papers [ 43 ].

All of the mainstream topics identified in our literature review are closely related, and there is a wealth of insights looking at the intersection between issues such as education and career progression or human capital and role . However, emerging topics are worthy of being furtherly explored. It would be interesting to see more work on the topic of female entrepreneurship , exploring aspects such as education , personality , governance , management and leadership . For instance, how can education support female entrepreneurship? How can self-efficacy and risk-taking behaviors be taught or enhanced? What are the differences in managerial and governance styles of female entrepreneurs? Which personality traits are associated with successful entrepreneurs? Which traits are preferred by venture capitalists and funding bodies?

The emerging topic of sustainability also deserves further attention, as our society struggles with climate change and its consequences. It would be interesting to see more research on the intersection between sustainability and entrepreneurship , looking at how female entrepreneurs are tackling sustainability issues, examining both their business models and their company governance . In addition, scholars are suggested to dig deeper into the relationship between family values and behaviors.

Moreover, it would be relevant to understand how women’s networks (social capital), or the composition and structure of social networks involving both women and men, enable them to increase their remuneration and reach top corporate positions, participate in key decision-making bodies, and have a voice in communities. Furthermore, the achievement of gender equality might significantly change firm networks and ecosystems, with important implications for their performance and survival.

Similarly, research at the nexus of (corporate) governance , career progression , compensation and female empowerment could yield useful insights–for example discussing how enterprises, institutions and countries are managed and the impact for women and other minorities. Are there specific governance structures that favor diversity and inclusion?

Lastly, we foresee an emerging stream of research pertaining how the spread of the COVID-19 pandemic challenged women, especially in the workforce, by making gender biases more evident.

For our analysis, we considered a set of 15,465 articles downloaded from the Scopus database (which is the largest abstract and citation database of peer-reviewed literature). As we were interested in reviewing business and economics related gender studies, we only considered those papers published in journals listed in the Academic Journal Guide (AJG) 2018 ranking of the Chartered Association of Business Schools (CABS). All the journals listed in this ranking are also indexed by Scopus. Therefore, looking at a single database (i.e., Scopus) should not be considered a limitation of our study. However, future research could consider different databases and inclusion criteria.

With our literature review, we offer researchers a comprehensive map of major gender-related research trends over the past twenty-two years. This can serve as a lens to look to the future, contributing to the achievement of SDG5. Researchers may use our study as a starting point to identify key themes addressed in the literature. In addition, our methodological approach–based on the use of the Semantic Brand Score and its webapp–could support scholars interested in reviewing other areas of research.

Supporting information

S1 text. keywords used for paper selection..

https://doi.org/10.1371/journal.pone.0256474.s001

Acknowledgments

The computing resources and the related technical support used for this work have been provided by CRESCO/ENEAGRID High Performance Computing infrastructure and its staff. CRESCO/ENEAGRID High Performance Computing infrastructure is funded by ENEA, the Italian National Agency for New Technologies, Energy and Sustainable Economic Development and by Italian and European research programmes (see http://www.cresco.enea.it/english for information).

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What does gender equality look like today?

Date: Wednesday, 6 October 2021

Progress towards gender equality is looking bleak. But it doesn’t need to.

A new global analysis of progress on gender equality and women’s rights shows women and girls remain disproportionately affected by the socioeconomic fallout from the COVID-19 pandemic, struggling with disproportionately high job and livelihood losses, education disruptions and increased burdens of unpaid care work. Women’s health services, poorly funded even before the pandemic, faced major disruptions, undermining women’s sexual and reproductive health. And despite women’s central role in responding to COVID-19, including as front-line health workers, they are still largely bypassed for leadership positions they deserve.

UN Women’s latest report, together with UN DESA, Progress on the Sustainable Development Goals: The Gender Snapshot 2021 presents the latest data on gender equality across all 17 Sustainable Development Goals. The report highlights the progress made since 2015 but also the continued alarm over the COVID-19 pandemic, its immediate effect on women’s well-being and the threat it poses to future generations.

We’re breaking down some of the findings from the report, and calling for the action needed to accelerate progress.

The pandemic is making matters worse

One and a half years since the World Health Organization declared COVID-19 a global pandemic, the toll on the poorest and most vulnerable people remains devastating and disproportionate. The combined impact of conflict, extreme weather events and COVID-19 has deprived women and girls of even basic needs such as food security. Without urgent action to stem rising poverty, hunger and inequality, especially in countries affected by conflict and other acute forms of crisis, millions will continue to suffer.

A global goal by global goal reality check:

Goal 1. Poverty

In 2021, extreme poverty is on the rise and progress towards its elimination has reversed. An estimated 435 million women and girls globally are living in extreme poverty.

And yet we can change this .

Over 150 million women and girls could emerge from poverty by 2030 if governments implement a comprehensive strategy to improve access to education and family planning, achieve equal wages and extend social transfers.

Goal 2. Zero hunger

The global gender gap in food security has risen dramatically during the pandemic, with more women and girls going hungry. Women’s food insecurity levels were 10 per cent higher than men’s in 2020, compared with 6 per cent higher in 2019.

This trend can be reversed , including by supporting women small-scale producers, who typically earn far less than men, through increased funding, training and land rights reforms.

Goal 3. Good health and well-being

Disruptions in essential health services due to COVID-19 are taking a tragic toll on women and girls. In the first year of the pandemic, there were an estimated 1.4 million additional unintended pregnancies in lower and middle-income countries.

We need to do better .

Response to the pandemic must include prioritizing sexual and reproductive health services, ensuring they continue to operate safely now and after the pandemic is long over. In addition, more support is needed to ensure life-saving personal protection equipment, tests, oxygen and especially vaccines are available in rich and poor countries alike as well as to vulnerable population within countries.

Goal 4. Quality education

A year and a half into the pandemic, schools remain partially or fully closed in 42 per cent of the world’s countries and territories. School closures spell lost opportunities for girls and an increased risk of violence, exploitation and early marriage .

Governments can do more to protect girls education .

Measures focused specifically on supporting girls returning to school are urgently needed, including measures focused on girls from marginalized communities who are most at risk.

Goal 5. Gender equality

The pandemic has tested and even reversed progress in expanding women’s rights and opportunities. Reports of violence against women and girls, a “shadow” pandemic to COVID-19, are increasing in many parts of the world. COVID-19 is also intensifying women’s workload at home, forcing many to leave the labour force altogether.

Building forward differently and better will hinge on placing women and girls at the centre of all aspects of response and recovery, including through gender-responsive laws, policies and budgeting.

Goal 6. Clean water and sanitation

In 2018, nearly 2.3 billion people lived in water-stressed countries. Without safe drinking water, adequate sanitation and menstrual hygiene facilities, women and girls find it harder to lead safe, productive and healthy lives.

Change is possible .

Involve those most impacted in water management processes, including women. Women’s voices are often missing in water management processes. 

Goal 7. Affordable and clean energy

Increased demand for clean energy and low-carbon solutions is driving an unprecedented transformation of the energy sector. But women are being left out. Women hold only 32 per cent of renewable energy jobs.

We can do better .

Expose girls early on to STEM education, provide training and support to women entering the energy field, close the pay gap and increase women’s leadership in the energy sector.

Goal 8. Decent work and economic growth

The number of employed women declined by 54 million in 2020 and 45 million women left the labour market altogether. Women have suffered steeper job losses than men, along with increased unpaid care burdens at home.

We must do more to support women in the workforce .

Guarantee decent work for all, introduce labour laws/reforms, removing legal barriers for married women entering the workforce, support access to affordable/quality childcare.

Goal 9. Industry, innovation and infrastructure

The COVID-19 crisis has spurred striking achievements in medical research and innovation. Women’s contribution has been profound. But still only a little over a third of graduates in the science, technology, engineering and mathematics field are female.

We can take action today.

 Quotas mandating that a proportion of research grants are awarded to women-led teams or teams that include women is one concrete way to support women researchers. 

Goal 10. Reduced inequalities

Limited progress for women is being eroded by the pandemic. Women facing multiple forms of discrimination, including women and girls with disabilities, migrant women, women discriminated against because of their race/ethnicity are especially affected.

Commit to end racism and discrimination in all its forms, invest in inclusive, universal, gender responsive social protection systems that support all women. 

Goal 11. Sustainable cities and communities

Globally, more than 1 billion people live in informal settlements and slums. Women and girls, often overrepresented in these densely populated areas, suffer from lack of access to basic water and sanitation, health care and transportation.

The needs of urban poor women must be prioritized .

Increase the provision of durable and adequate housing and equitable access to land; included women in urban planning and development processes.

Goal 12. Sustainable consumption and production; Goal 13. Climate action; Goal 14. Life below water; and Goal 15. Life on land

Women activists, scientists and researchers are working hard to solve the climate crisis but often without the same platforms as men to share their knowledge and skills. Only 29 per cent of featured speakers at international ocean science conferences are women.

 And yet we can change this .

Ensure women activists, scientists and researchers have equal voice, representation and access to forums where these issues are being discussed and debated. 

Goal 16. Peace, justice and strong institutions

The lack of women in decision-making limits the reach and impact of the COVID-19 pandemic and other emergency recovery efforts. In conflict-affected countries, 18.9 per cent of parliamentary seats are held by women, much lower than the global average of 25.6 per cent.

This is unacceptable .

It's time for women to have an equal share of power and decision-making at all levels.

Goal 17. Global partnerships for the goals

There are just 9 years left to achieve the Global Goals by 2030, and gender equality cuts across all 17 of them. With COVID-19 slowing progress on women's rights, the time to act is now.

Looking ahead

As it stands today, only one indicator under the global goal for gender equality (SDG5) is ‘close to target’: proportion of seats held by women in local government. In other areas critical to women’s empowerment, equality in time spent on unpaid care and domestic work and decision making regarding sexual and reproductive health the world is far from target. Without a bold commitment to accelerate progress, the global community will fail to achieve gender equality. Building forward differently and better will require placing women and girls at the centre of all aspects of response and recovery, including through gender-responsive laws, policies and budgeting.

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Stanford scholars examine gender bias and ways to advance equity across society

Stanford scholars have studied the obstacles women face across society – at work, in education, as leaders – and how to reach a more equitable society for everyone. 

The overturning of Roe v. Wade has heightened awareness of some of the broader issues the feminist movement and other allies for women’s rights have long championed, particularly advancing gender equality and economic well-being in societies around the globe.

Stanford scholars have studied some of the difficulties of reaching those goals and the many obstacles women face, whether it is at work, in the classroom and education, or as leaders. They have examined how gendered biases are perpetuated, why gender diversity and inclusion are imperative, and what can lead to prejudiced attitudes, assumptions, and adversities ultimately changing.

From the fields of business, social sciences, the humanities, law, education, health, and medicine, here are what Stanford researchers have to say about the evolution of women’s rights and the obstacles to advancing gender equity.

Impacts of overturning Roe v. Wade , and the U.S. Supreme Court

The decision by the U.S Supreme Court to overrule Roe v. Wade in the Dobbs v. Jackson Women’s Health case will carry many wide-reaching and serious consequences for women, say Stanford professors. By ending the constitutional right to abortion, a protection women have had for nearly 50 years, it will now be up to states to decide what reproductive choices are available for women – regardless of the circumstance. 

“No matter the reason a woman seeks to terminate a pregnancy – including because her health is jeopardized, because she was raped, because the fetus has a condition making death likely shortly after birth – a majority of state legislators may usurp that deeply personal decision,” said Stanford law Professor Jane S. Schacter in the wake of the decision. 

Here, Stanford professors shed light on the ramifications the reversal will have, as well as research on the divergence between the justices’ positioning versus public opinion, which the Roe v. Wade overruling highlighted.

A constitutional earthquake: Jane Schacter on SCOTUS decision to overturn Roe v. Wade

Stanford law Professor Jane Schacter, an expert on constitutional law and sexuality, discusses the Supreme Court’s decision to end the constitutional right to an abortion.

Using economics to understand the wide-reaching impacts of overturning Roe v. Wade

The greatest burden of abortion restrictions will likely fall onto low-income women and minorities, says Stanford economist Luigi Pistaferri.

Stanford’s Bernadette Meyler on possible SCOTUS decision to overturn Roe v. Wade

Constitutional law scholar Bernadette Meyler discusses the leaked Dobbs v. Jackson Women’s Health Organization memo and the implications of a possible decision.

The gap between the Supreme Court and most Americans’ views is growing

A new study finds that not only has the court’s majority shifted dramatically rightward in the past two years, its stances are now significantly more conservative than most Americans’.

Protecting reproductive health information after fall of Roe v. Wade

Michelle Mello writes that the overturning of Roe v. Wade – ending federal protection over a woman's right to an abortion – could also expose her personal health data in court.

The pandemic’s effect on women

While the overturning of Roe v. Wade has sent shockwaves across the country, the global pandemic continues to be problematic, particularly among women and people of color. According to Stanford sociologist Shelley Correll , the pandemic alone may set gender equality back a generation as women take on an unfair burden of job losses and child care.

“Feelings of burnout have increased over the last year for both men and women, but more so for women,” Correll said, noting how mental health challenges and the lack of reliable child care continue to be problematic. “My big concern, in terms of gender equality, is that this high level of burnout is going to either drive women out of the paid workforce entirely or cause them to dial back their careers to something that is more manageable.” 

Over the coming months, it will be increasingly clear what the ramifications of both the end of Roe v. Wade and the pandemic will have. But what is already apparent is the urgent need to ensure access to health care, child care, and education, Stanford scholars say. Here is some of that research.

It’s time to prioritize humane, thriving work environments

The global pandemic is an opportunity to make fundamental changes to how society approaches work by creating working environments centered around creativity, problem-solving and equity, says Adina Sterling.

The real benefits of paid family leave

Paid family leave is not a “silver bullet” for advancing gender equity in the workplace, Maya Rossin-Slater says, but it is beneficial for family health and well-being outcomes, particularly infant and maternal health and overall financial stability.

Gender equality could be set back by an entire generation, sociologist warns

Coming out of the pandemic is an opportunity to build more equitable workplaces. Otherwise, burnout is likely going to either drive women out of the paid workforce entirely or cause them to dial back their careers, with long-term consequences for gender equality, says Stanford scholar Shelley Correll.

Equity and inclusion key issues in new work-life balance

With work, school and family life all taking place in our homes, the challenges may be greater for women, according to a focus group consisting of corporate and nonprofit leaders convened by Stanford’s VMware Women’s Leadership Innovation Lab.

Stress during pregnancy doubled during pandemic

As the first shelter-in-place orders took hold in California, pregnant women reported substantially elevated depressive symptoms, potentially adversely affecting their health as well as that of their babies.

Feminism and overcoming gender discrimination across history

For feminists, choice over reproductive health symbolized the human right to self-determination , said Estelle Freedman in her seminal book, No Turning Back: The History of Feminism and the Future of Work (Ballantine Books, 2003). 

As Freedman explains, “Feminists have increasingly insisted that women’s health and children’s welfare must be central to international reproductive policies. In this way, reproductive choice can help alleviate economic injustice as well as extend human rights to women.”

Freedman, along with other Stanford scholars, has studied the evolution of feminist movements and women’s rights across history and the fight for economic justice and human rights in America and across the globe. Some have also examined these movements’ flaws, including historically overlooking people of color and people with a disability. Here are some of their findings.

How World War I strengthened women’s suffrage

Times of crisis can be catalysts for political change, says Stanford legal scholar Pamela S. Karlan. For women activists in the early 20th century, the catalyst was World War I.

The 19th Amendment is a milestone, not endpoint, for women’s rights in America

As the centennial of the 19th Amendment approaches, the milestone in women’s suffrage must also acknowledge the intersection of gender and racial justice in America, says Stanford scholar Estelle Freedman.

Left out of the vote

As the centennial of the 19th Amendment approaches, Stanford scholar Rabia Belt wants to acknowledge a history often overlooked in discourse about the franchise: people living with disabilities.

Why taking gender out of the equation is so difficult

Even as old stereotypes fade, gender remains “a very sticky category,” says Ashley Martin, assistant professor of organizational behavior.

Power forward

Tara VanDerveer, head coach of the Stanford women’s basketball team, talks about the state of women’s sports on the 50th anniversary of Title IX.

Roadblocks in the workplace

In 2020, women earned 83 cents to every dollar men earned, according to data from the U.S. Census Bureau. While the wage gap has narrowed over time, it still persists. Is it because of discrimination? Occupational differences? Workforce participation?

Scholars at the Stanford Graduate School of Business have tried to answer questions like these, including Stanford labor economist and Professor Emerita Myra Strober, who has dedicated her career to examining sexism across society, including the workplace.

“The American way, if you will, is to reward people who are valuable by paying them more. What’s not fair is rewarding them because you think they’re going to be more valuable before the game even starts. Managers should take people in entry-level positions and try to groom them all to see who turn out to be best,” Strober said in a 2016 interview . Strober suggests companies ought to examine salary disparities, offer paid parental leave and subsidize or offer childcare, and encourage workplace flexibility as ways to diversify and equalize the workplace.

Here is that interview, along with other research from scholars affiliated with the GSB who have examined gender differences and biases in the workplace and in leadership.

Is workplace equality the economy’s hidden engine?

In 1960, 94% of doctors and lawyers were white men. Today that number has fallen to 60%, and the economy has benefited dramatically because of it.

The language of gender bias in performance reviews

How negative stereotypes about men and women creep into a process intended to be meritocratic.

How race influences, amplifies backlash against outspoken women

When women break gender norms, the most negative reactions may come from people of the same race.

Having more power at the bargaining table helps women – but also sparks backlash

A large-scale study of job negotiations finds that women with stronger options were penalized for being too assertive.

How companies can solve the pay equity problem

A labor economist reveals how to close the pay gap.

Solving Silicon Valley’s gender problem

The authors of a survey on women in high tech answer the question: What now?

Making research, education more inclusive

In academic research, particularly the sciences, a gendered perspective has historically been overlooked, says Stanford historian Londa Schiebinger .

Such an oversight has come at a cost: For example, in clinical drug trials, women have been excluded on the grounds of reproductive safety  – meaning that when drugs hit market, doses may not be suited for female bodies. 

“Integrating sex and gender as variables in research, where relevant, enhances excellence in science and engineering,” said Schiebinger , who is the John L. Hinds Professor in the History of Science in Stanford’s School of Humanities and Sciences. “The operative question is how can we harness the creative power of sex and gender analysis for discovery and innovation? Does considering gender add a valuable dimension to research? Does it take research in new directions?”  

Schiebinger has spent her career finding creative ways to make science more inclusive. Here is some of that work, and work by others – including research showing the barriers women have faced as students in K-12 and at the PhD level.

A hidden obstacle for women in academia

A sweeping new study finds that women are penalized for pursuing research perceived to be “feminized” – an implicit bias surprisingly strong in fields associated with women.

Gender diversity is linked to research diversity

Gender diversity in science comes down to more than just who is on the team. The research approaches and types of questions the field addresses also shift – and lead to better science.

Sex and gender analysis improves science, Stanford scholars say

Including a gender and sex analysis in scientific research can open the door to discovery and innovation, according to a study performed by Stanford historian Londa Schiebinger and a group of scholars.

Female researchers pay more attention to sex and gender in medicine

Sex and gender affect how people react to drugs or other therapies, but are often overlooked in research. Stanford researchers find that medical research teams that include women more often account for sex and gender in their work.

Whose history? AI uncovers who gets attention in high school textbooks

Natural language processing reveals huge differences in how Texas history textbooks treat men, women, and people of color.

High-stakes exams can put female students at a disadvantage, Stanford researcher finds

A new study suggests that women are more heavily influenced than men by test anxiety, and points to ways to help close the gender gap.

