‘More Walk and Less Talk’: Changing gender bias in sports medicine

In the Danish Society of Sports Physical Therapy (DSSF), we were greatly inspired by the…

In the Danish Society of Sports Physical Therapy (DSSF), we were greatly inspired by the paper: ‘We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine’ published in the British Journal of Sports Medicine in 2018.1 The paper elegantly addresses gender bias in sports medicine,2 and how lack of diversity, whether it concerns skin colour, ethnicity, socioeconomic status, gender identity etc., as pointed out by Bekker et al, ‘structurally affords certain groups rights and privileges above others’. Bekker et al, use the term ‘manel’ to describe panels at conferences or meetings consisting only of men. This paper made it clear to us, that being intentional is different from having good intentions. We took it for granted that we were part of a culture that provided equal opportunities for all genders but never openly discussed it at scientific board meetings. We were wrong—and Bekker and coauthors facilitated a much-needed self-reflection.

It IS possible to achieve gender balance in Sports Medicine. The International Federation of Sports Physical Therapy World Congress changed from 26% and 14% women speakers in 2015 and 2017 to 46% and 53% women speakers in 2019 and 2022—which shows that it can be done if intentional efforts are applied.

In DSSF, we have recently started to review gender diversity among our conference speakers at Scandinavian Sports Medicine Congress (#sportskongres).3 4 When we retrospectively reviewed 2 years prior and 2 years after the Bekker et al1 paper from October 2018, the following pattern among conference speakers emerged: in 2017, we had 75% men among the speakers, and in 2018 we had 79%. Furthermore, in 2017 and 2018, 33% and 46% of all panels were manels. When reviewing the numbers after October 2018, it seems that slight improvement has occurred, in 2019 and 2020, with 67% and 71% men among the speakers, and 28% and 37% of all panels being manels. Things are changing for the better—but in the long run it will take a village,5 before we can declare that #sportskongres is gender balanced.

We encourage other sports medicine organisations to investigate gender balance to start a data-informed discussion of whether changes are needed and if they are improving fast enough. As we have experienced the numbers may not be as favourable as you think!

At #sportskongres, we have always aimed for multidisciplinary diversity and balance by using a quota approach, with four main plenary sessions running concurrently (sports physiotherapy, sports orthopaedics, sports rheumatology and sports science/physical activity) throughout the conference. Therefore, why not use quota to obtain gender balance as well? An intentional quota approach enables us to facilitate diversity at our conferences and activities. Diversity is not just about gender, and the focus can easily be expanded to target areas where certain people or groups are currently favoured in a way that it does not represent and encompass important aspects of a topic in sports medicine. Furthermore, we must make better use of conference speaking engagements as they are uniquely placed to facilitate a change in the power structure within the academic, research and clinical sectors of sports medicine to promote a move towards gender justice within our field. This means, making room for more diverse and difficult topics within our profession,6 and challenge who we perceive as experts. Sharing the conference stage with athletes and coaches is one example of how the established system can be disrupted, dismantled and restructured, and something we need much more focus on in the future.7

We encourage other sports medicine organisations to discuss using quotas and have a vision of gender equality.8 How great would it be to see sports medicine journals and sports medicine organisations, teams and associations transparently use quotas when they advocate for editors, reviewers and sports medicine professionals? We recognise that gender equality is a much more complex matter and cannot be simplified to a mere question of quotas. However, we suggest that the number of topics of relevance to women sports at conferences and publications authored by women in sports medicine journals can be improved by using transparent calls and quotas. Along the same lines, addressing manels can even be an explicit way to exemplify how the rest of our professional sports medicine ‘invitational’ and ‘hiring’ approach should evolve. In Denmark only 19% of our sports doctors’ association members are women, as opposed to 50% being women in our sports physiotherapists’ association (DSSF). It would be interesting to get insight to these numbers globally, as a lack of women sports doctors may play an important part in the difficulties with achieving gender equality in sports medicine and is something that needs to be addressed. After all, we can’t keep providing sports medicine content and insight that only addresses half the population.