Background:
Although a gender gap in anesthesiology articles has been reported in certain subsets of anesthesiology literature, a comprehensive analysis is still lacking. Our objective was to conduct a scientometric analysis of the evolution of gender equity among anesthesiology authors worldwide, including all available affiliations. We hypothesized that gender inequity has diminished over time, with relevant differences among countries.

Methods:
The MEDLINE/PubMed 2024 Baseline Repository was queried for all articles whose authors were affiliated with a department of anesthesiology. Author positions were sequenced into first, co-authors, and senior authors. Gender was inferred using online classification tools (genderize.io and gender-api.com). Geolocation was identified through text mining of the first author’s affiliation. The primary endpoint was the evolution of female authors from 1987 to 2023, calculated descriptively and by average annual growth rates. Secondary endpoints included the proportion of female authors in first or senior author position, the influence of senior authors’ gender on first authors’ gender, geographical differences, and future projections of parity (defined as 50% female authors).

Results:
Among 374,301 anesthesiology articles and 7,574 journals, the proportion of female authors increased from 13.6% (1987) to 34.3% (2023) with an average annual growth of 0.57% (95%-confidence interval 0.38% − 0.77%). First authors were female in 30.0% and senior authors in 20.7%, with increases from 11.7% (1987) to 36.9% (2023), and from 11.0% (1987) to 25.9% (2023), respectively. Female authors were overall more likely to be first authors when the senior author was also female. In 2023, only Thailand and Portugal had a percentage of female authors over 50%. Tunisia achieved the highest average annual growth rate of female authors at 2.28% (95%-CI 1.51% − 3.06%). Based on the assumption that current trends continue unchanged, overall gender parity is estimated to be achieved by 2050, for first authors by 2043 and for senior authors by 2072.

Conclusions:
Despite an increase in recent decades, women are still underrepresented as authors in academic anesthesiology, particularly in leading authorship positions. While relevant differences between countries exist, strategies addressing this gender gap at a country-specific level are needed to promote female authorship in academic anesthesiology.