Challenging gender bias in research

The standard use of the caucasian male as a universal subject in medical research is no longer ethically, scientifically, and socially plausible, say Olaya Madrid Pascual and colleagues

We are a gender equity research team whose latest project [1] investigated how many of the Cochrane reviews published in 2018 reported and analysed evidence on sex and gender, and how this correlated with the gender of the authors. Cochrane systematic reviews are a cornerstone for treatment recommendations, nevertheless, we found that sex and gender is scarcely considered in their reports. 

While the value of investigating this is clear to us, several of the reactions to our research has made it apparent that some members of the scientific community find our motives for undertaking this work an unsolvable mystery. 

Some of the common responses we’ve faced could be summarised as follows: is reporting by sex and gender really necessary? Why would you expect sex and gender to affect the final results on an intervention? And what about your own bias, as a group of only women?

We think that these kinds of questions largely miss the point. Not only do they show a worrying lack of awareness about the broad body of evidence that has shown how sex based differences can affect patients’ clinical presentations and responses to treatments, [2,3,4]  they’ve also failed in the attempt to shake the foundations of our work. Indeed, if anything, they’ve only encouraged us to carry on and expand our work, revealing how it is more relevant than ever. 

We would ourselves miss the point if we simply tried to answer those questions. The real issue here is not whether researching the omission of sex and gender reporting in the scientific literature is “really necessary,” but whether the standard use of the caucasian male as a universal subject in medical research is still ethically, scientifically, and socially plausible. For too long, this is what the medical and scientific establishment has always assumed, but this convention has legitimised itself for centuries only by pure repetition. Conversely, for some reason, what comes from outside this echo chamber has the burden of proof.

Some people will challenge whether we have gathered enough evidence to show that medical interventions working equally well in men and women is the premise of an echo chamber. Yet are there reasons to think that the caucasian male is representative of all human beings and should therefore be used as the default participant from which all effects are measured?

We appreciate that our understanding of the world is influenced by our own perspective and that there is no possible “view from nowhere.” We all are shaped by our sex and gender, ethnicity, personal history, or socioeconomic situation. Yet this should not be used as an excuse to discount a systematic error in the planning, data collection, analysis, and publication of research (otherwise known as “bias”). 

Those men who have raised concerns about our potential bias as a research group of only women need to understand that they are, at least, as influenced by their contexts as we are. They were assuming, once again, that manhood is the standard upon which everything needs to be compared. To our knowledge, research from groups of only men that present data about only men do not receive the same accusations of bias. 

Women researchers, as part of a scientific community that is heavily influenced by the wider environment (and the systems of power within it), can also be blinkered by the same biases as our male counterparts and overlook sex and gender in research. Yet at the same time, as members of the affected party so to speak, we’d argue that we might be more sensitive to gender bias in research and finding ways to counteract it. [5] We think that this outlook can help to build a richer and more inclusive body of science and scientific community, with the ultimate aim of representing and benefitting our diverse society.  

Olaya Madrid Pascual is an internal medicine physician from Spain. She lives in Zürich and works at the medical practice Kalkbreite. 

Emilia Roy Vallejo is an internal medicine physician and PhD candidate at the Internal Medicine Unit, Hospital Universitario de La Princesa, Madrid

Montserrat León García is a pharmacist and PhD candidate in public health at Universitat Autónoma de Barcelona.

They write this reflection on behalf of Research for Gender Equity, a collaborative research group that focuses on the underrepresentation of women in science.

Competing interests: None declared.

Acknowledgement: We would like to deeply thank and acknowledge the work done by the following women, whose ideas and reflections have contributed profoundly to this text: Montoya-Martínez, María; González-Barral, María; Cuadrado-Conde, Ana; Calderón-Larrañaga, Sara; Antequera-Martín, Alba. 

References:

• Antequera A, León M, Calderón S, et al. Sex and gender reporting and analysis in Cochrane reviews: a cross-sectional methods study. Preliminary results. BMJ Evidence-Based Medicine 2019;24:A18-A19.
• Dey S, Flather M, Devlin G, Brieger D, et al. Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events. Heart 2008;95(1):20-26.
• U.S. Government Accountability Office, GAO-01-286R. Drug safety: Most drugs withdrawn in recent years had greater health risks for women, 2001.  Available at: http://www.gao.gov/products/GAO-01-286R .
• Pinn V. Sex and Gender Factors in Medical Studies. JAMA 2003;289(4):397.
• Nielsen M, Andersen J, Schiebinger L, Schneider J. One and a half million medical papers reveal a link between author gender and attention to gender and sex analysis. Nature Human Behaviour 2017;1(11):791-796.

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• Open access
• Published: 13 December 2011

Gender relations and health research: a review of current practices

• Joan L Bottorff 1 ,
• John L Oliffe 3 ,
• Carole A Robinson 1 &
• Joanne Carey 2  

International Journal for Equity in Health volume  10 , Article number:  60 ( 2011 ) Cite this article

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Introduction

The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes.

To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations , gender interactions , relations gender , partner communication, femininities and masculinities were used to search online databases.

Through analysis of this literature we identified two main ways gender relations were integrated in health research: a) as emergent findings; and b) as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis.

Conclusions

Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women) are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

Health is affected by macro-level influences including social structures and institutions which shape the expectations of women and men, and the way their lives are organized [ 1 ]. To understand health practices and illness experiences it is increasingly recognized that accounting for gender is vital [ 2 , 3 ]. Gender, defined as the socially prescribed and experienced dimensions of femininity and masculinity in society, is evident in the diverse ways individuals engage in health behaviours [ 2 ].

In men's health literature, hegemonic masculinity has been associated with risk taking behaviours that compromise health and illness outcomes [ 4 – 8 ]. Conceptualizations of masculinities have also been used to examine an array of issues such as men's depression [ 9 , 10 ], prostate cancer [ 11 ] and testicular cancer [ 12 ]. Men's diet behaviours and food choices [ 13 – 16 ], tobacco use patterns [ 17 ] as well as help-seeking behaviours [ 18 – 20 ] have also been described in relation to masculinities. In contrast to the uptake of masculinities in men's health research, Lyons [ 14 ] points to the dearth of research that examines how femininities influence health experiences despite decades of work examining women's health issues. Researchers who have begun to examine femininity in relation to women's health practices have tended to treat femininity as a uniform concept [ 21 , 22 ]. Understanding the diversity of femininities that influence women's health experiences and behaviours is at a nascent stage.

Although there have been promising developments in accounting for gender influences in health research, the concepts of masculinity and femininity for the most part have been delinked despite the social constructionist premise that gender is relational. Further, this research has been predominantly premised on assumptions of associations between femininity and women, and masculinity and men rather than integrating gender structures that suggest a continuum of experience between men and women, and evolving forms of social relations of gender that influence health [ 23 ]. While accounting for a range of social determinants including race, social class, and sexual identity has rendered more sophisticated understandings of men's and women's health, health behaviours need to be understood in the context of men's and women's interactions on both personal and institutional levels [ 6 , 14 ]. There is strong evidence that gender relations both within and between men and women strongly influence health outcomes. For example, individuals who are married engage in more healthful behaviours, report healthier psychological and physical well being, and lower mortality rates compared to divorced, separated, widowed, or single individuals [ 23 , 24 ]. Although marriage is associated with improved health for women and men, its beneficial effects seem to be higher for men. Married men live longer than single men, and widowed men's life expectancy is significantly shortened following the loss of their partners [ 25 – 27 ]. In contrast marriage seems to protect women's health by increasing financial stability [ 25 ]. However, married women are more vulnerable than men to negative outcomes of dysfunctional relationships including intimate partner violence. Possible influences underpinning these discordant relationships include feminine ideals around nurturing others and linkages between masculinity and men's disregard for self-health. A gender relations approach recognizes the importance of gender dynamics and the circumstances under which they interact to influence health opportunities and constraints. More than a decade after Schofield, Connell, Walker, Wood, and Butland [ 4 ] advocated for increased attention to gender relations by signalling some designated pathways for "doing" gender relations and health research, there appears to be limited uptake of gender relations by health researchers.

The arguments supporting the use of gender theory in health research are compelling - the potential for better science, providing the basis for more effective health care and reducing health disparities [ 28 ]. Since gender relations is a cornerstone of gender theory, a scoping review of the empirical literature to describe developments in integrating gender relations in health research is needed to take stock of efforts to incorporate gender relations and provide direction for future research.

In what follows we review the theoretical developments that underpin our understanding of gender relations, review published studies to examine the ways in which the concept of gender relations has been integrated into health research, and offer recommendations for how the field might be advanced.

Theorizing Gender Relations

Feminist scholars have made significant contributions to conceptualizing gender relations as a set of relationships to address critiques of static and binary constructions of gender and to re-establish gender as socially constructed and relational. They have also advanced understandings of the complex diversity within and across genders by incorporating analysis of other social relationships including class, ethnicity and racialization, and their impact at various ages to acknowledge and anchor the context-specific influences that underlie gender dynamics [ 29 , 30 ].

One of the most influential voices in theorizing gender relations has been that of the Australian sociologist Raewyn Connell [ 31 – 33 ]. While Connell first wrote about hegemonic masculinity and corresponding emphasized femininity in 1987, it was the former concept that garnered most attention, particularly in men's health research. Connell advanced the theory that masculinities and femininities play out at a societal level, and while there are diverse and multiple forms, all are shaped by the structural influences wherein men dominate women. In recognizing the gender hierarchy, hegemonic masculinity was conceptualized as an idealized masculinity that subordinates other masculinities and femininities [ 31 , 34 ].

Although Judith Butler [ 35 ] theorizes that heterosexual desire unites masculine and feminine in a binary and hierarchical relationship, others position gender relations as part of recurring patterns embedded in interpersonal relationships, culture, and social structures and organizations that permeate all aspects of everyday life. Connell [ 32 ], for example, conceptualizes gender relations as being part of dynamic social life performed through daily interactions and practices, whereby individual actions collectively constitute and re-create prevailing understandings and enactments of masculinities and femininities but not in a uniform way. She describes four interconnected structures of gender relations: production relations reflected in sexual divisions of labour; power relations evident in the positioning of men as the dominant class in societal discourses and in the exercise of imperial powers; emotional relations that include the influence of hegemonic patterns and relationships in a variety of contexts (e.g., households, workplace); and symbolic representations of gender in society [ 33 , 36 ]

Howson's [ 37 ] work is an important contribution to gender relations, extending Connell's framework by describing categories of masculinities and femininities as emerging in response to hegemonic masculinity. A plurality of masculinities - complicit, marginalized, sub-ordinate and protest are proposed to operate in relation to hegemonic masculinity. In addition, Howson proposes three femininities that function in relation to hegemonic masculinity: emphasised, ambivalent and protest . This conceptualization of gender relations challenges constructs of masculinity and femininity as binary opposites amid highlighting the diversity within the gender categories, and the relational gender dynamics in society.

In summary, these theoretical frames provide a useful starting place for examining gender relations in health and hold implications for study designs. First, the relational quality of gender occurs in the interface: i) between masculinities/femininities, ii) among masculinities, and iii) among femininities. Second, the relational interactions can occur across, as well as with, the micro- or interpersonal level and the larger macro- or structural level. Third, conceptualizing gender as relational implies an ongoing, interactive dynamism that is subject to change over time. Forth, gender relations vary according to place such that local geo-political conditions are also significant in generating diversity. Gender relations, therefore, can help us move beyond the dyadic binary gender order that has predominated in health research.

Approaches to Gender Relations and Health Research

We conducted a scoping review of existing health research to explore the ways gender relations have begun to be taken into account to provide a description of current approaches and provide directions for future research. The key terms gender relations , gender interactions , relations gender , and partner communication were used to search online databases including CINAHL, PsychINFO, PubMed, and Sociological Abstracts (1999-2009). Two reviewers independently screened 811 abstracts, and identified 95 potentially relevant manuscripts. The full manuscripts were retrieved and reviewed in relation to criteria for inclusion. Manuscripts were included if they were published, peer-reviewed empirical reports (all types of research) where the primary focus was health and explicit references to gender relations were included in the conceptual framework, study design, or findings. We excluded studies of labour markets and other social structures that reflect gender relations in society when the objectives of the research were not explicitly linked to health. Also excluded were articles that used the term "gender relations" but focused on sex differences or sex-roles. Ten empirical papers met the inclusion criteria. In January of 2010, another search of the CINHAL, PUBMED, PsychINFO, and Sociological Abstracts was conducted using combinations of the terms masculinit*, femininit*, couple intervention, gender, gender relations and health . This elicited another four articles that met inclusion criteria.

In group meetings, the authors reviewed the manuscripts, and compared and contrasted the approaches used to incorporate the influence of gender relations. Through this analysis we identified two main ways gender relations were integrated in health research: a) as emergent findings; and b) as a basis for research design. In the latter, conceptualizations of gender relations were included in conceptual frameworks, guided data collection and were used to direct data analysis.

a. Gender Relations as an Emergent Finding

Gender relations was a concept used by some researchers as a way to interpret their data and in these cases gender relations emerged as a key finding. The contribution of these studies in furthering our understanding of gender relations varied. In some studies, gender relations emerged as a broad inductively derived finding rather than a nuanced gendered perspective and was neither informed by, or integrated with, the theoretical literature. While in other studies rich descriptions of the gender dynamics that emerge out of everyday interactions were provided.

For example, de Vera [ 38 ] conducted an ethnographic study to explore factors influencing birth spacing among seven rural Filipino couples using interviews conducted separately with husbands and wives, and supplementary data sources. One of the socio-cultural factors identified to influence birth spacing, labelled as "gender relations," describes the lack of communication between husband and wife, and culturally prescribed gender roles for women as wife and mother. Although some new insights were gained in this study, the concept of gender relations was not explored in an in-depth way using available data.

In a second example, Avotri and Walters [ 39 ] interviewed 75 Ghanaian women and found that "relationships with men" was a main theme linked to health problems, and integral to the structure of their lives. The findings were richly detailed and focused on three sub-themes: a) gender division of labour characterized by heavy responsibilities, limited control, and lack of access to resources; b) women's insecurity and vulnerability in their relationships with men where partner expectations were high and power or control was very low; and, c) physical and verbal abuse emergent within intimate relationships. The qualitative findings captured coexisting relational dependency and vulnerability leading to health problems for the women, and illustrated how gender relations could be used to explain the women's health issues.

The descriptive study by Avotri and Walters [ 39 ], and others like it, in which gender relations emerges as a key concept or finding have the potential to advance our knowledge of gender relations in several ways. First, linking descriptions of everyday social practices with how gender relations is enacted and the dense social context in which they emerge has the potential to enhance our understanding of gender regimes [ 40 ], and the processes by which gender influences health. Second, these emergent gender relations findings sensitize researchers to the central role of gender relations in health and the potential advantages of applying theoretical frameworks of gender relations to future study designs.

b. Gender Relations as a Basis for Research Design

Gender relations have also been explicitly operationalized in health research as a conceptual framework to shape problem formulation, data collection methods and data analysis approaches and tools. Each is described in more detail in the following sections.

Gender Relations as a Conceptual Framework

There are examples in the literature where researchers explicitly set out to examine the link between gender relations and health. In these studies, frameworks to conceptualize gender relations were foundational to study design. Most researchers drew on empirical literature to develop their own conceptual frameworks and included gender relations among a number of other factors. For example, Carter [ 41 ] was concerned with the influence of community context on household gender relations in rural Guatemala in an exploration of decision making about health matters. Drawing on findings from qualitative studies regarding contextual factors influencing gender relations, the research team developed a conceptual framework for this study. Using this approach, gender relations were conceptualized as social interactions, grounded in power dynamics between men and women in intimate partnerships, and affected by individual characteristics and contextual variables at household and community levels.

Other researchers developed conceptual frameworks drawing on conceptualizations of masculinities and femininities. Evans et al. [ 42 ] for example, focused on gendered dimensions of African Nova Scotians' experiences with breast and prostate cancer. The conceptualization of gender relations underpinning this study focused on masculinities, femininities, and the hegemony of idealized masculinity with its implications for sex-specific cancer care. In a similar way, Landstedt, Asplund, and Gadin [ 43 ] drew on the work of Connell [ 31 , 44 ] and were concerned with masculinities, femininities, power relations, and the reciprocal influence between gender practices and societal structures in positioning their study of adolescent mental health.

It is noteworthy that none of the studies provided a clear definition of gender relations as part of the conceptual framework underpinning this research. Nevertheless, such efforts to integrate the concept of gender relations within conceptual frameworks have served, in part, to foreground gender relations in health research. In contrast to these approaches, there are a few studies that have made explicit use of gender relations theory to anchor their research [ 45 – 47 ]. In each of these studies, Howson's schema was used to advance gender relations as a conceptual foundation and the pathways reflected in Howson's work were used to purposefully guide methodological approaches to data collection and analyses as well as the discussion of the findings.

Gender Relations: Developments in Data Collection

The integration of gender relations in health research has prompted important developments in quantitative and qualitative data collection methods to enhance the potential for examining the relationship between gender as a social dynamic and health.

Quantitative researchers have used a variety of approaches to measure gender relations including combinations of commonly used socio-structural variables. In an examination of gender relations at a society level, Chun, Khang, Kim, and Cho [ 48 ] hypothesized that gender inequities in Korean society might explain women's high morbidity, despite increasing prosperity in the country as a whole. The influence of gender relations was measured indirectly using existing survey data related to socio-structural determinants and included marital status, living arrangements, education, occupation, and employment status. Marital status, for example, was conceptualized as an important socio-structural factor that negatively influenced women's health in a patriarchal culture pointing to the obligations associated with women's gendered roles and the "double burden" of working, married women [ 48 ]. Others have used measures specifically designed to assess dimensions of gender relations. For example, Hunt [ 49 ] used the BEM Sex Role Inventory to examine "gender-related" experiences and health among two cohorts of women. Carter [ 41 ], on the other hand, designed four questions to "measure directly some aspects of gender relations and husbands' authority" in the aforementioned study of Guatemalan women. The questions focused on who keeps (guards) money for household expenses, who decides which health care provider to see when sick, what medicine is purchased, and what food to buy.

Other health researchers have used qualitative data collection approaches to examine the influence of gender relations. Semi-structured individual interviews have been used by some researchers. Bottorff et al. [ 50 ] used Howson's [ 37 ] framework of gender relations as a conceptual lens for examining heterosexual couples' tobacco use patterns. Adopting parallel semi-structured interviews with women and their male partners, the researchers asked participants to describe their interactions with their partners, and whether these interactions undermined or promoted tobacco reduction. Interviewers encouraged participants to provide examples of what might be overheard by someone listening to their conversations with partners related to smoking. Individual interview data with male and female partners were then brought together using dyad summaries to construct couple-level data related to interaction patterns and to facilitate an analysis of gender relations and comparisons within and between couple dyads [ 49 , 50 ].

Focus groups have also been used as a means to better understand gender relations in the context of norms related to sexual practices and HIV protection in several African locations [ 24 , 25 , 51 ]. These studies involved men and women in same-sex focus group interviews using similar questions to facilitate data comparisons. Ndinda et al. [ 24 ] were explicit about how they framed focus group questions to explore gender relations (e.g., Who generally decides on the use of contraception, condom use and child bearing in a sexual relationship? Can a woman say no to sex?). In Tolhurst et al.'s [ 26 ] investigation of how "gendered dynamics" within intra-household bargaining influenced seeking health care for children in the Upper Volta region of Ghana, focus group data were supplemented with a variety of qualitative and participatory methods including role-plays, pile-sorting exercises, community mapping, and wealth/wellbeing ranking exercises, key informant interviews, in-depth individual interviews and critical incident interviews.

