Sexual Harassment, Abuse, and Discrimination in Obstetrics and Gynecology: A Systematic Review.

Importance: Unlike other surgical specialties, obstetrics and gynecology (OB-GYN) has been predominantly female for the last decade. The association of this with gender bias and sexual harassment is not known. Objective: To systematically review the prevalence of sexual harassment, bullying, abuse, and discrimination among OB-GYN clinicians and trainees and interventions aimed at reducing harassment in OB-GYN and other surgical specialties. Evidence Review: A systematic search of PubMed, Embase, and ClinicalTrials.gov was conducted to identify studies published from inception through June 13, 2023.: For the prevalence of harassment, OB-GYN clinicians and trainees on OB-GYN rotations in all subspecialties in the US or Canada were included. Personal experiences of harassment (sexual harassment, bullying, abuse, and discrimination) by other health care personnel, event reporting, burnout and exit from medicine, fear of retaliation, and related outcomes were included. Interventions across all surgical specialties in any country to decrease incidence of harassment were also evaluated. Abstracts and potentially relevant full-text articles were double screened.: Eligible studies were extracted into standard forms. Risk of bias and certainty of evidence of included research were assessed. A meta-analysis was not performed owing to heterogeneity of outcomes. Findings: A total of 10 eligible studies among 5852 participants addressed prevalence and 12 eligible studies among 2906 participants addressed interventions. The prevalence of sexual harassment (range, 250 of 907 physicians [27.6%] to 181 of 255 female gynecologic oncologists [70.9%]), workplace discrimination (range, 142 of 249 gynecologic oncologists [57.0%] to 354 of 527 gynecologic oncologists [67.2%] among women; 138 of 358 gynecologic oncologists among males [38.5%]), and bullying (131 of 248 female gynecologic oncologists [52.8%]) was frequent among OB-GYN respondents. OB-GYN trainees commonly experienced sexual harassment (253 of 366 respondents [69.1%]), which included gender harassment, unwanted sexual attention, and sexual coercion. The proportion of OB-GYN clinicians who reported their sexual harassment to anyone ranged from 21 of 250 AAGL (formerly, the American Association of Gynecologic Laparoscopists) members (8.4%) to 32 of 256 gynecologic oncologists (12.5%) compared with 32.6% of OB-GYN trainees. Mistreatment during their OB-GYN rotation was indicated by 168 of 668 medical students surveyed (25.1%). Perpetrators of harassment included physicians (30.1%), other trainees (13.1%), and operating room staff (7.7%). Various interventions were used and studied, which were associated with improved recognition of bias and reporting (eg, implementation of a video- and discussion-based mistreatment program during a surgery clerkship was associated with a decrease in medical student mistreatment reports from 14 reports in previous year to 9 reports in the first year and 4 in the second year after implementation). However, no significant decrease in the frequency of sexual harassment was found with any intervention. Conclusions and Relevance: This study found high rates of harassment behaviors within OB-GYN. Interventions to limit these behaviors were not adequately studied, were limited mostly to medical students, and typically did not specifically address sexual or other forms of harassment.

Gender Disparity in Non-ACGME (Accreditation Council for Graduate Medical Education) Otolaryngology Fellowship Leadership.

OBJECTIVE: Women are underrepresented among practicing otolaryngology physicians with increasing disparities in leadership roles and higher levels of professional attainment in academic medicine. The purpose of this study is to determine the gender gap among fellowship directors within specific otolaryngology subspecialties, and how this compares to disparities among all academic appointments held by otolaryngologists. Additionally, we seek to better understand how years practiced, H-index, professorship status, and academic productivity differ between men and women in fellowship director roles. DESIGN: Cross-sectional. Publicly available data from non-ACGME accredited otolaryngology fellowships was collected from department websites and Doximity including gender, years of practice, and professor status of fellowship directors. Scopus was used to find H-index for identified fellowship directors. Fisher's Exact tests were used to determine if significant gender disparity existed between each fellowship and academic otolaryngology as whole. H-index and years of practice were plotted for men and women comparing the slope of lines of best fit as a measure of academic productivity. SETTING: Non-ACGME accredited otolaryngology fellowships in the US. PARTICIPANTS: Fellowship directors in non-ACGME accredited otolaryngology fellowships. RESULTS: Among 174 fellowship positions in our analysis, head and neck (17.3% women), laryngology (17.2% women), rhinology (5.7% women), and facial plastics (8.1% women) had significantly lower overall women representation compared to academic otolaryngology (36.6% women) (p < 0.05). As fellowship directors, women were significantly more productive than men given years practiced and H-index (p = 0.008). CONCLUSIONS: Gender disparities among otolaryngologists are amplified in the role of fellowship directors compared to broader academic otolaryngology. This is true despite women in these roles demonstrating higher academic productivity.

