Gender disparity of invited speakers at the American Association of Orthodontists Annual Session: A cross-sectional analysis 2015-2023

Introduction

The American Association of Orthodontists (AAO) Annual Session aims to educate members using expert speakers in the field. Selection to speak is an honor and can help further an orthodontist’s career and credibility. A European study found a significant gender discrepancy in selected speakers at their orthodontic meeting. This has not been investigated in the United States.

Methods

Speaker names from the 2015-2023 AAO Annual Sessions were obtained and analyzed for gender and then compared with active membership and orthodontic faculty percentages. In addition, the gender of each General Chair and Doctors’ Program Chair was analyzed and then compared with the female speaker and membership percentages. Because AAO research award winners are selected blindly, show expertise in the field, and are provided an opportunity to speak at the Annual Session, their gender was also confirmed and compared with membership percentage and female speaker percentage. Two-way chi-square tests were used, and P values of <0.05 were considered statistically significant. Mann-Kendall trend tests analyzed any potential changes in gender representation among AAO active memberships and AAO Annual Session speakers.

Results

Female doctors were underrepresented as speakers ( P values ranged from <0.001 to <0.05) in every year studied except 2020 compared with active membership and female faculty percentages. Female doctors were also significantly underrepresented as Annual Session General Chairs and Doctors’ Program Chairs ( P <0.01). The difference in female doctor representation among research awards winners (63%) compared with the Annual Session speakers (19%) was highly significant. Female representation in AAO active membership shows a significant increase from 2015 to 2023. The ratio of female-to-male speakers appears to be increasing but did not reach statistical significance.

Conclusions

Female doctors are underrepresented as selected speakers at the AAO Annual Session but comprise the majority of research award recipients. Efforts to provide opportunities for women to showcase their knowledge should be implemented.

Highlights

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Women comprise 36% of AAO active membership, with numbers trending upward.
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From 2015 to 2023, female doctor speakers were underrepresented at the Annual Session.
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From 2015 to 2023, more female doctors won an AAO research award than males.
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AAO Planning Committee members were not reflective of the 2015-2022 makeup of active membership.
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The new Committee on Conferences and Meetings did not produce more female speakers in 2023.

Presenting at a professional conference often represents reaching the height of prestige in the science, technology, engineering, and mathematics (STEM) professions. Selection as a speaker implies a high level of expertise and is necessary for advancement in many scientific careers. Previous studies have shown that females are underrepresented as speakers in various STEM-related fields. In medicine, the representation of female speakers was extremely low in conferences in 2013 and 2015 across 27 medical specialty conferences in the United States. Another study on medical conferences in the United States and Canada found that although the number of women as speakers has increased from 2007 to 2017 (24.6% to 34.1%), women are still not selected equally across all medical fields. It is a bleaker picture for mathematical conferences in which women represented only 14.8% of invited and plenary speakers at the International Congress of Mathematicians, with only 35 out of 237 speakers being women across 20 sessions of invited speakers.

Women are making significant steps toward equality in dentistry, but they continue to be overlooked when presenting at national conferences. Although there are more female than male dentists in the United Kingdom, data on the gender of invited speakers at dental conferences in the United Kingdom in 2018 and 2019 shows that women only made up 140 of the 352 invited speakers. As a result, women receive fewer opportunities to advance in their careers and are less likely to be recognized as an expert. This trend is common in other countries as well. For example, a study on dental conference speakers in Brazil found that even with an ever-increasing number of female dentists in their country, men comprised >80% of the invited speakers at their conferences.

The trend of increasing female representation in the dental field but with underrepresentation among conference speakers is also reflected in the dental specialties. In 2022, the European Journal of Orthodontics published a study on the gender disparity of invited speakers at European Orthodontic Society (EOS) conferences. The gender of speakers at EOS conferences was examined from 2015 to 2020. This study differentiated the types of speakers on the basis of the process used by the selection committee. Oral presentations were selected blind (ie, the author’s name and all identifying information were blocked out). However, invited speakers were selected with all identifying information available to the committee members. The results showed relatively equal representation among males and females for the blindly selected oral presentations. However, when looking at invited speakers, the researchers found that women made up only 15 of the 84 invited speakers over the past 5 years. The results of this study indicated that the work done by women was seen as equal to men when the gender of the author is unknown, but there is an implicit bias against women when considering those doctors who are invited to speak.

Although these data are substantial in showing a gender issue among invited speakers, it is limited to only Europe. The American Association of Orthodontists (AAO) is similar to the EOS in that its mission is to educate and advocate for their orthodontic members, and it hosts an annual conference with invited speakers. The AAO conference hosts almost 10,000 attendees annually and is considered one of the largest orthodontic meetings in the world. There has been no research on gender disparity between male and female speakers at this esteemed meeting. This study aimed to identify gender-based discrimination trends in choosing invited speakers for the AAO Annual Session.

Material and methods

For this cross-sectional study, speaker names from the 2015-2023 AAO Annual Sessions were directly requested from the AAO. These dates were selected because the AAO began tracking demographic data of their membership in 2015; therefore, a direct comparison between the percentage of female doctor members and female doctor speakers could be conducted. Each speaker’s name on the Doctors’ Program was analyzed from this list for gender. Gender was determined by a Google search of the individual and/or their associated LinkedIn profile. This method of using online tools to determine gender has been previously used in gender bias studies related to virology conferences. Based on these searches, the speakers were categorized as doctor or nondoctor speakers. Because this study is focused on the potential gender bias in selecting female doctors for speaking positions, all nondoctor speakers (female and male) were removed from the overall dataset. Over the 8 years studied, there were 1169 doctor lectures at the AAO Annual Session.