Evans et al. [ 42 ] made use of both mixed and single-sex focus groups to describe the influence of gendered and cultured relations on experiences of breast and prostate cancer among Africans living in Nova Scotia, Canada. In this study, focus group questions directly addressed gender relations: "What is the role of men and women in your community? What does being masculine and feminine mean to you? How has cancer affected how your body works/looks? How has cancer affected your relationship with your partner, family, friends, and community?"(p. 262) [ 42 ].

These studies illustrate that approaches to gender relations data collection are diverse and emergent. Efforts to include the voices of both men and women in studies of heterosexual gender relations are evident and point the way for exploration of other forms of gendered relations. There is also a need to develop measures of gender relations, and the current reliance on qualitative approaches, while reflecting the early stage of development in the field, might also garner gender relations items for inclusion on survey questionnaires.

Gender Relations as an Analytical Tool

Qualitative researchers have made explicit use of conceptualizations of gender relations as analytical tools. We describe three studies to highlight this methodological approach.

Bottorff et al. [ 47 ] interviewed women about the smoking practices of their men partners in the context of pregnancy and the postpartum. Howson's [ 37 ] framework was used as an analytical tool for questioning and interpreting women's narratives to examine how they constructed men's behaviors in relation to smoking and masculinity, and the way that they positioned their efforts to influence men's smoking.

Another study drawing on Howson's [ 37 ] and Schippers [ 27 ] theorizing in gender relations focused on how masculinities and femininities were operationalized among heterosexual couples in relation to food and diet in the context of prostate cancer [ 45 ]. Individual semi-structured interviews with men and their women partners were analyzed to identify and understand how gender relations in heterosexual couples influenced men's diets.

Additional advantages of using a gender relations approach are reflected in a study by Oliffe et al. [ 46 ] that examined men's depression through interviews with men who were formally diagnosed and/or self-identified as depressed, and their female partners. In this study each couple was assigned a particular gender relations category inductively derived from an analysis of the way depression-related couple interactions played out. For example, "trading places," embodied by most couples, was a pattern in which men were prepared to stay at home and assume domestic responsibilities while women took on 'breadwinning' responsibilities. Such an arrangement permitted men to manage their depression at home, avoid seeking professional help, and conceal the losses and deficits that depression posed for their masculinity. The study, drawing on Howson's [ 37 ] framework, concluded that examining hegemonic femininity (the feminine aspects of idealized heterosexual relationships) as well as pariah femininities (hegemonic masculine characteristics or practices that, when embodied by women, are simultaneously stigmatized and feminized), and male femininities was well founded [ 27 ].

Despite the growing attention to gender relations by theorists, the relatively small body of empirical health research that explicitly and purposefully incorporates gender relations suggests that this field of research is at a beginning stage. When researchers acknowledge the importance of gender relations to health practices and experiences, the degree to which they define and engage with gender relations varies considerably. In addition, it is noteworthy that the studies included in this review were predominantly focused on health behaviours and on interpersonal interactions rather than the influence of meso/macro level representations of gender relations on health. Although it is possible that other population-based gender studies were not identified, this may be a reflection of the nascent stage of the research. The lack of consistent language regarding gender relations may have also limited the number of papers included in this review. We often found that while the term 'gender relations' was used, gender relations was not directly addressed in the research. Some authors used sex and gender interchangeably, and while some defined gender , the concept of gender relations was rarely clearly articulated. Nevertheless, this review provides useful insights into this emerging area of research and points to key areas where developments are needed.

Conceptual clarity in the use of gender relations is clearly needed to strengthen health research. Recent efforts to use gender relations theoretical frameworks as a conceptual basis for research and to guide data collection and analysis are promising and afford momentum and direction for advancing the field. However, the concept of femininities in health research needs more attention along with broader considerations about what constitutes ideals in the context of gender relations between and among men and women. In this way, perpetuating the binary conceptualization that positions men and women as opposites might be avoided by paying attention to what, as well as how, specific relations work for and against health and well-being.

Although gender relations has featured most prominently in ethnographic work dedicated to understanding health practices in developing countries, the potential for studying men's and women's health behaviour in western societies and in micro yet increasingly globalized contexts is ever present. Wherever this research is conducted, gender relations and health studies will be strengthened by ensuring that diverse perspectives are included. The study of interactional patterns between and among women and men does not adequately distil gender relations unless a gendered perspective is taken. For example, in studies of gender relations in households the perspective of both partners is required, and research must extend beyond heterosexual couples to include same-sex relations and other types of family and peer relations. Although the identification and use of standard indicators for gender relations would allow researchers to account for gender relations (e.g., as a confounder or independent variable) in survey research, the complex, social terrain in which gender relations emerge is likely to require multi-dimensional measures developed for application to specific societal and cultural contexts.

The integration of gender relations in health research will also be advanced through sharing the details about how this work is and can be done. We often found that descriptions of data collection methods aimed specifically at capturing gender relations were missing or limited to a sentence or two. Difficult to determine, for example, in qualitative studies was how gender relations were captured through specific interview questions or observations. Methodological challenges reside here, and need to be acknowledged and addressed. If we take direction from contemporary theorists that gender relations are multiple and have components of hegemony and power dynamics, recognizing when these dynamics influence data collection is also important to modifying approaches to ensure the safety of vulnerable participants (e.g., partner conflict and/or abuse). Although conjoint interviews provide an opportunity to observe gender relations, there may be situations where these interviews place individuals at risk [ 52 ].

Theorists have identified locations or settings where gender relations might be best studied. For instance, gender as relational experience occurs on personal and intimate levels as well as on cultural and institutional levels [ 4 , 6 , 53 ]. This suggests that gender relations and health studies can and should occur in diverse locations and contexts to more fully apprehend the multiplicity and patterns within productions of gender relations and their influence on health.

Gender relations are an exciting and emergent area in need of more attention from health researchers. Health-related behaviours do not operate in isolation and need to be understood in the context of interactions within and between men and women across personal, interpersonal and institutional levels. A better understanding of gender relations and health in research and policy will have direct implications for health interventions and guide decisions about whether group, dyadic or single point programs are likely to be effective. In addition, this research has great potential to challenge relational patterns that are so often taken-for-granted and contribute to reducing gender inequalities in health.

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Acknowledgements

This research was supported through funding from the Canadian Institutes of Health Research (Institute of Gender and Health) for the Investigating Tobacco and Gender (iTAG) project (Grant #GTA-92065) as well as career support for Dr Oliffe in the form of a Canadian Institutes of Health Research new investigator award and Michael Smith Foundation for Health Research scholar award.

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• Published: 28 April 2020

The impact a-gender: gendered orientations towards research Impact and its evaluation

• J. Chubb   ORCID: orcid.org/0000-0002-9716-820X 1 &
• G. E. Derrick   ORCID: orcid.org/0000-0001-5386-8653 2  

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Using an analysis of two independent, qualitative interview data sets: the first containing semi-structured interviews with mid-senior academics from across a range of disciplines at two research-intensive universities in Australia and the UK, collected between 2011 and 2013 ( n  = 51); and the second including pre- ( n  = 62), and post-evaluation ( n  = 57) interviews with UK REF2014 Main Panel A evaluators, this paper provides some of the first empirical work and the grounded uncovering of implicit (and in some cases explicit) gendered associations around impact generation and, by extension, its evaluation. In this paper, we explore the nature of gendered associations towards non-academic impact (Impact) generation and evaluation. The results suggest an underlying yet emergent gendered perception of Impact and its activities that is worthy of further research and exploration as the importance of valuing the ways in which research has an influence ‘beyond academia’ increases globally. In particular, it identifies how researchers perceive that there are some personality traits that are better orientated towards achieving Impact; how these may in fact be gendered. It also identifies how gender may play a role in the prioritisation of ‘hard’ Impacts (and research) that can be counted, in contrast to ‘soft’ Impacts (and research) that are far less quantifiable, reminiscent of deeper entrenched views about the value of different ‘modes’ of research. These orientations also translate to the evaluation of Impact, where panellists exhibit these tendencies prior to its evaluation and describe the organisation of panel work with respect to gender diversity.

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Introduction.

The management and measurement of the non-academic impact Footnote 1 (Impact) of research is a consistent theme within the higher education (HE) research environment in the UK, reflective of a drive from government for greater visibility of the benefits of research for the public, policy and commercial sectors (Chubb, 2017 ). This is this mirrored on a global scale, particularly in Australia, where, at the ‘vanguard’ (Upton et al., 2014 , p. 352) of these developments, methods were first devised (but were subsequently abandoned) to measure research impact (Chubb, 2017 ; Hazelkorn and Gibson, 2019 ). What is broadly known in both contexts as an ‘Impact Agenda’—the move to forecast and assess the ways in which investment in academic research delivers measurable socio-economic benefit—initially sparked broad debate and in some instances controversy, among the academic community (and beyond) upon its inception (Chubb, 2017 ). Since then, the debate has continued to evolve and the ways in which impact can be better conceptualised and implemented in the UK, including its role in evaluation (Stern, 2016 ), and more recently in grant applications (UKRI, 2020 ) is robustly debated. Notwithstanding attempts to better the culture of equality and diversity in research, (Stern, 2016 ; Nature, 2019 ) in the broader sense, and despite the implementation of the Impact agenda being studied extensively, there has been very little critical engagement with theories of gender and how this translates specifically to more downstream gendered inequities in HE such as through an impact agenda.

The emergence of Impact brought with it many connotations, many of which were largely negative; freedom was questioned, and autonomy was seen to be at threat because of an audit surveillance culture in HE (Lorenz, 2012 ). Resistance was largely characterised by problematising the agenda as symptomatic of the marketisation of knowledge threatening traditional academic norms and ideals (Merton, 1942 ; Williams, 2002 ) and has led to concern about how the Impact agenda is conceived, implemented and evaluated. This concern extends to perceptions of gendered assumptions about certain kinds of knowledge and related activities of which there is already a corpus of work, i.e., in the case of gender and forms of public engagement (Johnson et al., 2014 ; Crettaz Von Roten, 2011 ). This paper explores what it terms as ‘the Impact a-gender’ (Chubb, 2017 ) where gendered notions of non-academic, societal impact and how it is generated feed into its evaluation. It does not wed itself to any feminist tradition specifically, however, draws on Carey et al. ( 2018 ) to examine, acknowledge and therefore amend how the range of policies within HE and how implicit power dynamics in policymaking produce gender inequalities. Instead, an impact fluidity is encouraged and supported. For this paper, this means examining how the impact a-gender feeds into expectations and the reward of non-academic impact. If left unchecked, the propagation of the impact a-gender, it is argued, has the potential to guard against a greater proportion of women generating and influencing the use of research evidence in public policy decision-making.

Scholars continue to reflect on ‘science as a gendered endeavour’ (Amâncio, 2005 ). The extensive corpus of historical literature on gender in science and its originators (Merton, 1942 ; Keller et al., 1978 ; Kuhn, 1962 ), note the ‘pervasiveness’ of the ‘masculine’ and the ‘objective and the scientific’. Indeed, Amancio affirmed in more recent times that ‘modern science was born as an exclusively masculine activity’ ( 2005 ). The Impact agenda raises yet more obstacles indicative of this pervasiveness, which is documented by the ‘Matthew’/‘Matilda’ effect in Science (Merton, 1942 ; Rossiter, 1993 ). Perceptions of gender bias (which Kretschmer and Kretschmer, 2013 hypothesise as myths in evaluative cultures) persist with respect to how gender effects publishing, pay and reward and other evaluative issues in HE (Ward and Grant, 1996 ). Some have argued that scientists and institutions perpetuate such issues (Amâncio, 2005 ). Irrespective of their origin, perceptions of gendered Impact impede evaluative cultures within HE and, more broadly, the quest for equality in excellence in research impact beyond academia.

To borrow from Van Den Brink and Benschop ( 2012 ), gender is conceptualised as an integral part of organisational practices, situated within a social construction of feminism (Lorber, 2005 ; Poggio, 2006 ). This article uses the notion of gender differences and inequality to refer to the ‘ hierarchical distinction in which either women and femininity and men and masculinity are valued over the other ’ (p. 73), though this is not precluding of individual preferences. Indeed, there is an emerging body of work focused on gendered associations not only about ‘types’ of research and/or ‘areas and topics’ (Thelwall et al., 2019 ), but also about what is referred to as non-academic impact. This is with particular reference to audit cultures in HE such as the Research Excellence Framework (REF), which is the UK’s system of assessing the quality of research (Morley, 2003 ; Yarrow and Davies, 2018 ; Weinstein et al., 2019 ). While scholars have long attended to researching gender differences in relation to the marketisation of HE (Ahmed, 2006 ; Bank, 2011 ; Clegg, 2008 ; Gromkowska-Melosik, 2014 ; Leathwood et al., 2008 ), and the gendering of Impact activities such as outreach and public engagement (Ward and Grant, 1996 ), there is less understanding of how far academic perceptions of Impact are gendered. Further, how these gendered tensions influence panel culture in the evaluation of impact beyond academia is also not well understood. As a recent discussion in the Lancet read ‘ the causes of gender disparities are complex and include both distal and proximal factors ’. (Lundine et al., 2019 , p. 742).

This paper examines the ways in which researchers and research evaluators implicitly perceive gender as related to excellence in Impact both in its generation and in its evaluation. Using an analysis of two existing data sets; the pre-evaluation interviews of evaluators in the UK’s 2014 Research Excellence Framework and interviews with mid-senior career academics from across the range of disciplines with experience of building impact into funding applications and/ or its evaluation in two research-intensive universities in the UK and Australia between 2011 and 2013, this paper explores the implicitly gendered references expressed by our participants relating to the generation of non-academic, impact which emerged inductively through analysis. Both data sets comprise researcher perceptions of impact prior to being subjected to any formalised assessment of research Impact, thus allowing for the identification of unconscious gendered orientations that emerged from participant’s emotional and more abstract views about Impact. It notes how researchers use loaded terminology around ‘hard’, and ‘soft’ when conceptualising Impact that is reminiscent of long-standing associations between epistemological domains of research and notions of masculinity/femininity. It refers to ‘hard’ impact as those that are associated with meaning economic/ tangible and efficiently/ quantifiably evaluated, and ‘soft’ as denoting social, abstract, potentially qualitative or less easily and inefficiently evaluated. By extending this analysis to the gendered notions expressed by REF2014 panellists (expert reviewers whose responsibility it is to review the quality of the retrospective impact articulated in case studies for the purposes of research evaluation) towards the evaluation of Impact, this paper highlights how instead of challenging these tendencies, shared constructions of Impact and gendered productivity in academia act to amplify and embed these gendered notions within the evaluation outcomes and practice. It explores how vulnerable seemingly independent assessments of Impact are to these widespread gendered- associations between Impact, engagement and success. Specifically, perceptions of the excellence and judgements of feasibility relating to attribution, and causality within the narrative of the Impact case study become gendered.

The article is structured as follows. First, it reviews the gender-orientations towards notions of ‘hard’ and ‘soft’ excellence in forms of scholarly distinction and explores how this relates to the REF Impact evaluation criteria, and the under-representation of women in the academic workforce. Specifically, it hypothesises the role of how gendered notions of excellence that construct academic identities contribute to a system that side-lines women in academia. This is despite associating the generation of Impact as a feminised skill. We label this as the ‘Impact a-gender’. The article then outlines the methodology and how the two, independent databases were combined and convergent themes developed. The results are then presented from academics in the UK and Australia and then from REF2014 panellists. This describes how the Impact a-gender currently operates through academic cultural orientations around Impact generation, and in its evaluation through peer-review panels by members of this same academic culture. The article concludes with a recommendation that the Impact a-gender be explored more thoroughly as a necessary step towards guiding against gender- bias in the academic evaluation, and reward system.

Literature review

Notions of impact excellence as ‘hard’ or ‘soft’.

Scholars have long attempted to consider the commonalities and differences across certain kinds of knowledge (Becher, 1989 , 1994 ; Biglan, 1973a ) and attempts to categorise, divide and harmonise the disciplines have been made (Biglan, 1973a , 1973b ; Becher, 1994 ; Caplan, 1979 ; Schommer–Aikins et al., 2003 ). Much of this was advanced with a typology of the disciplines from (Trowler, 2001 ), which categorised the disciplines as ‘hard’ or ‘soft’. Both anecdotally and in the literature, ‘soft’ science is associated with working more with people and less with ‘things’ (Cassell, 2002 ; Thelwall et al., 2019 ). These dichotomies often lead to a hierarchy of types of Impact and oppose valuation of activities based on their gendered connotations.

Biglan’s system of classifying disciplines into groups based on similarities and differences denotes particular behaviours or characteristics, which then form part of clusters or groups—‘pure’, ‘applied’, ‘soft’, ‘hard’ etc. Simpson ( 2017 ) argues that Biglan’s classification persists as one of the most commonly referred to models of the disciplines despite the prominence of some others (Pantin, 1968 ; Kuhn, 1962 ; Smart et al., 2000 ). Biglan ( 1973b ) classified the disciplines across three dimensions; hard and soft, pure and applied, life and non-life (whether the research is concerned with living things/organisms) . This ‘taxonomy of the disciplines’ states that ‘pure-hard’ domains tend toward the life and earth sciences,’pure-soft’ the social sciences and humanities, and ‘applied hard’ focus on engineering and physical science with ‘soft-applied’ tending toward professional practice such as nursing, medicine and education. Biglan’s classification looked at levels of social connectedness and specifically found that applied scholars Footnote 2 were more socially connected, more interested and involved in service activities, and more likely to publish in the form of technical reports than their counterparts in the pure (hard) areas of study. This resonates with how Impact brings renewed currency and academic prominence to applied researchers (Chubb, 2017 ). Historically, scholars inhabiting the ‘hard’ disciplines had a greater preference for research; whereas, scholars representing soft disciplines had a greater preference for teaching (Biglan, 1973b ). Further, Biglan ( 1973b ) also found that hard science scholars sought out greater collaborative efforts among colleagues when teaching as opposed to their soft science counterparts.

There are also long-standing gendered associations and connotations with notions of ‘hard’ and ‘soft’ (Storer, 1967 ). Typically used to refer to skills, but also used heavily with respect to the disciplines and knowledge domains, gendered assumptions and the mere use of ‘hard’ or ‘soft’ to describe knowledge production carries with it assumptions, which are often noted in the literature; ‘ we think of physics as hard and of political science as soft ’, Storer explains, adding how ‘hard seems to imply tough, brittle, impenetrable and strong, while soft on the other hand calls to mind the qualities of weakness, gentleness and malleability’ (p. 76). As described, hard science is typically associated with the natural sciences and quantitative paradigms whereas normative perceptions of feminine ‘soft’ skills or ‘soft’ science are often equated with qualitative social science. Scholars continue to debate dichotomised paradigms or ‘types’ of research or knowledge (Gibbons, 1999 ), which is emblematic of an undercurrent of epistemological hierarchy of the value of different kinds of knowledge. Such debates date back to the heated back and forth between scholars Snow (Snow, 2012 ) and literary critic Leavis who argued for their own ‘cultures’ of knowledge. Notwithstanding, these binary distinctions do few favours when gender is then ascribed to either knowledge domain or related activity (Yarrow and Davies, 2018 ). This is particularly pertinent in light of the current drive for more interdisciplinary research in the science system where there is also a focus on fairness, equality and diversity in the science system.

