Feminization still without leadership: women in Brazilian medical societies

Abstract

The feminization of medicine in Brazil has advanced over the last decades. Women accounted for 49.3% of practicing physicians in 2024, with a projection of 50.9% for 2025. Little has been documented, however, regarding how this transformation has reached the leadership of specialty societies. This study analyzed the sex distribution in the presidencies and scientific directorates of the 40 Brazilian medical societies of specialties with female or male predominance in the workforce, in light of Nancy Fraser's three-dimensional theory of justice. We assessed whether the composition of these positions adheres to the demographic profile of the specialty and how far it deviates from 50% parity. The design is observational, documentary, cross-sectional, and census-based. Inferential analysis combined the Poisson binomial distribution, logistic regression, Fisher's exact test, and a two-sided binomial test, with Holm correction. Women held 17.5% of presidencies and 10.8% of scientific directorates. In specialties where women constituted the majority of the workforce, their representation in leadership fell below demographic expectations (p < 0.001). In specialties where they were a minority, the observed proportion was consistent with the demographics (p = 0.424) but remained distant from 50% parity. The proportion of women in the workforce did not predict the sex of the president (OR 1.22; 95% CI 0.81 to 1.83). The leadership of Brazilian medical specialty societies is predominantly male, regardless of the demographic composition of the specialty, and the growth of women's presence in the workforce has not reached decision-making positions.