Analysis of justification for author order and gender bias in author order among those contributing equally.

The practice of designating two or more authors as equal contributors (ECs) on a scientific publication is increasingly common as a form of sharing credit. However, EC authors are often unclearly attributed on curriculum vitae (CVs) or citation engines, and it is unclear how research teams determine author order within an EC listing. In response to studies showing that male authors were more likely to be placed first in an EC listing, the American Society for Microbiology (ASM) required that authors explain the reasons for author order beginning in 2020. In this study, we analyze data from over 2,500 ASM publications to see how this policy affected gender bias and how research teams are making decisions on author order. Data on publications from 2018 to 2021 show that gender bias was largely nonsignificant both before and after authors were asked by ASM to provide an EC statement. The most likely reasons for EC order included alphabetical order, seniority, and chance, although there were differences for publications from different geographic regions. However, many research teams used unique methods in order selection, highlighting the importance of EC statements to provide clarity for readers, funding agencies, and tenure committees. IMPORTANCE: First-author publications are important for early career scientists to secure funding and educational opportunities. However, an analysis published in eLife in 2019 noted that female authors are more likely to be placed second even when both authors report they have contributed equally. American Society for Microbiology announced in response that they would require submissions to include a written justification of author order. In this paper, we analyze the resultant data and show that laboratories are most likely to use some combination of alphabetical order, seniority, and chance to determine author order. However, the prevalence of these methods varies based on the research team's geographic location. These findings highlight the importance of equal contributor statements to provide clarity for readers, funding agencies, and tenure committees. Furthermore, this work is critically important for understanding how these decisions are made and provides a glimpse of the sociology of science.

Structural gendered racism and preterm birth inequities in the United States.

Structural gendered racism - the "totality of interconnectedness between structural racism and sexism" - is conceptualized as a fundamental cause of the persistent preterm birth inequities experienced by Black and Indigenous people in the United States. Our objective was to develop a state-level latent class measure of structural gendered racism and examine its association with preterm birth among all singleton live births in the US in 2019. Using previously-validated inequity indicators between White men and Black women across 9 domains (education, employment, poverty, homeownership, health insurance, segregation, voting, political representation, incarceration), we conducted a latent profile analysis to identify a latent categorical variable with k number of classes that have similar values on the observed continuous input variables. Racialized group-stratified multilevel modified Poisson regression models with robust variance and random effects for state assessed the association between state-level classes and preterm birth. We found four distinct latent classes that were all characterized by higher levels of disadvantage for Black women and advantages for White men, but the magnitude of that difference varied by latent class. We found preterm birth risk among Black birthing people was higher across all state-level latent classes compared to White birthing people, and there was some variation of preterm birth risk across classes among Black but not White birthing people. These findings further emphasize the importance of understanding and interrogating the whole system and the need for multifaceted policy solutions.

Gender Representation on Editorial Boards of JAMA Network Journals.

Objective: Underrepresentation of women on editorial boards of biomedical journals has occurred for decades. The JAMA Network Journals have substantial and broad impact on advances in the biomedical sciences. We sought to determine the current status of gender representation on editorial boards of the 12 JAMA Network Journals. Methods: The gender of each editorial board member of the 12 JAMA Network Journals was classified based on review of online sources. The percentage of women on each board (i.e., number of women relative to total members) was calculated and compared to gender equity and parity benchmarks. The gender equity benchmark for each journal was defined as the percentage of women physicians in the medical specialty reflecting the journal's content based on Association of American Medical Colleges data. The gender parity benchmark for all journals was defined as 50% women. Results: There was considerable variation in the representation of women on the editorial boards of the JAMA Network Journals relative to gender equity and parity benchmarks. Women were underrepresented on 50% (6 of 12) of boards relative to gender equity and 67% (8 of 12) of boards relative to gender parity. Conclusions: Women were found to be underrepresented on 50% or more of the editorial boards of the JAMA Network Journals. This finding reflects gender inequities in academic publishing and the broader biomedical enterprise, which limits advances in the biomedical sciences and health care. Those JAMA Network Journals that continue to underrepresent women on their editorial boards are urged to remediate this longstanding issue.

Online images amplify gender bias.