Academic performance and the Impact a-gender

Audit culture in academia impacts unfairly on women (Morley, 2003 ), and is seen as contributory to the wide gender disparities in academia, including the under-representation of women as professors (Ellemers et al., 2004 ), in leadership positions (Carnes et al., 2015 ), in receiving research acknowledgements (Larivière et al., 2013 ; Sugimoto et al., 2015 ), or being disproportionately concentrated in non-research-intensive universities (Santos and Dang Van Phu, 2019 ). Whereas gender discrimination also manifests in other ways such as during peer review (Lee and Noh, 2013 ), promotion (Paulus et al., 2016 ), and teaching evaluations (Kogan et al., 2010 ), the proliferation of an audit culture links gender disparities in HE to processes that emphasise ‘quantitative’ analysis methods, statistics, measurement, the creation of ‘experts’, and the production of ‘hard evidence’. The assumption here is that academic performance and the metrics used to value, and evaluate it, are heavily gendered in a way that benefits men over women, reflecting current disparities within the HE workforce. Indeed, Morely (2003) suggests that the way in which teaching quality is female dominated and research quality is male dominated, leads to a morality of quality resulting in the larger proportion of women being responsible for student-focused services within HE. In addition, the notion of ‘excellence’ within these audit cultures implicitly reflect images of masculinity such as rationality, measurement, objectivity, control and competitiveness (Burkinshaw, 2015 ).

The association of feminine and masculine traits in academia (Holt and Ellis, 1998 ), and ‘gendering its forms of knowledge production’ (Clegg, 2008 ), is not new. In these typologies, women are largely expected to be soft-spoken, nurturing and understanding (Bellas, 1999 ) yet often invisible and supportive in their ‘institutional housekeeping’ roles (Bird et al., 2004 ). Men, on the other hand are often associated with being competitive, ambitious and independent (Baker, 2008 ). When an individual’s behaviour is perceived to transcend these gendered norms, then this has detrimental effects on how others evaluate their competence, although some traits displayed outside of these typologies go somewhat ‘under the radar’. Nonetheless, studies show that women who display leadership qualities (competitiveness, ambition and decisiveness) are characterised more negatively than men (Rausch, 1989 ; Heilman et al., 1995 ; Rossiter, 1993 ). Incongruity between perceptions of ‘likeability’ and ‘competence’ and its relationship to gender bias is present in evaluations in academia, where success is dependent on the perceptions of others and compounded within an audit culture (Yarrow and Davis, 2018). This has been seen in peer review, reports for men and women applicants, where women were disadvantaged by the same characteristics that were seen as a strength on proposals by men (Severin et al., 2019 ); as well as in teaching evaluations where women receive higher evaluations if they are perceived as ‘nurturing’ and ‘supportive’ (Kogan et al., 2010 ). This results in various potential forms of prejudice in academia: Where traits normally associated with masculinity are more highly valued than those associated with femininity (direct) or when behaviour that is generally perceived to be ‘masculine’ is enacted by a woman and then perceived less favourably (indirect/ unconscious). That is not to mention direct sexism, rather than ‘through’ traits; a direct prejudice.

Gendered associations of Impact are not only oversimplified but also incredibly problematic for an inclusive, meaningful Impact agenda and research culture. Currently, in the UK, the main funding body for research in the UK, UK Research and Innovation (UKRI) uses a broad Impact definition: ‘ the demonstrable contribution that excellent research makes to society and the economy ’ (UKRI website, 2019 ). The most recent REF, REF2014, Impact was defined as ‘ …an effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia ’. In Australia, the Australian Research Council (ARC) proposed that researchers should ‘embed’ Impact into the research process from the outset. Both Australia and the UK have been engaged in policy borrowing around the evaluation of societal impact and share many similarities in approaches to generating and evaluating it. Indeed, Impact has been deliberately conceptualised by decision-makers, funders and governments as broad in order to increase the appearance of being inclusivity, to represent a broad range of disciplines, as well as to reflect the ‘diverse ways’ that potential beneficiaries of academic research can be reached ‘beyond academia’. The adoption of societal impact as a formalised criterion in the evaluation of research excellence was initially perceived to be potentially beneficial for women, due to its emphasis on concepts such as ‘public engagement’; ‘duty’ and non-academic ‘cooperation/collaboration’ (Yarrow and Davies, 2018 ). In addition, the adoption of narrative case studies to demonstrate Impact, rather than adopting a complete metrics-focused exercise, can also be seen as an opportunity for women to demonstrate excellence in the areas where they are over-represented, such as teaching, cultural enrichment, public engagement (Andrews et al., 2005 ), informing public policy and improving public services (Schatteman, 2014 ; Wheatle and BrckaLorenz, 2015). However, despite this, studies highlight how for the REF2014, only 25% of Impact Case Studies for business and management studies were from women (Davies et al., 2020 ).

With respect to Impact evaluation, previous research shows that there is a direct link between notions of academic culture, and how research (as a product of that culture) is valued and evaluated (Leathwood and Reid, 2008 ; p. 120). Geertz ( 1983 ) argues that academic membership is a ‘cultural frame that defines a great part of one’s life’ influences belief systems around how academic work is orientated. This also includes gendered associations implicit in the academic reward system, which in turn influences how academics believe success is to be evaluated, and in what form that success emerges. This has implications in how academic associations of the organisation of research work and the ongoing constructions of professional identity relative to gender, feeds into how these same academics operate as evaluators within a peer review system evaluation. In this case, instead of operating to challenge these tendencies, shared constructions of gendered academic work are amplified to the extent that they unconsciously influence perceptions of excellence and the judgements of feasibility as pertaining to the attribution and causality of the narrative argument. As such, in an evaluation of Impact with its ambiguous definition (Derrick, 2018 ), and the lack of external indicators to signal success independent of cultural constructions inherent in the panel membership, effects are assumed to be more acute. In this way, this paper argues that the Impact a-gender can act to further disadvantage women.

The research combines two existing research data sets in order to explore implicit notions of gender associated with the generation and evaluation of research Impact beyond academia. Below the two data sets and the steps involved in analysing and integrating findings are described along with our theoretical positioning within the feminist literature Where verbatim quotation is used, we have labelled the participants according to each study highlighting their role and gender. Further, the evaluator interviews specify the disciplinary panel and subpanel to which they belonged, as well as their evaluation responsibilities such as: ‘Outputs only’; ‘Outputs and Impact’; and ‘Impacts only’.

Analysis of qualitative data sets

This research involved the analysis and combination of two independently collected, qualitative interview databases. The characteristics and specifics of both databases are outlined below.

Interviews with mid-senior academics in the UK and Australia

Fifty-one semi-structured interviews were conducted between 2011 and 2013 with mid-senior academics at two research-intensive universities in Australia and the UK. The interviews were 30–60 min long and participants were sourced via the research offices at both sites. Participants were contacted via email and invited to participate in a study concerning resistance towards the Impact agenda in the UK and Australia and were specifically asked for their perceptions of its relationship with freedom, value and epistemic responsibility and variations across discipline, career stage and national context. Mostly focused on ex ante impact, some interviewees also described their experiences of Impact in the UK and Australia, in relation to its formal assessment as part of the Excellence Innovation Australia (EIA) for Australia and the Research Excellence Framework (REF) in the UK.

Participants comprised mid to senior career academics with experience of winning funding from across the range of disciplines broadly representative of the arts and humanities, social sciences, physical science, maths and engineering and the life and earth sciences. For the purposes of this paper, although participant demographic information was collected, the relationship between the gender of the participants, their roles, disciplines/career stage was not explicitly explored instead, such conditions were emergent in the subsequent inductive coding during thematic analysis. A reflexive log was collected in order to challenge and draw attention to assumptions and underlying biases, which may affect the author, inclusive of their own gender identity. Further information on this is provided in Chubb ( 2017 ).

Pre- and post-evaluation interviews with REF2014 evaluators

REF2014 in the UK represented the world’s first formalised evaluation of ex-post impact, comprising of 20% of the overall evaluation. This framework served as a unique experimental environment with which to explore baseline tendencies towards impact as a concept and evaluative object (Derrick, 2018 ).

Two sets of semi-structured interviews were conducted with willing participants: sixty-two panellists were interviewed from the UK’s REF2014 Main Panel A prior to the evaluation taking place; and a fifty-seven of these were re-interviewed post-evaluation. Main Panel A covers six Sub-panels: (1) Clinical Medicine; (2) Public Health, Health Services and Primary Care; (3) Allied Health Professions, Dentistry, Nursing and Pharmacy; (4) Psychology, Psychiatry and Neuroscience; (5) Biological Sciences; and (6) Agriculture, Veterinary and Food Sciences. Again, the relationship between the gender of the participants and their discipline is not the focus for the purposes of this paper.

Database combination and identification of common emergent themes

The inclusion of data sets using both Australian and UK researchers was pertinent to this study as both sites were at the cusp of implementing the evaluation of Impact formally. These researcher interviews, as well as the evaluator interviews were conducted prior to any formalised Impact evaluation took place, but when both contexts required ex ante impact in terms of certain funding allocation, meaning an analysis of these baseline perceptions between databases was possible. Further, the inclusion of the post-evaluation interviews with panellists in the UK allowed an exploration of how these gendered perceptions identified in the interviews with researchers and panellists prior to the evaluation, influenced panel behaviour during the evaluation of Impact.

Initially, both data sets were analysed using similar, inductive, grounded-theory-informed approaches inclusive of a discourse and thematic analysis of the language used by participants when describing impact, which allowed for the drawing out of metaphor (Zinken et al., 2008 ). This allowed data combination and analysis of the two databases to be conducted in line with the recommendations for data-synthesis as outlined in Weed ( 2005 ) as a form of interpretation. This approach guarded against the quantification of qualitative findings for the purposes of synthesis, and instead focused on an initial dialogic approach between the two authors (Chubb and Derrick), followed by a re-analysis of qualitative data sets (Heaton, 1998 ) in line with the outcomes of the initial author-dialogue as a method of circumventing many of the drawbacks associated with qualitative data-synthesis. Convergent themes from each, independently analysed data set were discussed between authors, before the construction of new themes that were an iterative analysis of the combined data set. Drawing on the feminist tradition the authors did not apply feminist standpoint theory, instead a fully inductive approach was used to unearth rich empirical data. An interpretative and inductive approach to coding the data using NVIVO software in both instances was used and a reflexive log maintained. The availability of both full, coded, qualitative data sets, as well as the large sample size of each, allowed this data-synthesis to happen.

Researcher’s perceptions of Impact as either ‘hard’ or ‘soft’

Both UK and Australian academic researchers (researchers) perceive a guideline of gendered productivity (Davies et al., 2017 ; Sax et al., 2002 ; Astin, 1978 ; Ward and Grant, 1996 ). This is where men or women are being dissuaded (by their inner narratives, their institutions or by colleagues) from engaging in Impact either in preference to other (more masculine) notions of academic productivity, or towards softer (for women) because they consider themselves and are considered by others to be ‘good at it’. Participants often gendered the language of Impact and introduced notions of ‘hard’ and ‘soft’. On the one hand, this rehearses and resurfaces long-standing views about the ‘Matthew Effect’ because often softer Impacts were seen as being of less value by participants, but also indicates that the word impact itself carries its own connotations, which are then weighed down further by more entrenched gender associations.

Our research shows that when describing Impact, it was not necessarily the masculinity or femininity of the researcher that was emphasised by participants, rather researchers made gendered presumptions around the type of Impact, or the activity used to generate it as either masculine or feminine. Some participants referred to their own research or others’ research as either ‘hard’ or as ‘soft and woolly’. Those who self-professed that their research was ‘soft’ or woolly’ felt that their research was less likely to qualify as having ‘hard’ impact in REF terms Footnote 3 ; instead, they claimed their research would impact socially, as opposed to economically; ‘ stuff that’s on a flaky edge — it’s very much about social engagement ’ (Languages, Australia, Professor, Male) . One researcher described Impact as ‘a nasty Treasury idea,’ comparing it to: a tsunami, crashing over everything which will knock out stuff that is precious ’ . (Theatre, Film and TV, UK, Professor, Male) . This imagery associates the concept of impact with force and weight (or hardness as mentioned earlier) particularly in disciplines where the effect of their research may be far more nuanced and subtle. One Australian research used force to depict the impact of teaching and claimed Impact was like a footprint, and teaching was ‘ a pretty heavy imprint ’ (Environment, UK, Professor, Male) . Participants characterised ‘force and weight’ as masculine, suggesting that some connotations of Impact and the associated activities may be gendered. The word ‘Impact’ was inherently perceived by many researchers as problematic, bound with linguistic connotations and those imposed by the official definitions, which in many cases are perceived as negative or maybe even gendered (Chubb, 2017 ): ‘ The etymology of a word like impact is interesting. I’ve always seen what I do as being a more subtle incremental engagement, relevance, a contribution ’. (Theatre, Film and TV, UK, Professor, Male) .

Researchers associated the word ‘impact’ with hard-ness, weight and force; ‘ anything that sorts of hits you ’ (Languages, UK, Senior Lecturer, Female) . One researcher suggested that Impact ‘ sounds kind of aggressive — the poor consumer! ’ (History, Australia, Professor, Female) . Talking about her own research in the performing arts, one Australian researcher commented: ‘ It’s such a pain in the arse because the Arts don’t fit the model. But in a way they do if you look at the impact as being something quite soft ’ (Music, Australia, Professor, Female) . Likewise, a similar comparison was seen by a female researcher from the mechanical engineering discipline: ‘ My impact case study wasn’t submitted mainly because I’m dealing with that slightly on the woolly side of things ’ (Mechanical Engineering, Australia, Professor, Female) . Largely, gender related comments hailed from the ‘hard’ science and from arts and humanities researchers. Social scientists commented less, and indeed, one levelled that Impact was perhaps less a matter of gender, and more a matter of ability (Chubb, 2017 ): ‘ It’s about being articulate! Both guys and women who are very articulate and communicate well are outward looking on all of these things ’ ( Engineering Education, Australia, Professor, Female).

Gendered notions of performativity were also very pronounced by evaluators who were assessing the outputs only, suggesting how these panel cultures are orientated around notions of gender and scientific outputs as ‘hard’ if represented by numbers. The focus on numbers was perceived by the following panellist as ‘ a real strong tendency particularly amongst the Alpha male types ’ within the panel that relate to findings about the association of certain traits—risk aversion, competitiveness, for example, with a masculinised market logic in HE;

And I like that a lot because I think that there is a real strong tendency particularly amongst the Alpha male types of always looking at the numbers, like the numbers and everything. And I just did feel that steer that we got from the panel chairs, both of them were men by the way, but they were very clear, the impact factors and citations and the rank order of a journal is this is information that can be useful, but it’s not your immediate first stop. (Panel 1, Outputs and Impact, Female)

However, a metric-dominant approach was not the result of a male-dominated panel environment and instead, to the panels credit, evaluators were encouraged not to use one-metric as the only deciding factor between star-rating of quality. However, this is not to suggest that metrics did not play a dominant role. In fact, in order to resolve arguments, evaluators were encouraged to ‘ reflect on these other metrics ’ (Panel 3, Outputs only, Male) in order to rectify arguments where the assessment of quality was in conflict. This use of ‘other metrics’ was preferential to a resolution of differences that are based on more ‘soft’ arguments that are based on understanding where differences in opinion might lie in the interpretation of the manuscript’s quality. Instead, the deciding factor in resolving arguments would be the responsibility, primarily, of a ‘hard’ concept of quality as dictated by a numerical value;

Read the paper, judge the quality, judge the originality, the rigour, the impact — if you have to because you’re in dispute with another assessor, then reflect on these other metrics. So I don’t think metrics are that helpful actually if and until you’ve got a real issue to be able to make a decision. But I worry very much that metrics are just such a simple way of making the process much easier, and I’m worried about that because I think there’s a bit of game playing going on with impact factors and that kind of thing. (Panel 3, Outputs Only, Male)

Table 1 outlines the emergent themes, which, through inductive coding participants broadly categorised domains of research, their qualities and associations, types of activities and the gendered assumption generally made by participants when describing that activity. The table is intended only to provide an indicative overview of the overall tendencies of participants toward certain narratives as is not exhaustive, as well as a guide to interpret the perceptions of Impact illustrated in the below results.

Table one describes the dichotomous views that seemed to emerge from the research but it’s important to note that researchers associated Impact as related to gender in subtle, and in some cases overt ways. The data suggests that some male participants felt that female academics might be better at Impact, suggesting that female academics might find it liberating, linked it to a sense of duty or public service, implying that it was second nature. In addition, some male participants associated types of Impact domains as female-orientated activity and the reverse was the case with female and male-orientated ‘types’ of Impact. For example, at one extreme, a few male researchers seemed to perceive public engagement as something, which females would be particularly good at, generalising that they are not competitive ‘ women are better at this! They are less competitive! ’ (Environment, UK, Professor, Male) . Indeed, one male researcher suggested that competitiveness actually helps academics have an impact and does not impede it:

I get a huge buzz from trying to communicate those to a wider audience and winning arguments and seeing them used. It’s not the use that motivates me it’s the process of winning, I’m competitive! (Economics, UK, Professor, Male)

Analysis also revealed evidence that some researchers has gendered perceptions of Impact activities just as evaluators did. Here, women were more likely to promote the importance of engaging in Impact activities, whereas men were focused on producing indicators with hard, quantitative indicators of success. Some researchers implied that public engagement was not something entirely associated with the kinds of Impact needed to advance one’s career and for a few male researchers, this was accordingly associated with female academics. Certain female researchers in the sciences and the arts suggested similarly that there was a strong commitment among women to carry out public engagement, but that this was not necessarily shared by their male counterparts who, they perceived, undervalued this kind of work:

I think the few of us women in the faculty will grapple with that a lot about the relevance of what we’re doing and the usefulness, but for the vast majority of people it’s not there… [She implies that]…I think there is a huge gender thing there that every woman that you talk to on campus would consider that the role of the university is along the latter statement (*to communicate to the public). The vast majority of men would not consider that’s a role of the university. There’s a strong gender thing. (Chemical Engineering, Australia, Professor, Female)

Notwithstanding, it is important to distinguish between engagement and Impact. This research shows that participants perceive Impact activities to be gendered. There was a sense from one arts female researcher that women might be more interested in getting out there and communicating their work but that crucially, it is not the be-all and end- all of doing research: ‘ Women feel that there’s something more liberating, I can empathise with that, but that couldn’t be the whole job ’. Music, Australia, Professor, Female Footnote 4 . When this researcher, who was very much orientated towards Impact, asked if there were enough interviewees, she added ‘ mind you, you’ve probably spoken to enough men in lab coats ’. This could imply that inward-facing roles are associated with male-orientated activity and outward facing roles as perceived as more female orientated. Such sentiments perhaps relate to a binary delineation of women as more caring, subjective, applied and of men as harder, scientific and theoretical/ rational. This links to a broader characterisation of HE as marketised and potentially, more ‘male’ or at least masculinised—where increasing competitiveness, marketisation and performativity can be seen as linked to an increasingly macho way of doing business (Blackmore, 2002 ; Deem, 1998 ; Grummell et al., 2009 ; Reay, n.d. ). The data is also suggestive of the attitude that communication is a ‘soft’ skill and the interpersonal is seen as a less masculine trait. ‘ This is a huge generalisation but I still say that the profession is so dominated by men, undergraduates are so dominated by men and most of those boys will come into engineering because they’re much more comfortable dealing with a computer than with people ’ (Chemical Engineering, Australia, Professor, Female) . Again, this suggests women are more likely to pursue those scientific subjects, which will make a difference or contribute to society (such as nursing or environmental research, certainly those subjects that would be perceived as less ‘hard’ science domains).

