Gender Equity Issues in Orthopaedics: A Scoping Review.

Abstract

<h4>Background</h4>Patients have improved outcomes when their diversity is reflected in the healthcare team providing treatment. Despite recent increases in female representation, orthopaedics continues to lag behind other medical specialties. The purpose of this study was to identify major themes relating to gender equity in orthopaedics, examine trends in gender representation, and summarize the existing evidence within these themes.<h4>Methods</h4>We conducted a scoping review in accordance with PRISMA guidelines using Medline, EMBASE and Global Index Medicus to identify original research articles on gender equity issues in orthopaedics. Data-driven studies examining issues across the orthopaedic training spectrum were included. A thematic analysis was conducted and descriptive statistics were used to describe trends within each theme.<h4>Results</h4>In total, 179 studies were included representing seven themes: gender diversity and representation (<i>n</i> = 45), research and authorship (<i>n</i> = 41), leadership and mentorship (<i>n</i> = 30), microaggressions and lived experiences (<i>n</i> = 24), gender-based health impacts (<i>n</i> = 13), monetary aspects (<i>n</i> = 10), and geographic representation (<i>n</i> = 5), with 11 miscellaneous studies. Nearly 80% (<i>n</i> = 133) of studies originated from the USA, and 74.4% of studies were published from 2021 to 2025. Nearly all included studies reported that while there have been modest improvements in female representation, there remains significant gender disparity, and the field lags behind other specialties.<h4>Conclusion</h4>This scoping review identified a compelling volume of literature demonstrating that women are underrepresented across all career stages in orthopaedics. Women surgeons disproportionately experience microaggressions, discrimination and health impacts. While representation is improving, concerted, collaborative efforts are needed to achieve gender parity in the field globally.<h4>Supplementary information</h4>The online version contains supplementary material available at 10.1007/s43465-025-01415-4.