Each year, people spend less time reading and more time viewing images1, which are proliferating online2-4. Images from platforms such as Google and Wikipedia are downloaded by millions every day2,5,6, and millions more are interacting through social media, such as Instagram and TikTok, that primarily consist of exchanging visual content. In parallel, news agencies and digital advertisers are increasingly capturing attention online through the use of images7,8, which people process more quickly, implicitly and memorably than text9-12. Here we show that the rise of images online significantly exacerbates gender bias, both in its statistical prevalence and its psychological impact. We examine the gender associations of 3,495 social categories (such as 'nurse' or 'banker') in more than one million images from Google, Wikipedia and Internet Movie Database (IMDb), and in billions of words from these platforms. We find that gender bias is consistently more prevalent in images than text for both female- and male-typed categories. We also show that the documented underrepresentation of women online13-18 is substantially worse in images than in text, public opinion and US census data. Finally, we conducted a nationally representative, preregistered experiment that shows that googling for images rather than textual descriptions of occupations amplifies gender bias in participants' beliefs. Addressing the societal effect of this large-scale shift towards visual communication will be essential for developing a fair and inclusive future for the internet.

'Seeing is believing' - gender disparities in otolaryngology-head and neck surgery in Africa: a narrative review.

PURPOSE OF REVIEW: Various factors affect otolaryngology - head and neck surgery (OHNS) services in low- and middle-income countries (LMICs); including inadequate infrastructure, limited academic positions, unfavorable hospital research policies, and traditional misconceptions about gender and surgery, among others. Although gender inequalities exist globally, they are particularly pronounced in LMICs, especially in Africa. RECENT FINDINGS: A comparative narrative literature review for relevant manuscripts from January 1, 2017 to through January 10th, 2024, using PubMed, Embase and Google Scholar for articles from the United States/Canada and Africa was done. 195 relevant articles were from the United States/Canada, while only 5 were from Africa and only 1 manuscript was relevant to OHNS. The reviewed articles reported that gender disparities exist in medical training, authorship, and career advancement. We highlight possible solutions to some of these disparities to promote a more gender-diversified workforce in OHNS in Africa as well as all over the world. SUMMARY: Additional studies on gender disparities in Africa, are needed. These studies will highlight need for inclusive policies, structured and accessible mentorship programs; through which these disparities can be highlighted and addressed. This will in the long run ensure sustainability of OHNS care in LMICs.

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Diferencias en los niveles de sexismo en estudiantes de educación física según variables sociodemográficas / Differences in the levels of sexism in physical education students according to sociodemographic variables / Diferenças nos níveis de sexismo em estudantes de educação física segundo variáveis sociodemográficas

El sexismo es el conjunto de creencias y características que son socialmente consideradas apropiadas para hombres y mujeres, en el caso de los varones, actividades asociadas a la fuerza, virilidad, entre otras características, mientras que a las damas se ligan actividades como la belleza, expresión corporal, entre otras. El objetivo de la presente investigación fue analizar las diferencias en el sexismo en los estudiantes en formación de pedagogía en educación física de una Universidad de Santiago de Chile según diversas variables sociodemográficas. Para ello se aplicó el Inventario de Sexismo Ambivalente (ISA) a 201 participantes. Los resultados evidenciaron bajos niveles de sexismo, los niveles de sexismo hostil y benevolente disminuyen conforme avanza la carrera y que los hombres puntúan más alto que las mujeres los dos tipos de sexismo. Se concluye que el sexo, año de carrera, orientación sexual y las creencias religiosas influyen en los niveles de sexismo de los estudiantes de Educación Física.

Sexism is the set of beliefs and characteristics that are socially considered appropriate for men and women, in the case of men, activities associated with strength, and virility, among other features, while the ladies are related to activities such as beauty and body expression, among others. The objective of the present research was to analyze the differences in sexism among the students in pedagogy training in physical education at the University of Santiago de Chile according to various sociodemographic variables. The Ambivalent Sexism Inventory (ASI) was applied to 201 participants. The results showed low levels of sexism, the levels of hostile and benevolent sexism decrease as the career progresses, and that men score higher than women in the two types of sexism. It is concluded that sex, career year, sexual orientation, and religious beliefs influence the sexism levels of physical education students.

Sexismo é o conjunto de crenças e características que são socialmente consideradas apropriadas para homens e mulheres, no caso dos homens, atividades associadas à força, virilidade, entre outras características, enquanto as mulheres estão ligadas a atividades como beleza, expressão corporal, entre outras. O objetivo da presente pesquisa foi analisar as diferenças no sexismo nos estudantes em formação de pedagogia em educação física de uma Universidade de Santiago do Chile segundo diversas variáveis sociodemográficas. Para este fim, o Inventário do Sexismo Ambivalente (ISA) foi aplicado a 201 participantes. Os resultados mostraram baixos níveis de sexismo, com níveis de sexismo hostil e benevolente diminuindo à medida que o curso avançava, e que os homens pontuavam mais alto que as mulheres em ambos os tipos de sexismo. Conclui-se que gênero, ano de estudo, orientação sexual e crenças religiosas influenciam os níveis de sexismo dos estudantes de Educação Física.