There was also a sense that Impact activity, namely in this case public engagement and community work, was associated with women more than men by some participants (Amâncio, 2005 ). However, public engagement and certain social impact domains appeared to have a lower status and intellectual worth in the eyes of some participants. Some inferred that social and ‘soft’ impacts are seen as associated. With discipline. For instance, research concerning STEM (Science, Technology, Engineering and Medicine) subjects with females. They in turn may be held in low esteem. Some of the accounts suggest that soft impacts are perceived by women as not ‘counting’ as Impact:

‘ At least two out of the four of us who are female are doing community service and that doesn’t count, we get zero credit, actually I would say it gets negative credit because it takes time away from everything else ’. (Education Engineering, Australia, Professor, Female)

This was intimated again by another female UK computer scientist who claimed that since her work was on the ‘woolly side’ of things, and her impacts were predominantly in the social and public domain, she would not be taken seriously enough to qualify as a REF Impact case study, despite having won an award for her work:

‘ I don’t think it helps that if I were a male professor doing the same work I might be taken more seriously. It’s interesting, why recently? Because I’ve never felt that I’ve not been taken seriously because I’m a woman, but something happened recently and I thought, oh, you’re not taking me seriously because I’m a woman. So I think it’s a part ’. (Computer Science, UK, Professor, Female)

Researchers also connect the ‘hard’ and ‘soft’ associations with Impact described earlier to male and female traits. The relationship between Impact and gender is not well understood and it is not clear how much these issues are directly relatable to Impact or more symptomatic of the broader picture in HE. In order to get a broader picture, it is important to examine how these gendered notions of Impact translate into its evaluation. Some participants suggested that gender is a factor in the securing of grant money—certainly this comment reveals a local speculation that ‘the big boys’ get the grants, in Australia, at least: ‘ ARC grants? I’ve had a few but nothing like the big boys that get one after the other ,’ (Chemical Engineering, Australia, Professor, Female) . This is not dissimilar to the ‘alpha male’ comments from the evaluators described below who note a tendency for male evaluators to rely on ‘hard’ numbers whose views are further examined in the following section.

Gendered excellence in Impact evaluation

In the pre-evaluation interviews, panellists were asked about what they perceived to be ‘excellent’ research and ‘excellent’ Impact. Within this context, are mirrored conceptualisations of impacts as either ‘soft’ or ‘hard’ as was seen with the interviews with researchers described above. These conceptualisations were captured prior to the evaluation began. They can therefore be interpreted as the raw, baseline assumptions of Impact that are free from the effects of the panel group, showed that there were differences in how evaluators perceived Impact, and that these perceptions were gendered.

Although all researchers conceptualised Impact as a linear process for the purposes of the REF2014 exercise (Derrick, 2018 ), there was a tendency for female evaluators to be open to considering the complexity of Impact, even in a best-case scenario. This included a consideration that Impact as dictated within the narrative might have different indicators of value to different evaluators; ‘ I just think that that whole framing means that there is a form of normative standard of perfect impact ’ (Main Panel, Outputs and Impacts, Female) . This evaluator, in particular, went further to state how that their impression of Impact would be constructed from the comparators available during the evaluation;

‘ Given that I’m presenting impact as a good story, it would be like you saying to me; ‘Can you describe to me a perfect Shakespearean play?’…. well now of course, I can’t. You can give me lots of plays but they all have different kinds of interesting features. Different people would say that their favourite play was different. To me, if you’re taking interpretivist view, constructivist view, there is no perfect normative standard. It’s just not possible ’. (Panel 1, Outputs and Impacts, Female)

Female evaluators were also more sensitive to other complex factors influencing the evaluation of Impact, including time lag; ‘ …So it takes a long time for things like that to be accepted…it took hundreds of studies before it was generally accepted as real ’ (Panel 1, Outputs and Impacts, Female ); as well as the indirect way that research influences policy as a form of Impact;

‘ I don’t think that anything would get four stars without even blinking. I think that is impossible to answer because you have to look at the whole evidence in this has gone on, and how that does link to the impact that is being claimed, and then you would then have to look at how that impact, exactly how that research has impacted on the ways of the world, in terms of change or in terms of society or whatever. I don’t think you can see this would easily get four stars because of the overall process is being looked at, as well as the actual outcome ’ . (Panel 3, Outputs and Impact, Female)

Although these typologies were not absolute, there was a lack of complexity in the nuances around Impact. There was also heavily gendered language around Impacts as measurable, or not, that mirrored the association of Impact as being either ‘hard’, and therefore measurable, or ‘soft, and therefore more nuanced in value. In this way, male evaluators expressed Impact as a causal, linear event that occurred ‘ in a very short time ’ (P2, Outputs and Impact, Male) and involved a single ‘ star ’ (P3, Impacts only, Male) or ‘ impact champion ’ (Main Panel, Outputs and Impacts, Male) that drove it from start (research), to finish (Impact). These associations about Impact being ‘soft’ and ‘hard’ made by evaluators, mirror the responses from researchers in the above sections. In the example below, the evaluator used words such as ‘ strong ’ and ‘ big way ’ to describe Impact success, as well as emphasises causality in the argument;

‘ …if it has affected a lot of people or affected policy in a strong way or created change in a big way, and it can be clearly linked back to the research, and it’s made a difference ’. (Panel 2, Outputs and Impact, Male)

These perhaps show disciplinary differences as much as gendered differences. Further, there was a stronger tendency for male evaluators to strive towards conceptualisations of excellence in Impact as measurable or ‘ it’s something that is decisive and actionable ’ (Panel 6, Impacts, Male) . One male evaluator explained his conceptualised version of Impact excellence as ‘ straightforward ’ and therefore ‘ obviously four-star ’ due to the presence of metrics with which to measure Impact. This was a perception more commonly associated with male evaluators;

‘ …if somebody has been able to devise a — let’s say pancreatic cancer — which is a molecular cancer, which hasn’t made any progress in the last 40 years, and where the mortality is close to 100% after diagnosis, if someone devised a treatment where now suddenly, after diagnosis of pancreatic cancer, 90 percent of the people are now still alive 5 years later, where the mortality rate is almost 0%, who are alive after 5 years. That, of course, would be a dramatic, transformative impact ’. (Panel 1, Outputs and Impact, Male)

In addition, his tendency to seek various numeric indicators for measuring, and therefore assessing Impact (predominantly economic impact), as well as compressing its realisation to a small period of time ( ‘ suddenly ’ ) in a causal fashion, was more commonly expressed in male evaluators. This tendency automatically indicates the association of impacts as either ‘soft’ or ‘hard’ and divided along gendered norms, but also expresses Impact in monetary terms;

‘ Something that went into a patient or the company has pronounced with…has spun out and been taken up by a commercial entity or a clinical entity ’ (Panel 3, Outputs and Impacts, Male) , as well as impacts that are marketised; ‘ A new antimicrobial drug to market ’. (Panel 6, Outputs and Impact, Male) .

There was also the perception that female academics would be better at engagement (Johnson et al., 2014 ; Crettaz Von Roten, 2011 ) due to its link with notions of ‘ duty ’ (as a mother), ‘ engagement ’ and ‘ public service ’ are reflected in how female evaluators were also more open to the idea that excellent Impact is achieved through productive, ongoing partnerships with non-academic stakeholders. Here, the reflections of ‘duty’ from the evaluators was also mirrored by in interviews with researchers. Indeed, the researchers merged perceptions of parenthood, an academic career and societal impact generation. One female researcher drew on her role as a mother as supportive of her ability to participate in Impact generation, ‘ I have kids that age so… ’ (Biology, UK, Senior Lecturer, Female) . Indeed, parenthood emerged from researchers of both genders in relation to the Impact agenda. Two male participants spoke positively about the need to transfer knowledge of all kinds to society referencing their role as parents: ‘ I’m all for that. I want my kids to have a rich culture when they go to school ’ (Engineering, Australia, Professor, Male, E2) , and ‘ My children are the extension of my biological life and my students are an extension of my thoughts ’ (Engineering, Australia, Professor, Male, E1) . One UK female biologist commented that she indeed enjoys delivering public engagement and outreach and implies a reference to having a family as enabling her ability to do so: ‘ It’s partly being involved with the really well-established outreach work ,’ (Biology, UK, Senior Lecturer, Female) .

For the evaluators, the idea that ‘public service’ as second nature for female academics, was reflected in how female evaluators perceived the long, arduous and serendipitous nature of Impact generation, as well as their commitment to assessing the value of Impact as a ‘pathway’ rather than in line with impact as a ‘product’. Indeed, this was highlighted by one male evaluator who suggested that the measurement and assessment of Impact ‘ …needs to be done by economists ’ and that

‘ you [need] to put in some quantification one everything…[that] puts a negative value on being sick and a positive large value on living longer. So, yeah, the greatest impact would be something that saves us money and generates income for the country but something broad and improves quality of life ’. (Panel 2, Impacts, Male)

Since evaluators tend to exercise cognitive bias in evaluative situations (Langfeldt, 2006 ), these preconceived ideas about Impact, its generation and the types of people responsible for its success are also likely to permeate the evaluative deliberations around Impact during the peer review process. What is uncertain is the extent that these messages are dominant within the panel discourse, and therefore the extent that they influence the formation of a consensus within the group, and the ‘dominant definition’ of Impact (Derrick, 2018 ) that emerges as a result.

Notions of gender from the evaluators post-evaluation

Similar notions of gender-roles in academia pertaining to notions of scientific productivity were echoed by academics who were charged with its evaluation as part of the UK’s 2014 Research Excellence Framework. Interviews with evaluators revealed not only that the panel working-methods and characteristics about what constituted a ‘good’ evaluator were implicitly along gendered norms, but also that the assumed credit assumptions of performativity were also based on gender.

In assessments of the Impact criterion, an assessment that is not as amenable to quantitative representation requiring panels to conceptualise a very complex process, with unstandardised measures of significance and reach, there was still a gendered perception of Impact being ‘women’s work’ in academia. This perception was based on the tendency towards conceptualising Impact as ‘slightly grubby’ and ‘not very pure’, which echoes previously reported pre-REF2014 tensions that Impact is a task that an academic does when they cannot do real research (de Jong et al., 2015 );

But I would say that something like research impact is — it seems something slightly grubby. It’s not seen as not — by the academics, as not very pure. To some of them, it seems women’s work. Talking to the public, do you see what I mean? (Main Panel, Outputs and Impact, Female)

In addition, gendered roles also relate to how the panel worked with the assessment of Impact. Previous research has outlined how the equality and diversity assessment of panels for REF2014 were not conducted until after panellists were appointed (Derrick, 2018 ), leading to a lack of equal-representation of women on most panels. Some of the female panellists reflected that this resulted not only in a hyper-awareness of one’s own identity and value as a woman on the panel, but also implicitly associating the role that a female panellist would play in generating the evaluation. One panellist below, reflected that she was the only female in a male-dominated panel, and that the only other females in the room were the panel secretariat. The panellist goes further to explain how this resulted in a gendered-division of labour surrounding the assessment of Impact;

I mean, there’s a gender thing as well which isn’t directing what you’re talking about what you’re researching, but I was the only woman on the original appointed panel. The only other women were the secretariat. In some ways I do — there was initially a very gendered division of perspective where the women were all the ones aggregate the quantitative research, or typing it all up or talking about impact whereas the men were the ones who represented the big agenda, big trials. (Main Panel, Outputs and Impact, Female)

In addition, evaluators expressed opinions about what constituted a good and a bad panel member. From this, the evaluation showed that traits such as the ability to work as a ‘team’ and to build on definitions and methods of assessment for Impact through deliberation and ‘feedback’ were perceived along gendered lines. In this regard, women perceived themselves as valuable if they were ‘happy to listen to discussions’, and not ‘too dogmatic about their opinion’. Here, women were valued if they played a supportive, supplementary role in line with Bellas ( 1999 ), which was in clear distinction to men who contributed as creative thinkers and forgers of new ideas. As one panellist described;

A good panel member is an Irish female. A good panel member was someone who was happy to — someone who is happy to listen to discussions; to not be too dogmatic about their opinion, but can listen and learn, because impact is something we are all learning from scratch. Somebody who wasn’t too outspoken, was a team player. (Panel 3, Outputs and Impact, Female)

Likewise, another female evaluator reflected on the reasons for her inclusion as a panel member was due to her ‘generalist perspective’ as opposed to a perspective that is over prescribed. This was suggestive of how an overly specialist perspective would run counter to the reasons that she was included as a panellist which was, in her opinion, due to her value as an ethnic and gender ‘token’ to the panel;

‘ I think it’s also being able to provide some perspective, some general perspective. I’m quite a generalist actually, I’m not a specialist……So I’m very generalist. And I think they’re also well aware of the ethnic and gender composition of that and lots of reasons why I’m asked on panels. (Panel 1, Outputs and Impact, Female)

Women perceived their value on the panel as supportive, as someone who is prepared to work on the team, and listen to other views towards as a generalist, and constructionist, rather than as an enforced of dogmatic views and raw, hard notions of Impact that were represented through quantitative indicators only. As such, how the panel operated reflects general studies of how work can be organised along gender lines, as well as specific to workload and power in the academy. The similarity between the gendered associations towards conceptualising Impact from the researchers and evaluators, combined with how the panel organises its work along gendered lines, suggests how panel culture echoes the implicit tendencies within the wider research community. The implications of this tendency in relation to the evaluation of non-academic Impact is discussed below.

Discussion: an Impact a-gender?

This study shows how researchers and evaluators in two, independent data sets echoed a gendered orientation towards Impact, and how this implies an Impact a-gender. That gendered notions of Impact emerged as a significant theme from two independent data sets speaks to the importance of the issue. It also illustrates the need for policymakers and funding organisations to acknowledge its potential effects as part of their efforts towards embedding a more inclusive research culture around the generation and evaluation of research impact beyond academia.

Specifically, this paper has identified gendered language around the generation of, and evaluation of Impact by researchers in Australia and the UK, as well as by evaluators by the UK’s most recent Research Excellence Framework in 2014. For the UK and Australia, the prominence of Impact, as well as the policy borrowing between each country (Chubb, 2017 ) means that a reliable comparison of pre-evaluation perceptions of researchers and evaluators can be made. In both data sets presumptions of Impact as either ‘soft’ or ‘hard’ by both researchers and evaluators were found to be gendered. Whereas it is not surprising that panel culture reflects the dominant trends within the wider academic culture, this paper raises the question of how the implicit operation of gender bias surrounding notions of scientific productivity and its measurement, invade and therefore unduly influence the evaluation of those notions during peer-review processes. This negates the motivation behind a broad Impact definition and evaluation as inclusive since unconscious bias towards women can still operate if left unchecked and unmanaged.

Gendered notions of excellence were also related to the ability to be ‘competitive’, and that once Impact became a formalised, countable and therefore competitive criterion, it also become masculine where previously it existed as a feminised concept related to female academic-ness. As a feminised concept, Impact once referred to notions of excellence requiring communication such as public engagement, or stakeholder coordination—the ‘softer’ impacts. However, this association only remains ‘soft’ insofar as Impact remains unmeasurable, or more nuanced in definition. This is especially pertinent for the evaluation of societal impact where already conceived ideas of engagement and ‘ women’s work ’ influence how evaluators assess the feasibility of impact narratives for the purposes of its assessment. This paper also raises the question that notions of gender in relation to Impact persist irrespective of the identities assumed for the purposes of its evaluation (i.e., as a peer reviewer). This is not to say that academic culture in the UK and Australia, where Impact is increasingly being formalised into rewards systems, is not changing. More that there is a tendency in some evaluations for the burden of evidence to be applied differently to genders due to tensions surrounding what women are ‘good’ at doing: engagement, versus what ‘men’ are good at doing regarding Impact. In this scenario, quantitative indicators of big, high-level impacts are to be attributable to male traits, rather than female. This has already been noted in student evaluations of teaching (Kogan et al., 2010 ) and of academic leadership performance where the focus on the evaluation is on how others interpret performance based on already held gendered views about competence based on behaviours (Williams et al., 2014 ; Holt and Ellis, 1998 ). As such, when researchers transcend these gendered identities that are specific to societal impact, there is a danger of an Impact-a-gender bias arising in the assessment and forecasting of Impact. This paper extends this understanding and outlines how this may also be the case for assessments of societal impact.

By examining perceptions, as well as using an inductive analysis, this study was able to unearth unconsciously employed gendered notions that would not have been prominent or possible to pick up if we asked the interviewees about gender directly. This was particularly the case for the re-analysis of the post-evaluation interviews. However, future studies might consider incorporating a disciplinary-specific perspective as although the evaluators were from the medical/biomedical disciplines, researchers were from a range of disciplines. This would identify any discipline-specific risk towards an Impact a-gender. Nonetheless, further work that characterises the impact a-gender, as well as explores its wider implications for gender inequities within HE is currently underway.

How research evidence is labelled as excellent and therefore trustworthy, is heavily dictated by an evaluation process that is perceived as impartial and fair. However, if evaluations are compounded by gender bias, this confounds assessments of excellence with gendered expectation of non-academic impact. Consequently, gendered expectations of excellence for non-academic impact has the potential to: unconsciously dissuade women from pursuing more masculinised types of impact; act as a barrier to how female researchers mobilise their research evidence; as well as limit the recognition female researchers gain as excellent and therefore trustworthy sources of evidence.

The aim of this paper was not to criticise the panellists and researchers for expressing gendered perspectives, nor to present evidence about how researchers are unduly influenced by gender bias. The results shown do not support either of these views. However, the aim of this paper was to acknowledge how gender bias in research Impact generation can lead to a panel culture dominated by academics that translate the implicit and explicit biases within academia that influence its evaluation. This paper raises an important question regarding what we term the ‘Impact a-gender’, which outlines a mechanism in which gender bias feeds into the generation and evaluation of a research criterion, which is not traditionally associated with a hard, metrics-masculinised output from research. Along with other techniques used to combat unconscious bias in research evaluation, simply by identifying, and naming the issue, this paper intends to combat its ill effects through a community-wide discussions as a mechanism for developing tools to mitigate its wider effect if left unchecked or merely accepted as ‘acceptable’. In addition, it is suggested that government and funding organisations explicitly refer to the impact a-gender as part of their wider EDI (Equity, Diversity and Inclusion) agendas towards minimising the influence of unconscious bias in research impact and evaluation.

Data availability

Data is available upon request subject to ethical considerations such as consent so as not to compromise the individual privacy of our participants.

Change history

19 may 2020.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

For the purposes of this paper, when the text refers to non-academic, societal impact, or the term ‘Impact’ we are referring to the change and effect as defined by REF2014/2021 and the larger conceptualisation of impact that is generated through knowledge exchange and engagement. In this way, the paper refers to a broad conceptualisation of research impact that occurs beyond academia. This allows a distinction between Impact as central to this article’s contribution, as opposed to academic impact, and general word ‘impact’.

Impact scholars or those who are ‘good at impact’ are often equated with applied researchers.

One might interpret this as meaning ‘economic impact’.

This is described in the next section as ‘women’s work’ by one evaluator.

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Acknowledgements

This research was funded by the UK Economic and Social Research Council (ESRC) Future Research Leaders Programme (ES/K008897/2). We would also like to acknowledge their peers for offering their views on the paper in advance of publication and in doing so thank Dr. Richard Watermeyer, University of Bath, Professor Paul Wakeling, University of York and Dr. Gabrielle Samuel, Kings College London.