For the 2015-2022 Annual Sessions, the AAO used a planning committee coordinating all programming and selecting speakers. This planning committee is personally selected by the AAO president and varies from 5-10 people each year. To determine if there is a correlation between the gender of planning committee members and the percentage of female speakers at the conference, Annual Session programs from the past 8 years were found online, and the names of the General Chairs and Doctors’ Program Chairs were counted. Committee members with titles related to the staff program, featured speakers, and local arrangements were not included as they were not relevant to this study. The gender of each General Chair and Doctors’ Program Chair was determined using the same method as the speakers using online searches using Google and LinkedIn.

Because the AAO Annual Session planning committee solely determines the selection of Annual Session speakers, it is also important to see if this group is representative of its membership. In addition to determining if there is a correlation between planning committee members and female speakers at the Annual Session, this study also sought to determine the correlation of gender representation among General Chairs and Doctors’ Program Chairs compared with active AAO membership.

The AAO recently formed the Committee on Conferences and Meetings (CCon), recognizing that their planning committee model needed an update. The inaugural committee consisted of 13 orthodontists selected from various backgrounds intending to represent the membership. This committee planned the 2023 Annual Session, and these data are included in the study.

The method for choosing speakers for the AAO Annual Session involves the planning committee (2015-2022) or CCon (2023) reviewing the resumes of interested candidates. In addition, the committee can suggest speakers and programming they think will interest attendees. The official AAO selection criteria involve reviewing a member’s needs assessment, looking for high-quality continuing education courses, and finding speakers with “talent, knowledge, and expertise” through an interview with AAO. With these criteria, it is impossible to select speakers without knowledge of who the person is and thus their gender.

Each year at the Annual Session, the AAO research awards are presented to doctors who have completed what is considered the most outstanding orthodontics research in that year. Thus, these doctors would be considered to have “talent, knowledge, and expertise,” which is one of the main selection criteria stated by the AAO. Unlike the traditional Annual Session speaker selection, determining the AAO research award winners is completely blind. All identifying information of the applicant is removed, and the AAO Committee on Scientific Affairs reads and evaluates the research paper without knowing who completed the research. Although anonymizing the AAO research award process was originally intended to reduce bias against certain universities and professors, it does provide an opportunity to evaluate the gender distribution of speakers chosen solely on the basis of merit. Winners of the 3 major AAO research awards (Milo Hellman Award, Harry Sicher Award, and Thomas Graber Award) for the past 9 Annual Sessions were found on the AAO Web site. Their names were noted, and their gender was confirmed using the online methods discussed above.

Although faculty appointment is not a specific criterion for speaker selection, many speakers at the Annual Session hold faculty positions and are thus considered experts in their field. To determine if there is a discrepancy between female speaker percentage and female faculty percentage, the AAO was contacted for data on the gender of AAO active academic membership.

Raw data were entered into Microsoft Excel, including male and female AAO Annual Session speakers, AAO research award winners, AAO Annual Session committee members, AAO active membership, and AAO active academic memberships. Two-way chi-square tests with Excel were used to analyze the gender representation of AAO Annual Session speakers compared with overall AAO active memberships for 2015-2023. Gender representation of AAO Annual Session speakers compared with AAO active academic memberships was analyzed for 2018-2023 because the AAO did not have reliable gender data for this membership category before 2018. A P value of <0.05 was considered statistically significant.

Two-way chi-square tests were also used to evaluate the 2015-2022 AAO Annual Session General Chairs and Doctors’ Program Chairs compared with AAO active membership to analyze if the gender representation of committee members was also representative of membership. A P value of <0.05 was considered statistically significant. For the 2023 meeting, the new standing committee was used. Because this model differs from previous years, these committee members were not included in these calculations.

Gender representation of 2015-2023 AAO research award winners were compared with AAO Annual Session speakers and AAO active membership from the same period using 2-way chi-square tests to analyze if gender differences existed among blinded award winners, hand-selected speakers, and general members. A P value of <0.05 was considered statistically significant.

Finally, Mann-Kendall trend tests analyzed any potential changes in gender representation among AAO active membership and AAO Annual Session speakers. A P value of <0.05 was considered statistically significant.

Results

A total of 1169 doctor lectures and 54 research award winners from the 2015-2023 AAO Annual Sessions, 28 program chairs from the 2015-2022 Annual Sessions, and 13 CCon members for the 2023 Annual Session were evaluated for gender. The ratio of female-to-male doctor speakers at the AAO Annual Session was compared with overall active membership in the AAO for 2015-2023 and compared with the AAO Active Academic Members for 2018-2023.

In every year except 2020, there was a statistically significant difference between the ratio of female-to-male doctor speakers and overall AAO membership, with female doctors underrepresented as speakers in all years ( Fig 1 ). This difference was highly significant for 2015, 2016, 2018, 2019, and 2023 ( P <0.001), with 2017, 2022 ( P <0.05), and 2021 ( P <0.01) also showing a significant difference. Although the 2020 Annual Session also showed a lower ratio of female-to-male speakers than overall membership, the results were not statistically significant. This may be due to the small sample size that year. Because of the coronavirus pandemic, the live AAO Annual Session scheduled for spring 2020 was canceled, and a small virtual meeting was put together with only 19 doctor speakers. The mean number of doctor speakers in 2015-2019 and 2021-2023 was 144.