Linking gender, climate change and security in the Pacific Islands Region: A systematic review.

This systematic review aims to address gaps in understanding how concepts of gender, climate change and security are given meaning and linked in empirical scholarship within the Pacific Islands Region. The review assesses the 53 articles returned through Web of Science, SCOPUS and ProQuest databases that are derived from empirical research and refer to gender, climate change and security. The findings indicate that this is an emerging topic in a region that is one of the most vulnerable to climate change across the globe. Most frequently gender analysis is given superficial treatment; there is limited literature that connects gendered vulnerabilities to historical legacies and structural inequalities; and women's critical roles that create security are often overlooked and devalued. The review indicates that greater work is needed to question perceived threats to security and to reveal how climate change, gendered institutions, systems and spaces, historical legacies and politics interact to construct security in the Pacific Islands Region.

Female participation in the editorial committees of medical journals in Latin America / Participación femenina en los comités editoriales de revistas médicas en Latinoamérica

Introduction: Female participation in the field of medicine and research has increased in recent years; however, there are still inequities in the proportion of men and women in medical leadership, especially in management positions and editorial committees of scientific journals. Objective: To identify female participation in the editorial committees of medical journals in Latin America and explore the association with editorial positions and impact indicators. Materials and methods: We conducted a descriptive bibliometric study to determine female participation in the editorial committees of medical & journals in Latin America. We included 113 medical journals published in Latin America and indexed in Scopus, updated and current in 2020, selected from the Scimago Journal Country Rank portal. The gender of editorial committee members was identified on the web pages of each magazine. Results: Regarding editorial leadership in the 113 journals included, women represented 12.9% of 264 members; as for the functions within the editorial committee, of 1,449 members, 28.9% were women while in advisory committees, of 4,575 members 19.0% were women. The presence of women in editorial committees was higher in journals from Chile, Brazil, and Venezuela in specialties such as public health, pediatrics, and anesthesiology. Conclusions: Female participation in the editorial committees of medical journals in Latin America is low.

Introducción. La participación femenina en el campo de la medicina y la investigación se ha incrementado en los últimos años; sin embargo, aún existen inequidades en la proporción de hombres y mujeres, especialmente en los cargos directivos y la participación en los comités editoriales de revistas científicas. Objetivo. Establecer la participación femenina en los comités editoriales de revistas médicas en Latinoamérica, y explorar su asociación con los cargos editoriales y los indicadores de impacto. Materiales y métodos. Se hizo un estudio descriptivo de tipo bibliométrico de revistas médicas de Latinoamérica indizadas en Scopus, actualizadas y vigentes en el 2020, las cuales se seleccionaron del portal de Scimago & Journal Country Rank. Los equipos editoriales se categorizaron en tres grupos según sus funciones y, posteriormente, se registró el sexo de sus miembros a partir de sus nombres. Resultados. Se incluyeron 113 revistas. En cuanto al liderazgo editorial, entre los 264 directores de comités editoriales, las mujeres representaban el 12,9 %. En lo concerniente a las diferentes funciones, de 1.449 miembros, las mujeres eran el 28,9 %, en tanto que, de los 4.575 miembros de comités consultivos, el 19,0 % correspondía a mujeres. Se observó una mayor presencia de mujeres en los comités editoriales de revistas de Chile, Brasil y Venezuela, y en las especialidades de salud pública, pediatría y anestesiología. Conclusiones. La participación femenina en los comités editoriales de revistas médicas de Latinoamérica es escasa.

Addressing Gender-Based Disparities in Earning Potential in Academic Medicine.