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Chubb, J., Derrick, G.E. The impact a-gender: gendered orientations towards research Impact and its evaluation. Palgrave Commun 6 , 72 (2020). https://doi.org/10.1057/s41599-020-0438-z

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Gender Stereotypes and Discrimination: How Sexism Impacts Development

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• 1 University of Kentucky, Lexington, KY, United States. Electronic address: [email protected].
• 2 University of Kentucky, Lexington, KY, United States.
• PMID: 26956071
• DOI: 10.1016/bs.acdb.2015.11.001

In this chapter, we summarize and integrate some of the latest developmental science research on gender stereotypes and discrimination in childhood and adolescence. We focus on five forms of sexism: (a) stereotypes and discrimination against boys regarding their school behaviors and disciplinary actions; (b) stereotypes and discrimination against girls in science, technology, engineering, and mathematics (STEM) domains; (c) stereotypes and discrimination in sports; (d) peer gendered harassment, including sexual harassment and teasing because of gender atypicality or nonconformity; and (e) sexualized gender stereotypes that sexually objectify girls and assume boys are sexually voracious. First, we document each type of sexism and examine children's awareness and perceptions of that bias, including their own self-reports and attributions. We examine the implications of this sexism for children and adolescents' developmental health (i.e., social, academic, and psychological well-being). We then draw connections between these various areas of research, focusing on how these different forms of sexism interact to reduce equity and justice among children and negatively impact positive developmental outcomes. The chapter concludes with suggestions for future research.

Keywords: Discrimination; Gender stereotypes; STEM; Sexual harassment; Sexualization.

© 2016 Elsevier Inc. All rights reserved.

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Research: When Employees Identify with Their Company, They’re Less Likely to Recognize Gender Discrimination

• Jamie L. Gloor,
• Tyler Okimoto,
• Brooke Gazdag,
• Michelle Ryan

Beware the “not here” bias.

Identifying as an organizational member — or feeling a strong sense of attachment to the organization — is generally a positive thing for employees and employers. But our research on workplace incivility and mistreatment shows that it can also shape when — and if — employees recognize and respond to subtle forms of discrimination against women at work. Evidence shows that leaders, as well as employees, play a key role in identifying and remedying gender discrimination in all its forms. If the goal is to proactively address gender discrimination in the workplace and encourage leaders and workers to remove their rose-colored glasses, this article offers a few suggestions.

You’re in the elevator of your office building. The doors open and two coworkers — one male and one female — enter the elevator in a heated debate. The female employee is trying to explain an issue on a project she’s leading, but the male employee interrupts her: “ Geez, I’ve heard enough of you and your opinions!” The woman falls silent, clearly upset and shaken by the comment.

• JG Jamie L. Gloor is a Swiss National Science Foundation professor of Leadership & Diversity Science at the University of St.Gallen in Switzerland. Her research, teaching, and speaking focus on diversity and inclusion, leadership, humor, and sustainability to craft more equitable, enjoyable, and productive workplaces with positive impact.
• TO Tyler Okimoto is a professor of management and academic dean within the faculty of Business, Economics, and Law at the University of Queensland. His research aims to understand the factors that bias employee judgments and lead to discrimination at work, and how organizations can work through biased viewpoints to promote consensus and a greater sense of fairness.

Xinxin Li is an associate professor of management at the Antai College of Economics and Management at the Shanghai Jiao Tong University. Her research focuses on DEI, business ethics, and emotions at work.

• BG Brooke Gazdag is an associate professor and academic director of executive education at the Kühne Logistics University in Hamburg, Germany. Through her research and teaching, she seeks to improve employees’ experience at work through leadership, negotiations, and diversity and inclusion.

Michelle Ryan is a professor of social and organizational psychology and the director of the Global Institute for Women’s Leadership at The Australian National University. Her work centers on understanding the psychological processes underlying workplace gender inequality, and designing and implementing innovative and evidence-based interventions to increase gender equality.

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Women live more years in ill-health than men, finds gender health gap study

While men are disproportionally affected by conditions that cause early death, women are left with higher levels of illness and disability

Women live longer than men but experience more years in poor health, according to a global gender health gap analysis that experts say underlines an urgent need for action to boost women’s health.

Globally, there are substantial differences between women and men when it comes to health, with limited progress in bridging health gaps over the past three decades, according to the study examining the impact of the world’s 20 leading causes of disease.

The findings were published in the Lancet Public Health journal.

Non-fatal conditions that cause illness and disability, such as musculoskeletal problems, mental health issues and headache disorders, particularly affect women, researchers found.

At the same time men are disproportionally affected by conditions that cause premature death, such as cardiovascular diseases, respiratory and liver diseases, Covid-19 and road injuries.

The health differences between women and men continue to grow with age, leaving women with higher levels of illness and disability throughout their lives, as they tend to live longer than men.

The study’s senior author , Dr Luisa Sorio Flor at the Institute for Health Metrics and Evaluation (IHME), University of Washington, said: “This report clearly shows that over the past 30 years global progress on health has been uneven.

“Females have longer lives but live more years in poor health, with limited progress made in reducing the burden of conditions leading to illness and disability, underscoring the urgent need for greater attention to non-fatal consequences that limit women’s physical and mental function, especially at older ages. Similarly, males are experiencing a much higher and growing burden of disease with fatal consequences.”

The study is also a call for countries to boost their reporting of sex and gender data, said Sorio Flor. “The timing is right for this study and call to action – not only because of where the evidence is now, but because Covid-19 has starkly reminded us that sex differences can profoundly impact health outcomes.

“One key point the study highlights is how females and males differ in many biological and social factors that fluctuate and, sometimes, accumulate over time, resulting in them experiencing health and disease differently at each stage of life and across world regions.

“The challenge now is to design, implement and evaluate sex- and gender-informed ways of preventing and treating the major causes of morbidity and premature mortality from an early age and across diverse populations.”

The study looked at the disparities in the 20 leading causes of illness and death between men and women, across ages and regions.

The modelling research used data from the Global Burden of Disease Study 2021 , and did not include sex-specific health conditions, such as gynaecological conditions or prostate cancers.

The analysis estimates that for 13 out of the top 20 causes of illness and death, including Covid-19, road injuries, and a range of heart, respiratory and liver diseases, the rate was higher in men than women in 2021.

Among the conditions evaluated, the findings suggested that the biggest contributors that disadvantage women are low back pain, depressive disorders, headache disorders, anxiety disorders, bone and muscle disorders, Alzheimer’s disease and other dementias, and HIV and Aids.

These conditions contribute to illness and disability throughout life as opposed to leading to premature death, the study found.

The study’s co-lead author Gabriela Gil, from the IHME, said: “It’s clear that women’s healthcare needs to extend well beyond areas that health systems and research funding have prioritised to date, such as sexual and reproductive concerns.”

“Conditions that disproportionately impact females in all world regions, such as depressive disorders, are significantly underfunded compared with the massive burden they exert, with only a small proportion of government health expenditure globally earmarked for mental health conditions.

“Future health system planning must encompass the full spectrum of issues affecting females throughout their lives, especially given the higher level of disability they endure and the growing ratio of females to males in ageing populations.”

The analysis was limited to data on females and males and could not produce estimates for gender-diverse or sex-diverse groups, highlighting the need for more data spanning the sex and gender spectrums.

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Q&A: Learning About the Cancer Care Challenges LGBTQ+ People Face

May 1, 2024 , by Edward Winstead

LGBTQ+ people with cancer can face unexpected questions from health care providers and health insurance companies during their care.

Sexual and gender minority (SGM) people who are being treated for cancer may experience certain challenges. In this Q&A, Gwendolyn Quinn, Ph.D., a health psychologist at New York University Perlmutter Cancer Center and part of the center’s LGBTQ+ Cancer Care and Research Program, describes some of those challenges and ways to address them.

This Q&A has an accompanying story on efforts to expand research on sexual and gender minority groups and cancer .

You conducted one of the first surveys asking oncologists about their knowledge, attitudes, and practice behaviors towards sexual and gender minority individuals. What did you learn?

The oncologists we surveyed had limited knowledge about the health needs of sexual and gender minority people. Some of those surveyed expressed the idea, “I’m a good doctor, and I treat all my patients the same. I don’t need to know this information to treat them well.” But we know that information about a person’s sexual orientation and gender identity can be helpful during cancer care. Our survey also found a lack of comfort in treating transgender individuals, and the reason for this was a lack of training.

Are health care providers today trained in how to care for SGM patients?

People who went to medical school more than a decade ago got very little, if any, training about the LGBTQ+ community in general and, more specifically, transgender and nonbinary people. The good news is that most of the oncologists we surveyed expressed interest in learning more about the unique health needs of LGBTQ+ patients. We are planning a follow-up survey to see how things have changed in the 5 years since our earlier survey.

What are some challenges SGM people might experience during cancer care?

There are many nuances we have not yet worked out for SGM people receiving cancer care. Consequently, these individuals can face unexpected questions from health care providers and health insurance companies during their care.

For example, we’ve seen issues related to how transgender people identify and how their insurance companies have their sex listed. Let’s say a transgender man has changed how they identify on documents such as their driver’s license and health insurance. If doctors put in an order for the person to have a hysterectomy, that’s going to look like an error to the insurance company because, based on their documentation, the person is a man and wouldn’t have a uterus.

Are there other examples?

For people who identify as a different sex from the one they were assigned at birth, having routine blood work in the hospital can lead to questions. Consider, for example, someone who was assigned male at birth and now identifies as a woman. The person’s wrist bracelet in the hospital correctly says “female.” But when their blood work is done, the lab might come back saying there’s an error because the patient has Y chromosomes, which are present in males.

How do you try to help SGM people who may experience these issues?

We cannot always prevent unexpected questions and situations. But if we know a person’s SGM status, we might be able to help the person anticipate some of these challenges. We’ve found that patients who share their SGM status with us have appreciated knowing what to expect. They feel listened to.

Do people with cancer typically share their SGM status with health care providers?

Not always. Some patients will say, “I have pancreatic cancer. Why does information about my sexual orientation and gender identity matter? It isn’t related to my cancer care.” We have been trying to promote the idea that this information can be helpful throughout cancer care and beyond.

How might knowing a person’s SGM status help them after cancer treatment?

Gwendolyn Quinn, Ph.D., LGBTQ+ Cancer Care and Research Program NYU Perlmutter Cancer Center

If a cisgender gay man who has been treated for prostate cancer is seeking a support group, he might not feel comfortable in a support group of heterosexual men talking about their sexual experiences and sexual dysfunctions. If we know his status, we can try to help him find resources that are tailored to his needs. It is important that we provide these resources.

What other challenges do SGM people with cancer face?

Another important area for SGM people with cancer involves planning. Many SGM people are closest to their chosen families rather than their biological families. If an SGM person has a partner but they are not legally married, we may need to help them understand what might happen. For example, if they become incapacitated because of the cancer and are not legally married, the person’s biological family may be able to come in and make decisions about their care. We can certainly help people plan and provide guidance. And to be able to help, we need to know a person’s SGM status.

Do you have any final thoughts on this topic?

The population of SGM people is growing. Talking about how best to care for these individuals when they develop cancer is just as important as talking about advances such as new treatments for the disease.

[This conversation has been edited for clarity and length.]

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The Enduring Grip of the Gender Pay Gap

Table of contents, how the gender pay gap increases with age, mothers with children at home tend to be less engaged with the workplace, while fathers are more active, employed mothers earn about the same as similarly educated women without children at home; both groups earn less than fathers, progress in closing the gender pay gap has slowed despite gains in women’s education, gender pay gap differs widely by race and ethnicity, broader economic forces may impact men’s and women’s earnings in different ways, what’s next for the gender pay gap.

The gender pay gap – the difference between the earnings of men and women – has barely closed in the United States in the past two decades. In 2022, American women typically earned 82 cents for every dollar earned by men. That was about the same as in 2002, when they earned 80 cents to the dollar. The slow pace at which the gender pay gap has narrowed this century contrasts sharply with the progress in the preceding two decades: In 1982, women earned just 65 cents to each dollar earned by men.

There is no single explanation for why progress toward narrowing the pay gap has all but stalled in the 21st century. Women generally begin their careers closer to wage parity with men, but they lose ground as they age and progress through their work lives, a pattern that has remained consistent over time. The pay gap persists even though women today are more likely than men to have graduated from college. In fact, the pay gap between college-educated women and men is not any narrower than the one between women and men who do not have a college degree. This points to the dominant role of other factors that still set women back or give men an advantage.

One of these factors is parenthood. Mothers ages 25 to 44 are less likely to be in the labor force than women of the same age who do not have children at home, and they tend to work fewer hours each week when employed. This can reduce the earnings of some mothers, although evidence suggests the effect is either modest overall or short-lived for many. On the other hand, fathers are more likely to be in the labor force – and to work more hours each week – than men without children at home. This is linked to an increase in the pay of fathers – a phenomenon referred to as the “ fatherhood wage premium ” – and tends to widen the gender pay gap.

Related: Gender pay gap in U.S. hasn’t changed much in two decades

Family needs can also influence the types of jobs women and men pursue , contributing to gender segregation across occupations. Differential treatment of women, including gender stereotypes and discrimination , may also play a role. And the gender wage gap varies widely by race and ethnicity.

Pew Research Center conducted this study to better understand how women’s pay compared with men’s pay in the U.S. in the economic aftermath of the COVID-19 outbreak .

The study is based on the analysis of monthly Current Population Survey (CPS) data from January 1982 to December 2022 monthly files ( IPUMS ). The CPS is the U.S. government’s official source for monthly estimates of unemployment . For a quarter of the sample each month, the CPS also records data on usual hourly earnings for hourly workers and usual weekly earnings and hours worked for other workers. In this report, monthly CPS files were combined to create annual files to boost sample sizes and to analyze the gender pay gap in greater detail.

The comparison between women’s and men’s pay is based on their median hourly earnings. For workers who are not hourly workers, hourly earnings were computed as the ratio of usual weekly earnings to usual weekly hours worked. The samples include employed workers ages 16 and older with positive earnings, working full time or part time, including those for whom earnings were imputed by the Census Bureau . Self-employed workers are excluded because their earnings are not recorded in the CPS.

The COVID-19 outbreak affected data collection efforts by the U.S. government in its surveys, especially in 2020 and 2021, limiting in-person data collection and affecting the response rate. It is possible that some measures of economic outcomes and how they vary across demographic groups are affected by these changes in data collection.

“Mothers” and “fathers” refer to women and men 16 and older who have an own child younger than 18 living in the household.

The U.S. labor force, used interchangeably with the workforce in this analysis, consists of people 16 and older who are either employed or actively looking for work.

White, Black and Asian workers include those who report being only one race and who are not Hispanic. Hispanics are of any race. Asian workers include Pacific Islanders. Other racial and ethnic groups are included in all totals but are not shown separately.

“High school graduate” refers to those who have a high school diploma or its equivalent, such as a General Education Development (GED) certificate, and those who had completed 12th grade, but their diploma status was unclear (those who had finished 12th grade but not received a diploma are excluded). “Some college” include workers with an associate degree and those who attended college but did not obtain a degree.

Younger women – those ages 25 to 34 and early in their work lives – have edged closer to wage parity with men in recent years. Starting in 2007, their earnings have consistently stood at about 90 cents to the dollar or more compared with men of the same age. But even as pay parity might appear in reach for women at the start of their careers, the wage gap tends to increase as they age.

Consider, for example, women who were ages 25 to 34 in 2010. In that year, they earned 92% as much as men their age, compared with 83% for women overall. But by 2022, this group of women, now ages 37 to 46, earned only 84% as much as men of the same age. This pattern repeats itself for groups of women who were ages 25 to 34 in earlier years – say, 2005 or 2000 – and it may well be the future for women entering the workforce now.

A good share of the increase in the gender pay gap takes place when women are between the ages of 35 and 44. In 2022, women ages 25 to 34 earned about 92% as much as men of the same ages, but women ages 35 to 44 and 45 to 54 earned 83% as much. The ratio dropped to 79% among those ages 55 to 64. This general pattern has not changed in at least four decades.

The increase in the pay gap coincides with the age at which women are more likely to have children under 18 at home. In 2022, 40% of employed women ages 25 to 34 had at least one child at home. The same was true for 66% of women ages 35 to 44 but for fewer – 39% – among women ages 45 to 54. Only 6% of employed women ages 55 to 64 had children at home in 2022.

Similarly, the share of employed men with children at home peaks between the ages of 35 to 44, standing at 58% in 2022. This is also when fathers tend to receive higher pay, even as the pay of employed mothers in same age group is unaffected.

Parenthood leads some women to put their careers on hold, whether by choice or necessity, but it has the opposite effect among men. In 2022, 70% of mothers ages 25 to 34 had a job or were looking for one, compared with 84% of women of the same age without children at home. This amounted to the withdrawal of 1.4 million younger mothers from the workforce. Moreover, when they are employed, younger mothers tend to put in a shorter workweek – by two hours per week, on average – than other women their age. Reduced engagement with the workplace among younger mothers is also a long-running phenomenon.

Fathers, however, are more likely to hold a job or be looking for one than men who don’t have children at home, and this is true throughout the prime of their working years , from ages 25 to 54. Among those who do have a job, fathers also work a bit more each week, on average, than men who do not have children at home.

As a result, the gender gap in workplace activity is greater among those who have children at home than among those who do not. For example, among those ages 35 to 44, 94% of fathers are active in the workforce, compared with 75% of mothers – a gap of 19 percentage points. But among those with no children at home in this age group, 84% of men and 78% of women are active in the workforce – a gap of 6 points.

These patterns contribute to the gap in workplace activity between men and women overall. As of 2022, 68% of men ages 16 and older – with or without children at home – are either employed or seeking employment. That compares with 57% of women, a difference of 11 percentage points. This gap was as wide as 24 points in 1982, but it narrowed to 14 points by 2002. Men overall also worked about three hours more per week at a job than women in 2022, on average, down from a gap of about six hours per week in 1982.

Parenthood affects the hourly earnings of employed women and men in unexpected ways. While employed mothers overall appear to earn less than employed women without children at home, the gap is driven mainly by differences in educational attainment between the two groups. Among women with similar levels of education, there is little gap in the earnings of mothers and non-mothers. However, fathers earn more than other workers, including other men without children at home, regardless of education level. This phenomenon – known as the fatherhood wage premium – is one of the main ways that parenthood affects the gender pay gap among employed workers.

Motherhood does have important effects on the potential earnings of women. Women who experience breaks in their careers after becoming mothers sacrifice at least some of their earnings . Some mothers may never work for pay after having children, passing on earnings altogether. But it is difficult to know what the earnings of mothers might have been and, as a result, it is hard to know for certain what the full effect of motherhood is on women’s earnings. Estimates suggest that motherhood may account for much of the current shortfall in the earnings potential of women overall. 1

Among employed men and women, the impact of parenting is felt most among those ages 25 to 54, when they are most likely to have children under 18 at home. In 2022, mothers ages 25 to 34 earned 85% as much as fathers that age, but women without children at home earned 97% as much as fathers. In contrast, employed women ages 35 to 44 – with or without children – both earned about 80% as much as fathers. The table turns for women ages 45 to 54, with mothers earning more than women with no children at home. Among those ages 35 to 44 or 45 to 54, men without children earned only 84% as much as fathers.

But these patterns in the earnings of employed mothers and women with no children at home are influenced greatly by differences in education levels between the two. Among employed women ages 25 to 34, some 61% of women without children at home had a bachelor’s degree or higher level of education in 2022, compared with 37% of mothers. It follows that among women ages 25 to 34, those without children at home (a more highly educated group, on average) earned more than women with at least one child at home. Conversely, employed mothers ages 45 to 54 were more likely than other women to have at least a bachelor’s degree – 58% vs. 42%. For that reason, mothers ages 45 to 54 earned more than women without children. 2

When the earnings of mothers are compared with those of women without children at home who have the same level of education, the differences either narrow or go away. Among employed women ages 25 to 34 with at least a bachelor’s degree, both mothers and women without children at home earned 80% as much as fathers in 2022. Among women ages 25 to 34 with a high school diploma and no further education, mothers earned 79% as much as fathers and women with no children at home earned 84% as much. The narrowing of the gap in earnings of mothers and women without children at home after controlling for education level also extends to other age groups.

Thus, among the employed, the effect of parenthood on the gender pay gap does not seem to be driven by a decrease in mothers’ earnings relative to women without children at home. Instead, the widening of the pay gap with parenthood appears to be driven more by an increase in the earnings of fathers. Fathers ages 25 to 54 not only earn more than mothers the same age, they also earn more than men with no children at home. Nonetheless, men without children at home still earn more than women with or without children at home.

Although there is little gap in the earnings of employed mothers and women with no children at home who have the same level of education, there is a lingering gap in workplace engagement between the two groups. Whether they had at least a bachelor’s degree or were high school graduates, mothers ages 25 to 34 are less likely to hold a job or be looking for one. Similarly, younger mothers on average work fewer hours than women without children at home each week, regardless of their education level. The opposite is true for fathers compared with men without children at home.

The share of women with at least a bachelor’s degree has increased steadily since 1982 – and faster than among men. In 1982, 20% of employed women ages 25 and older had a bachelor’s degree or higher level of education, compared with 26% of employed men. By 2022, 48% of employed women had at least a bachelor’s degree, compared with 41% of men. Still, women did not see the pay gap close to the same extent from 2002 to 2022 as they did from 1982 to 2002.

In part, this may be linked to how the gains from going to college have changed in recent decades, for women and men alike. The college wage premium – the boost in earnings workers get from a college degree – increased rapidly during the 1980s. But the rise in the premium slowed down over time and came to a halt around 2010. This likely reduced the relative growth in the earnings of women.

Although gains in education have raised the average earnings of women and have narrowed the gender pay gap overall, college-educated women are no closer to wage parity with their male counterparts than other women. In 2022, women with at least a bachelor’s degree earned 79% as much as men who were college graduates, and women who were high school graduates earned 81% as much as men with the same level of education. This underscores the challenges faced by women of all education levels in closing the pay gap.

Notably, the gender wage gap has closed more among workers without a four-year college degree than among those who do have a bachelor’s degree or more education. For example, the wage gap for women without a high school diploma narrowed from 62% in 1982 to 83% in 2022 relative to men at the same education level. But it closed only from 69% to 79% among bachelor’s degree holders over the same period. This is because only men with at least a bachelor’s degree experienced positive wage growth from 1982 to 2022; all other men saw their real wages decrease. Meanwhile, the real earnings of women increased regardless of their level of education.

As women have improved their level of education in recent decades, they’ve also increased their share of employment in higher-paying occupations, such as managerial, business and finance, legal, and computer, science and engineering (STEM) occupations. In 1982, women accounted for only 26% of employment in managerial occupations. By 2022, their share had risen to 40%. Women also substantially increased their presence in social, arts and media occupations. Over the same period, the shares of women in several lower-paying fields, such as administrative support jobs and food preparation and serving occupations, fell significantly.

Even so, women are still underrepresented in managerial and STEM occupations – along with construction, repair and production, and transportation occupations – when compared with their share of employment overall. And there has been virtually no change in the degree to which women are over represented in education, health care, and personal care and services occupations – the last of which are lower paying than the average across all occupations. The distribution of women and men across occupations remains one of the drivers of the gender pay gap . But the degree to which this distribution is the result of personal choices or gender stereotypes is not entirely clear.

Looking across racial and ethnic groups, a wide gulf separates the earnings of Black and Hispanic women from the earnings of White men. 3 In 2022, Black women earned 70% as much as White men and Hispanic women earned only 65% as much. The ratio for White women stood at 83%, about the same as the earnings gap overall, while Asian women were closer to parity with White men, making 93% as much.

The pay gap narrowed for all groups of women from 1982 to 2022, but more so for White women than for Black and Hispanic women. The earnings gap for Asian women narrowed by about 17 percentage points from 2002 to 2022, but data for this group is not available for 1982.

To some extent, the gender wage gap varies by race and ethnicity because of differences in education, experience, occupation and other factors that drive the gender wage gap for women overall. But researchers have uncovered new evidence of hiring discrimination against various racial and ethnic groups, along with discrimination against other groups, such as LGBTQ and disabled workers. Discrimination in hiring may feed into differences in earnings by shutting out workers from opportunities.

Changes in the gender pay gap are also shaped by economic factors that sometimes drive men’s and women’s earnings in distinctive ways. Because men and women tend to work in different types of jobs and industries, their earnings may respond differently to external pressures.

More specifically, men’s earnings essentially didn’t change from 1982 to 2002. Potential reasons for that include a more rapid decline in union membership among men, a shift away from jobs calling for more physical skills, and global competition that sharply reduced employment in manufacturing in the 1980s. At the same time, women’s earnings increased substantially as they raised their level of education and shifted toward higher-paying occupations.

But in some ways, the economic climate has proved less favorable for women this century. For reasons that are not entirely clear, women’s employment was slower to recover from the Great Recession of 2007-2009. More recently, the COVID-19 recession took on the moniker “ she-cession ” because of the pressure on jobs disproportionately held by women . Amid a broader slowdown in earnings growth from 2000 to 2015, the increase in women’s earnings from 2002 to 2022 was not much greater than the increase in men’s earnings, limiting the closure in the gender pay gap over the period.

Higher education, a shift to higher-paying occupations and more labor market experience have helped women narrow the gender pay gap since 1982. But even as women have continued to outpace men in educational attainment, the pay gap has been stuck in a holding pattern since 2002, ranging from 80 to 85 cents to the dollar.

More sustained progress in closing the pay gap may depend on deeper changes in societal and cultural norms and in workplace flexibility that affect how men and women balance their careers and family lives . Even in countries that have taken the lead in implementing family-friendly policies, such as Denmark, parenthood continues to drive a significant wedge in the earnings of men and women. New research suggests that family-friendly policies in the U.S. may be keeping the pay gap from closing. Gender stereotypes and discrimination, though difficult to quantify, also appear to be among the “last-mile” hurdles impeding further progress.

What is the gender wage gap in your metropolitan area? Find out with our pay gap calculator

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• Open access
• Published: 07 May 2024

Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians

• Cătălina Angela Crișan 1 ,
• Răzvan Pop   ORCID: orcid.org/0000-0003-4877-178X 2 ,
• Roland Stretea 1 ,
• Zaki Milhem 1 &
• Alina-Ioana Forray 3  

Human Resources for Health volume  22 , Article number:  28 ( 2024 ) Cite this article

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The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges.

We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0–100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors.

The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels.

Conclusions

Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Peer Review reports

According to data from the World Health Organization (WHO) reporting data, between 2019 and 2023, the coronavirus disease 2019 (COVID-19) affected more than 772 million people and claimed more than 6.9 million lives [ 1 ]. Because of the pandemic, the world has been experiencing an unprecedented health crisis and drastic changes to personal and professional lives due to worldwide panic, fear, and anxiety [ 2 , 3 ]. Despite extensive protective measures and immunization, the SARS-CoV-2 virus is still responsible for more than 800 thousand deaths worldwide in 2023 [ 4 ]. The pressure on the healthcare system persists, leading to the overburdening of health services and medical staff, especially in emergency departments [ 5 , 6 , 7 ]. In the Romanian healthcare context, the COVID-19 pandemic has illuminated the vulnerabilities and challenges in the health system, particularly in emergency preparedness and service delivery. The study by Stafie et al. (2021) provides insights into the Romanian healthcare system's response, highlighting the increased workload and lack of protection and well-being among physicians [ 8 , 9 ]. Research shows that frontline healthcare workers (HCWs) who are involved in direct patient care during a pandemic experience greater anxiety and have more serious consequences due to mental and physical exhaustion, longer working hours, and the threat of infecting their families [ 10 ]. Hence, HCWs are putting their physical and psychological integrity at risk to stop the spread of COVID-19. According to the literature, medical personnel with direct engagement in COVID-19 management and lack of adequate psychological support were more likely to develop personal, work, and patient-related burnout [ 11 , 12 ]. The pandemic has raised multiple psychological challenges among HCWs. Such pressure may encourage the silent development of mental health issues such as depression, substance use, or post-traumatic stress disorder [ 13 , 14 ]. The never-ending ethical dilemmas, loss of colleagues or loved ones, family problems due to overworking, and other professional and personal conflicts have drastically lowered the life quality of medical staff [ 15 , 16 ]. In this context, the concept of resilience, particularly in healthcare workers during the COVID-19 pandemic, has been a focal point in recent research. Resilience refers to the capacity of individuals to manage hardships and flourish in their personal and social lives [ 17 ]. This dynamic process is influenced by individual traits and environmental factors [ 18 ]. Psychological resilience, in the context of a crisis, is the ability to cope emotionally and return to a pre-crisis state [ 19 ]. In the healthcare setting, resilience has been characterized as a multidimensional psychological trait that enables individuals to thrive in the face of adversity [ 20 ]. Several studies focused on the psychosocial impact of COVID-19 on healthcare workers, identifying resilience as an essential factor in adapting to and overcoming stress [ 21 , 22 ]. Thus, HCWs' resilient conduct in a stressful workplace has been linked to a higher quality of life and better health [ 23 ]

The present study is based on the transactional stress/coping model. This model posits that individuals’ coping responses and psychosocial resources critically influence health and stress outcomes, emphasizing the need to study the personal psychological resources of workers to maintain health despite exposure to adverse conditions [ 24 ]. The transactional theory of stress is a useful framework to comprehend the impact of the pandemic on healthcare providers. According to this theory, individuals are not passive recipients of stress, but active agents who can deploy personal psychological resources to cope with adverse conditions. Therefore, it is important to study the psychological well-being of healthcare workers to maintain their health in the face of challenging circumstances [ 25 ].

A systematic review from 2021 underscores the significance of coping behaviors, resilience, and social support in HCWs' mental health during the COVID-19 pandemic. Coping strategies are divided into problem-focused, emotion-focused, and dysfunctional types. Increased coping strategies and building resilience are considered protective factors against the mental health consequences of a stressful situation. For instance, resilient individuals are more likely to engage in positive coping activities, which buffer the negative impact of work-related stress on mental health [ 26 ]. However, given the ongoing impact of the COVID-19 pandemic, there is a need to identify helpful psychosocial factors and resources that can mitigate the impact of stress during emergent crises. The quality of life (QOL) is influenced by an individual's subjective experiences and environmental interactions, being shaped by cultural and personal value systems [ 27 ]. Hobfoll's Conservation of Resources Theory further elucidates this by linking QOL to personal resource levels, suggesting that managing and augmenting resources like resilience and coping skills enhances life satisfaction and health, particularly in high-stress environments [ 28 ].

Previous findings suggest that demographic variables such as age, gender, educational qualifications, marital status, living residence, and professional background have been shown to influence resilience and the domains of quality of life among healthcare workers during the COVID-19 pandemic [ 29 , 30 , 31 ]. Therefore, the present study, aims to offer insights into the relationship between sociodemographic characteristics of Romanian physicians and their psychological resilience and quality of life.

After COVID-19 was declared a pandemic on 11th March 2020 by WHO, each government started establishing restrictions to minimize transmission of the SARS-CoV-2 virus. All measures have inevitably increased mental health pressure among HCWs, who now had both their professional and personal lives affected by the pandemic [ 32 , 33 , 34 ]. Romania's government followed WHO containment guidelines. However, many residents returning from overseas, insufficient healthcare system infrastructure, and sociocultural variables raised obstacles at various stages of the epidemic's containment [ 35 , 36 ]. Because the pandemic stretched the Romanian healthcare system far beyond its limit, the need to identify proper coping and resilience mechanisms for HCWs is urgent [ 37 , 38 ].

The primary objective of this research is to thoroughly investigate the factors that affected the resilience and quality of life (QOL) of Romanian physicians during the state of emergency due to the COVID-19 pandemic in 2021. We aim to elucidate how different coping strategies, as evaluated by the COPE inventory, helped in alleviating the psychological and work-related stresses experienced by the physicians who participated in our study. By employing a cross-sectional study design, we explored how demographic factors and coping strategies together are associated with resilience and the four QOL domains as defined by the WHO: physical, psychological, social, and environmental health. Moreover, the research analyzed the association between resilience and the QOL domains. Additionally, the study aimed to document the patterns of substance use and psychiatric morbidity among these physicians during the COVID-19 pandemic.

Study design and subject recruitment

Between January 2021 and January 2022, we conducted a cross-sectional study that aimed to assess the resilience of Romanian-speaking physicians who lived and worked in Romania, in coping with the COVID-19 pandemic and how it affected their quality of life. We used an anonymous survey of 124 questions distributed to physicians through e-mail lists and social media. The study participants were over 18 years old and were all physicians. Exclusion criteria included medical students and other types of healthcare workers.

Questionnaires used in data collection

The first section of the questionnaire included questions related to sociodemographic characteristics. Participants were queried about various demographic attributes such as age, gender, educational qualifications, marital status, living residence, and professional background. The second section of the questionnaire referred to preexisting mental health disorders, substance use behaviours, and psychiatric examinations during the emergency state.

The third section of the questionnaire addressed participants' resilience, which was measured using the Romanian version of the 25-item Connor-Davidson Resilience Scale (CD-RISC-25). Developed by Connor and Davidson in 2003, the scale consists of 25 items, each rated on a 5-point Likert scale (0–4), with higher scores reflecting greater resilience. The total score can range from 0 to 100 [ 39 ].

The fourth questionnaire section included the World Health Organization Quality of Life Scale-Short form (WHOQOL-BREF). The scale consists of 26 questions, scoring between 1 and 5. It has four subscales: physical domain (containing 7 items), psychological domain (containing 6 items), social relations domain (containing 3 items), and environmental domain (containing 8 items). Each item is rated on a 5-point scale. The mean score of items within each domain is used to calculate the domain score. Mean scores are then multiplied by 4 in order to make domain scores comparable with the scores used in the WHOQOL-100 scale, and subsequently transformed to a 0–100 scale. The quality of life increases as the score gets higher. The last section evaluated data concerning the coping mechanisms of study participants with the Romanian version of the COPE inventory. It comprises fifteen 4-item scales grouped into three categories: problem-focused, emotion-focused, and dysfunctional coping. The COPE Inventory consists of 60 items and 15 subscales, which include acceptance, active coping, behavioral disengagement, denial, seeking emotional support, seeking instrumental support, mental disengagement/self-distraction, planning, positive reinterpretation, religion, restraint, substance use, suppression of competing activities, venting, and humor [ 40 ].

Statistical analysis

In this cross-sectional analysis, demographic variables, substance use behaviors, and psychiatric morbidity were summarized using descriptive statistics with frequencies and percentages. Means, standard deviations, medians, and interquartile ranges were employed for continuous variables. All analyses were performed on SPSS Software (version 29; MacOS).

Initially, each independent variable was examined separately for its association with resilience (CD-RISC scores) and quality of life (WHOQOL-BREF domains). This step helped in understanding individual variable effects. Following the univariate analysis, we utilized the 'Enter' method for the multivariate linear regression analysis. This approach was chosen due to its ability to simultaneously consider all identified predictor variables, each potentially influential on our outcomes of interest: resilience (CD-RISC scores) and quality of life (WHOQOL-BREF domains). The 'Enter' method is particularly effective in exploratory studies where predictors are identified individually from the literature, allowing us to assess their collective impact in a single model. Unstandardized coefficients (B) with 95% confidence intervals (CI) were reported for both univariate and multivariate analyses. To ensure the robustness of the multivariate regression analysis, we checked for multicollinearity among independent variables. Statistical significance was set at p-values of less than 0.05 for *, less than 0.01 for **, and less than 0.001 for ***. Independent variables for resilience included coping strategies categorized as problem-focused, emotion-focused, and dysfunctional coping, demographic variables (sex, age, marital status, education level, and area of residence), and professional status. In the case of the physical domain, mental domain, social relations domain, and environmental domain of QOL, CD-RISC was additionally added as an independent variable.

A total of 367 individuals completed the questionnaire, but 102 were excluded (27.79%) as they identified as other health professionals or as students in health sciences programs. The demographic data of the survey participants is presented in Table  1 . Out of the respondents, 265 physicians participated in the survey. The study population predominantly comprises females (84.5%) between the ages of 31 and 50 years (54.7%), mostly residing in urban areas (92.1%). A slight majority hold advanced academic qualifications (55.1%), and the participants' professional backgrounds are diverse, with senior specialist physicians being the most prevalent group (37.4%). Most participants have been married at some point (63.8%).

Table 2 measured the substance use behaviors during the COVID-19 emergency state and medical examinations requested in this period for certain mental health disorders, as well as relapses for psychiatric conditions during this period. The demographic data delineates substance use behaviors and psychiatric morbidity during the COVID-19 period, offering critical insights. The tabulation reveals a nuanced picture of tobacco use alterations, with 32.8% of participants reporting an increase, contrasting with a 10.9% decrease. Notably, new initiations and cessations of tobacco use were minimal at 3.0% and 2.6%, respectively, while non-smokers constituted a predominant 50.6%. Alcohol consumption patterns depicted a minor segment engaging in heavy use (1.1%), whereas the majority oscillated between light (46.0%) and non-drinking behaviors (42.3%). Psychoactive substance utilization was comparatively infrequent (7.2%). Medical examination requests predominantly aligned with anxious states (11.7%), followed by depressive states (9.4%) and sleep disorders (6.8%), while psychiatric pathology relapses were relatively low at 7.2%.

Table 3 provides a comprehensive statistical overview of various psychological measures studied during the COVID-19 period. The Connor-Davidson Resilience Scale (CD-RISC) scores manifest a mean of 66.19, indicative of the resilience levels within the sample. The WHOQOL-Brief domains, ranging from general to environmental areas, elucidate facets of quality of life, with mean scores oscillating between 7.82 in the general area and 28.69 in the environmental area. The COPE inventory delineates coping strategies, categorized into problem-focused, emotion-focused, and dysfunctional coping. Problem-focused coping exhibits an overall mean of 59.72, emphasizing active coping strategies such as planning and the use of instrumental support. Emotion-focused coping, underscored by a mean of 54.54, reveals reliance on emotional support and positive reframing among other strategies. Dysfunctional coping mechanisms, marked by a mean of 39.94, highlight the utilization of various avoidance strategies, including substance use and behavioral disengagement. Each measure, complemented by the presentation of mean, median, and interquartile range values, provides a nuanced understanding of the participants’ psychological adaptation during the COVID-19 period.