Importance: Gender-based disparities in compensation in academic medicine are recognized, but their estimated impacts on early career earning potential and strategies to mitigate them have not been well studied. Objectives: To compare earning potential between female and male academic physicians in the first 10 years of posttraining employment and to evaluate the estimated impact of promotion timing, starting salary, and salary growth rate on earning potential. Design, Setting, and Participants: Using publicly available mean debt and compensation data for full-time employed academic physicians in the US from 2019 to 2020, starting salary, salary in year 10 of employment, annual salary growth rate, and overall earning potential in the first 10 years of employment were estimated for each gender by subspecialty. The estimated impacts of promotion timing and potential interventions, including equalizing starting salaries and annual salary growth rates, were modeled. Data analysis was performed from March to May 2021. Exposures: Gender and subspecialty. Main Outcomes and Measures: Starting salary, annual salary growth rate, year-10 salary, and earning potential in first 10 years of employment. Results: This cross-sectional study included compensation data from 24 593 female and 29 886 male academic physicians across 45 subspecialties. Women had lower starting salaries in 42 of 45 subspecialties (93%), year-10 salaries in 43 of 45 subspecialties (96%), mean annual salary growth rates in 22 of 45 subspecialties (49%), and earning potential in 43 of 45 subspecialties (96%) (median [IQR], $214 440 [$130 423-$384 954], or 10%, less). A 1-year delay in promotion from assistant to associate professor reduced women's earning potential by a median (IQR) of $26 042 ($19 672-$35 671), but failure to be promoted at all reduced it by a median (IQR) of $218 724 ($176 317-$284 466). Equalizing starting salaries could increase women's earning potential by a median (IQR) of $250 075 ($161 299-$381 799) in the subspecialties for which starting salaries for women were lower than those for men. Equalizing annual salary growth rates could increase women's earning potential by a median (IQR) of $53 661 ($24 258-$102 892) in the subspecialties for which mean annual salary growth rates were lower for women than for men. Conclusions and Relevance: The findings of this study suggest that gender-based disparities in starting salary and early career earning potential are pervasive in academic medicine in the US. Equalizing starting salaries would address the majority of the differences in earning potential.

Disparate participation by gender of conference attendants in scientific discussions.

One important metric of a radiologist's visibility and influence is their ability to participate in discussion within their community. The goal of our study was to compare the participation level of men and women in scientific discussions at the annual meeting of the Radiological Society of North America (RSNA). Eleven volunteers collected participation data by gender in 59 sessions (286 presentations) at the 2018 RSNA meeting. Data was analyzed using a combination of Chi-squared, paired Wilcoxon signed-rank and T-test. Of all RSNA professional attendees at the RSNA, 68% were men and 32% were women. Of the 2869 presentations listed in the program, 65% were presented by men and 35% were presented by women. Of the 286 presentations in our sample, 177 (61.8%) were presented by men and 109 (38.1%) were presented by women. Of these 286 presentations, 81 (63%) were moderated by men and 47 (37%) were moderated by women. From the audience, 190 male attendees participated in 134 question-and-answer (Q&A) sessions following presentations and 58 female attendees participated in 52 Q&A sessions (P<0.001). Female attendees who did participate in Q&A sessions talked for a significantly shorter period of time (mean 7.14 ± 17.7 seconds, median 0) compared to male attendees (28.7 ± 29.6 seconds, median 16; P<0.001). Overall, our findings demonstrate that women participated less than men in the Q&A sessions at RSNA 2018, and talked for a shorter period of time. The fact that women were outnumbered among their male peers may explain the difference in behavior by gender.

Prevalence of gender-based and sexual harassment within orthopedic surgery in Canada.

BACKGROUND: Gender-based and sexual harassment are prevalent in the medical profession. We aimed to quantify the prevalence of such behaviours within orthopedic surgery in Canada and to identify any risk factors for experiencing gender-based or sexual harassment in the workplace. METHODS: In collaboration with the Canadian Orthopaedic Association, we conducted a Canada-wide email questionnaire survey in June 2019 of all orthopedic surgeons registered with the Canadian Orthopaedic Association and the Canadian Orthopaedic Residents' Association. The development of our questionnaire was informed by a review of the literature and published surveys on gender-based and sexual harassment, and consultation with researchers in intimate partner violence. We conducted a multivariable logistic regression analysis to identify risk factors for harassment. RESULTS: Of the 1783 surgeons invited to participate, 465 returned the questionnaire (response rate 26.1%); the response rate was 48.1% for females and 22.1% for males. Overall, 331/433 respondents (76.4%, 95% confidence interval [CI] 72%-80%) and 315/423 respondents (74.5%, 95% CI 70%-78%) reported having experienced at least 1 occurrence of gender-based and sexual harassment, respectively. Women were significantly more likely than men to have experienced both gender-based and sexual harassment (odds ratio [OR] 16.2, 95% CI 4.8-54.0, and OR 2.2, 95% CI 1.2-4.0, respectively). Respondents who identified as nonwhite were significantly less likely than those who identified as white to have experienced gender-based harassment (OR 0.5, 95% CI 0.3-0.99). CONCLUSION: The prevalence of gender-based and sexual harassment is high within Canadian orthopedic surgery, and women are at highest risk for experiencing harassment. The results may provide the impetus for orthopedic societies to develop action plans and to re-examine and enforce policies to address these damaging behaviours appropriately.