The data provided in Table  4 aims to elucidate the relationship between various variables and levels of resilience, as measured by the Connor-Davidson Resilience Scale (CD-RISC 25). In the univariate analysis, problem-focused coping was positively associated with resilience levels (B = 0.855, 95% CI [0.645, 1.065], p < 0.001***). This association remained significant in the multivariate analysis, though attenuated (B = 0.370, 95% CI [0.147, 0.594], p = 0.001**). A significant positive relationship was observed between emotion-focused coping and resilience levels, both in univariate (B = 0.754, 95% CI [0.573, 0.935], p < 0.001***) and multivariate analyses (B = 0.689, 95% CI [0.492, 0.886], p < 0.001***). Dysfunctional coping exhibited a negative association with resilience levels in the univariate (B = -0.481, 95% CI [-0.696, -0.266], p < 0.001***) and multivariate analyses (B = − 0.567, 95% CI [− 0.748, − 0.385], p < 0.001***). Being male, as opposed to female (reference), was significantly associated with higher resilience levels in univariate analysis (B = 6.462, 95% CI [1.695, 11.229], p = 0.008**), with this relationship maintaining significance in multivariate analysis (B = 4.444, 95% CI [0.613, 8.276], p = 0.023*). Different age groups exhibited varied levels of resilience. Individuals under 30 showed lower resilience levels in univariate analysis (B = − 4.865, 95% CI [− 8.731, − 0.999], p = 0.014*), but this association was not significant in multivariate analysis. Having a master’s or doctoral degree, compared to a bachelor’s (reference), was positively associated with resilience levels in univariate analysis (B = 6.030, 95% CI [2.595, 9.466], p = 0.001**), but lost significance in the multivariate analysis. No significant association was found between urban or rural residential location and resilience levels in either univariate or multivariate analysis. Unmarried individuals showed lower resilience levels in univariate analysis (B = − 4.554, 95% CI [− 8.147, − 0.962], p = 0.013*), but this was not significant in multivariate analysis. Variations in resilience were observed based on professional status. Resident physicians showed lower resilience in univariate analysis (B = − 5.641, 95% CI [− 9.277, − 2.006], p = 0.002**), but this relationship was not significant in multivariate analysis. Senior specialists showed higher resilience in univariate analysis (B = 6.637, 95% CI [3.116, 10.157], p < 0.001***), with the association trending towards significance in the multivariate analysis (B = 3.549, 95% CI [− 0.196, 7.295], p = 0.063).

The univariate and multivariate linear regression analyses were conducted to examine the relationships between several variables and the four domains of QOL measured by the WHO QOL-BREF. The variables included CD-RISC scores, problem-focused coping, emotion-focused coping, dysfunctional coping, and several demographic factors. The results of these analyses are presented in the Table  5 .

In the univariate analysis, CD-RISC scores were positively associated with all four domains of QOL (Physical: B = 0.43, 95% CI [0.32, 0.54], p < 0.001***; Psychological: B = 0.68, 95% CI [0.58, 0.79], p < 0.001***; Relationship: B = 0.63, 95% CI [0.48, 0.78], p < 0.001***; Environment: B = 0.43, 95% CI [0.34, 0.52], p < 0.001***). Problem-focused coping was positively associated with the physical domain (B = 0.31, 95% CI [0.09, 0.54], p = 0.007**), psychological domain (B = 0.73, 95% CI [0.48, 0.98], p < 0.001***), relationship domain (B = 0.72, 95% CI [0.40, 1.04], p < 0.001***), and environment domain (B = 0.46, 95% CI [0.26, 0.66], p < 0.001***) in the univariate analysis. In the multivariate analysis, however, problem-focused coping was not significantly associated with any of the domains of QOL.

Emotion-focused coping was significantly and positively associated with all QOL domains in the univariate analysis (Physical: B = 0.41, 95% CI [0.21, 0.60], p < 0.001***; Psychological: B = 0.71, 95% CI [0.50, 0.92], p < 0.001***; Relationship: B = 0.80, 95% CI [0.53, 1.06], p < 0.001***; Environment: B = 0.41, 95% CI [0.24, 0.58], p < 0.001***). In the multivariate analysis, emotion-focused coping remained significantly associated with the physical domain (B = 0.28, 95% CI [0.05, 0.52], p = 0.019*), psychological domain (B = 0.37, 95% CI [0.13, 0.61], p = 0.003**), and relationship domain (B = 0.38, 95% CI [0.05, 0.72], p = 0.024*), but not with the environment domain.

Dysfunctional coping was significantly associated with the physical domain (B =− 0.52, 95% CI [-0.73, -0.31], p < 0.001***), psychological (B =− 0.53, 95% CI [-0.77, -0.29], p < 0.001***), and relationship domains (B =− 0.41, 95% CI [-0.60, -0.21], p < 0.001***) in the univariate analysis. In the multivariate analysis, dysfunctional coping remained significantly and negatively associated with the psychological domain (B =− 0.31, 95% CI [-0.58, -0.03], p = 0.031*), but not with the physical or relationship domains.

In the univariate analysis, gender was significantly associated with the psychological domain of WHO QOL-BREF, with males having higher scores than females (B = 7.30, 95% CI [1.96, 12.65], p = 0.008**). Participants under 30 had significantly lower scores in the psychological domain than those over 30 (B =− 5.14, 95% CI [-9.48, -0.80], p = 0.021*). Individuals with a master's or doctoral degree had significantly higher scores in the psychological (B = 6.20, 95% CI [2.33, 10.07], p = 0.002**) and environment (B = 4.44, 95% CI [1.39, 7.49], p = 0.004**) domains compared to those with a bachelor's degree. Resident physicians had significantly lower scores in the psychological domain than specialists and senior specialists (B =− 5.09, 95% CI [-9.19, -0.99], p = 0.015). The multivariate analysis found no significant association between gender and the physical, relationship, and environment domains. The psychological domain was not significantly associated with age or education level in the multivariate analysis. Resident physicians showed a significant positive association with the relationship domain compared to specialists and senior specialists (B = 12.17, 95% CI [3.35, 20.98], p = 0.007**). No other significant associations were found in the multivariate analysis.

The objective of our study was to thoroughly analyze how various factors contribute to the resilience and quality of life (QOL) of Romanian physicians during the COVID-19 emergency in 2021. Utilizing the COPE inventory to assess coping strategies, we examined the association between coping strategies and QOL domains and resilience. Our cross-sectional approach also explored the interplay between demographic factors, coping strategies, and their overall association with resilience and the WHO's four QOL domains. Moreover, we aimed to investigate the role of resilience in influencing these QOL areas and to document substance use and psychiatric morbidity during this period.

The COVID-19 pandemic has had a significant impact on physicians' mental health, resulting in heightened levels of stress, anxiety, depression, and fatigue. This is primarily due to the increased work demands, limited opportunities for recovery, and high-intensity, time-pressured working patterns associated with managing the pandemic [ 41 ]. High rates of depression, distress, and suicidal thoughts in the HCWs during the lockdown were alarming [ 42 ]. It is crucial for healthcare systems to provide short and long-term psychological support for physicians caring for patients during infectious disease outbreaks [ 43 ].

Physicians and other healthcare workers have an important role during times of public health crises, such as the COVID‐19 pandemic. We investigated the main coping and resilience mechanisms and the role of positive and negative stress-reducing activities on mental and physical well-being in Romanian HCWs. Our findings regarding demographic characteristics (mean age) and resilience score are in line with other published reports on mental health outcomes among healthcare workers exposed to the COVID‐19 pandemic [ 44 , 45 ]. Our cohort is represented by a majority of female physicians, which in turn represent a small part of all female Romanian physicians [ 46 ]. Although 84.5% of physicians from our sample are females and 27.5% are under 30 years old, this is in line with the European healthcare personnel statistics, which show that in 2021, more than 70% of the total number of physicians in Romania were women, with 34.4% of Romanian physicians being under 35 years old and only 20.4% of physicians were aged 55 years and over in 2021 [ 47 ]. Problem-focused and emotion-focused coping strategies were positively associated with higher resilience and with better quality of life across several domains, whereas dysfunctional coping had a negative association. The persistent negative association of dysfunctional coping with the physical and psychological domain of QOL and resilience in the multivariate analysis was notable, as it implies a consistent detrimental effect regardless of other factors. The interrelationship between coping mechanisms, resilience, and quality of life suggests that interventions aimed at improving coping skills could enhance overall life satisfaction and well-being during crises. A review conducted in 2021 has revealed that effective coping mechanisms are essential for managing emergencies and related occupational stress. Negative coping strategies such as escape and avoidance mechanisms or overcommitment have been linked to poor mental health outcomes. On the other hand, maintaining a positive attitude towards the problem, having a strong social network, receiving peer support, working in a team, being self-reliant, negotiating problems efficiently, and practicing self-care can all help to reduce stress levels and improve resilience [ 48 ]. The data indicated a nuanced shift in substance use, with an increase in tobacco use for nearly one-third of participants, which might reflect stress-related behaviors during COVID-19. In 2020, Vanderbruggen et al. [ 49 ] found that overall alcohol consumption and cigarette smoking increased during the lockdown, with reasons including boredom and lack of social contacts In 2021, Mounir I et al. [ 50 ] reported that hospital workers who experienced increased sadness and distress during the lockdown were more likely to use tobacco. Giovenco et al. [ 51 ] highlighted that changes in tobacco use patterns were driven by individual-level factors such as anxiety and irregular routines, as well as limited access to alternative products like electronic nicotine delivery systems. These findings collectively suggest a nuanced shift in substance use, with an increase in tobacco use potentially linked to stress-related behaviors during the COVID-19 pandemic.

Effective coping strategies, whether problem-focused or emotion-focused, might serve as mediators in the relationship between stressors experienced during the COVID-19 pandemic and mental health outcomes. Gender differences in resilience might be attributed to social, behavioral, or biological factors that contribute to how individuals respond to stress.

Additionally, in our previous paper about coping mechanisms and resilience in psychiatric trainees during the pandemic, we also found that good psychological mechanisms and adaptiveness decrease vulnerability to impairment [ 52 ]. Crișan et al., found similar results regarding the negative relation between dysfunctional coping and physical health among Romanian citizens during the current war in Ukraine [ 53 ]. From our knowledge, there is no research data regarding the correlation between coping strategies evaluated using COPE inventory and quality of life evaluated using WHOQOL-BREF among Romanian HCWs during the COVID-19 pandemic. Therefore, further research is needed in this field.

This study provides insights into the impact of the COVID-19 pandemic on dysfunctional coping mechanisms, which in turn have an impact on certain life quality domains. Nurturing improved coping abilities and resilience may contribute to beneficial healthcare workforce mental health. These findings advocate for the implementation of organizational interventions tailored to cultivate resilience and improved coping behaviors, utilizing counseling, fostering social connections, and specific resilience training. Such interventions could include the establishment of trauma risk management programs to empower workers to support their peers, thus nurturing a thriving work environment. Additionally, incorporating practices such as self-care routines, group discussions, mindfulness sessions, and targeted training can be instrumental in fostering resilience, ultimately contributing to a more robust and adaptive workforce [ 48 ]. The findings could inform public health strategies and interventions aimed at supporting mental health during emergency situations.

The study, while offering valuable insights into substance use, mental health disorders, and coping mechanisms during the COVID-19 emergency state, is not without limitations. Firstly, the cross-sectional nature of the study precludes the establishment of causality; longitudinal studies would be needed to discern the temporal relationships between the pandemic, substance use behaviors, and the development of psychiatric conditions. Secondly, the reliance on self-reported data could introduce recall bias or social desirability bias, potentially skewing the reported prevalence of substance use and mental health symptoms. Thirdly, the sample may not be representative of the broader population, as it might over-represent individuals with internet access or those more inclined to participate in research studies, limiting the generalizability of the findings. Furthermore, while the study provides associations between coping mechanisms and resilience, it does not account for all potential confounding variables such as previous mental health history, socioeconomic status, or access to healthcare services, which could significantly influence these outcomes. Finally, the study's focus on certain demographic factors (like education level, gender, marital status) might overlook other critical variables (like ethnicity, specific occupational stressors, or pre-existing health conditions) that might have offered a more nuanced understanding of the population’s mental health and coping behaviors during the pandemic. These limitations suggest a need for cautious interpretation of the results and an impetus for future research that addresses these gaps.

The study elucidates a multifaceted picture of how the COVID-19 pandemic impacted substance use, mental health, and coping mechanisms among a sample of participants. The study suggests that promoting adaptive coping strategies, providing robust support for mental health, and understanding the demographic variables that influence resilience are critical in mitigating the negative effects of a pandemic on the mental health and quality of life of physicians. These findings offer guidance for healthcare providers, policymakers, and public health practitioners to develop tailored interventions aimed at supporting populations during times of crisis. Future research should focus on developing better measures of resilience that would capture constructs that are unique to pandemics.

Availability of data and materials

The datasets used and analyzed during the current study are available from the University of Medicine and Pharmacy "Iuliu Hațieganu". Data are available from the authors upon reasonable request and with the permission of the University of Medicine and Pharmacy "Iuliu Hațieganu".

Abbreviations

Coronavirus infectious disease 2019

Coping Orientation to Problems Experienced

Connor-Davidson Resilience Scale 25

The World Health Organization Quality of Life Brief Version

Quality of life 

The World Health Organization

Healthcare workers

Severe acute respiratory syndrome coronavirus 2

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Crișan, C.A., Pop, R., Stretea, R. et al. Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians. Hum Resour Health 22 , 28 (2024). https://doi.org/10.1186/s12960-024-00909-w

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‘Labour Won the Local Elections but it has a Problem – it Can’t Engage With UK Muslims’

Labour’s triumph was almost entirely due to a collapse in Conservative support. To succeed in the General Election it must directly engage with a new generation of British Muslim voters

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The results were mixed for Labour in the UK’s local elections on Thursday. Yes, the opposition party gained more than 180 council seats and eight councils. It triumphed in almost all mayoral elections, including an iconic but narrow victory in the West Midlands. It captured the Parliamentary seat of Blackpool South in a by-election with a 26.3% swing, the third-largest since 1945. But there were also setbacks. Labour lost control of Oldham council.  The Deputy Leader of the council lost his safe Labour seat to an independent, and former Labour voters helped the Greens break through in Bristol. The outcome in the West Midlands was in doubt – ultimately, the margin was only 1,508 votes – because of the 11.7% share for independent candidate Akhmed Yakoob. Before the final drama in Birmingham, a Labour official complained, “It’s the Middle East, not West Midlands, that will have won [ Conservative incumbent] Andy Street the mayoralty. Once again Hamas are the real villains.” The Labour Party is in an “uncomfortable position on Gaza and it is not just Muslim voters”, one expert said. Photo: Jeff Gilbert / Alamy The eventual outcome, added to other triumphs such as Mayor Sadiq Khan’s in London, removed the “ Gaza factor” from the headlines. But it is still present: for beyond these elections and the national vote later this year, Labour’s leadership has a problem: an issue of how they engage with the UK’s Muslims. On Saturday, Labour leader Keir Starmer addressed those who have voted for the party in the past but felt they could not do so this time: “I’ve heard you and I’ve listened. I hope to gain your respect and trust again in the future.” Left unspoken was the fact that Labour’s triumph was almost entirely because of a collapse in Conservative support – the 34% share for Starmer’s party was almost the same as in 2022, 2023, and 2024. Analysing the vote in 930 wards, Professor Will Jennings, of the University of Southampton summarised, “Labour is in an uncomfortable position on Gaza. And it is not just Muslim voters.”  ‘Keir Starmer’s General Election Reality and Why Comparisons with Tony Blair’s Victory Are Problematic’ Professor Chris Painter explores the likely determinants of the next general election outcome – which polls consistently predict Labour will win Professor Chris Painter In the 20 constituencies in the UK with a Muslim electorate over 30% who elected a Labour MP in 2019, the opposition party’s share dropped 18%. In a General Election, independents might not take seats from Labour. However, they could dent the party where there is more than one contender for First Past the Post. In the long run, the effect could be greater if the Liberal Democrats or Greens build their appeal or if there is a rejuvenated One Nation form of Conservatism. Starmer’s LBC interview on October 11 , in which he said “Israel has the right” to withhold power and water from Palestinian civilians, laid the foundations for this electoral desertion. The justification of collective punishment carried even greater weight because Starmer – a former Director of Public Prosecutions – knows the codes of international law. BREAKING The Local Election Results Flush the Conservative Party’s Culture War Strategy Down the Gender Neutral Toilet The Conservative party’s strategy of trying to win the general election through a mixture of ‘culture wars and the trans debate’ is only worsening their defeats to Labour Adam Bienkov Within 24 hours, Labour denied that Starmer intended to support an Israeli cutting of supplies, saying that he was just backing Israel’s right to defend itself. But the damage was done: almost seven months later, Independents and Greens played the interview as part of their election tactics on social media. Some Labour stalwarts recognised this could be a problem. Pat McFadden, the party’s national election coordinator, said it will  “work to get people’s support back”.  But what does that entail? First and maybe foremost, Labour politicians and officials need to stop pinning blame on Muslims for voting the “wrong” way. The community exercised their democratic right: whether the issue is Gaza or another concern, the party needs to uphold democracy  – and everyone in a democracy – and the right to choose any candidate without retribution. The British Muslim community is under duress. Labour needs to appreciate this, carrying out a sincere outreach. At the same time, the party should not fall into the belief that British Muslims only care about foreign issues. The  “Hamas are the real villains”  comment by the Labour staffer in the West Midlands was eventually condemned. Much more is needed, however, to ensure that Labour acts to stamp out Islamophobia as it did with anti-semitism and homophobia. The British Muslim community needs to be respected as an integral part of the democratic process and not as some fifth column who should “do as I do”. ‘Keir Starmer’s Condemnation of “Terror” in Gaza is a Step Forward — But Just the Beginning’ Starmers speech at a recent Iftar in London is a seismic shift in the Labour Party’s approach to both the Middle East conflict and anti-Muslim prejudice in the UK Nafeez Ahmed If the Labour Party is sincere about engagement, it must move away from its traditional structures. Labour has relied on community leaders and mosque networks, as well as using Biradri (clan) systems to secure votes from Pakistani constituents. The local elections demonstrated that these methods are no longer effective. Most Labour candidates posted with an older British Muslim electorate, largely ignoring the demographic of young, professional, and university or college-educated voters using social media. Publicity and endorsements from Muslim men aged 45 to 65 sounded in an echo chamber where Islamic civil society had little presence. Labour cannot just engage with members of the British Muslim who tell the party what it wants to hear. Starmer and his team need to look beyond traditional gatekeepers and iftar (fast-breaking) meals with individuals who are detached from the realities of issues from Oldham to Bradford to Blackburn to Walsall. They need to draw lessons from campaigns such as  Akhmad Yaqoob  in the West Midlands and  Tiger Patel  in Blackburn, who engaged directly with a new generation of British Muslim voters. ENJOYING THIS ARTICLE? HELP US TO PRODUCE MORE Receive the monthly Byline Times newspaper and help to support fearless, independent journalism that breaks stories, shapes the agenda and holds power to account. PAY ANNUALLY – £39.50 A YEAR PAY MONTHLY – £3.75 A MONTH MORE OPTIONS We’re not funded by a billionaire oligarch or an offshore hedge-fund. We rely on our readers to fund our journalism. If you like what we do, please subscribe. British Muslims who resigned as members of the party did so on principle. Many were not from the hard left but were centrists who felt our voices were ignored on every level when we just wanted a robust opposition to the mass killing in Gaza. Accepting, engaging, and reasserting a social contract with British Muslim voters cannot be hollow promises or a rejection of their concerns: it must be an active process of dialogue. In the 1979 General Election, the party was run out of power with the Conservative billboard, “Labour Isn’t Working”. Even if it returns to power in 2024, it can only succeed if it avoids the future viral slogan on social media, “Labour Isn’t Listening”. After his victory in the West Midlands, Richard Parker acknowledged that Gaza is “a very important point and it matters to this region”. “I’ve been out speaking and listening to many of our inner city communities, including the Muslim community. “I understand their concerns, I understand how important this issue is to them. I’m hoping if…demonstrate to them we do care and we understand their concerns, we can rebuild that trust and we can win them back to Labour.” On his first day in office on Monday, Parker wrote on X , formerly Twitter: “The situation in Rafah is very worrying. An Israeli offensive must not go ahead. There must be an end to the loss of innocent lives. There should immediately be a ceasefire, the release of hostages and aid should be allowed into Gaza.” But is Parker a marker of a new Labour, both with respect to Gaza and to its approach to the UK’s Muslims? Or is he just an exception to a disturbing rule? Only time will tell.

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