RESEARCH ARTICLE Is authorship by women in Brazilian academic surgery increasing? A five-year retrospective analysis Mariana Graner ID 1 , Alexandra M. Buda ID 2 , Carolina B. Moura 3 , Letı ´cia Campos ID 4 , Isabella FariaID 5 , Paul Truche ID 2 , Fabio Botelho 6 , Laura Pompermaier 2 , Aline Gil Alves Guilloux ID 1 , Alexis N. Bowder ID 2 , Julia Ferreira 6,7 * 1 School of Medicine, University of São Paulo, São Paulo, SP, Brazil, 2 Harvard Medical School—Program in Global Surgery and Social Change, Boston, MA, United States of America, 3 Faculdade de Sau´ de e Ecologia Humana, Vespasiano, MG, Brazil, 4 Faculty of Medical Sciences Universidade de Pernambuco, Recife, PE, Brazil, 5 Federal University of Minas Gerais, Belo Horizonte, MG, Brazil, 6 Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children’s Hospital, Montreal, Canada, 7 McGill University, Montreal, Canada * julia.ferreira2@mail.mcgill.ca Abstract Women remain underrepresented in 80% of Brazilian surgical specialties, however, women representation within the Brazilian academic surgical literature remains unknown. This study aims to evaluate the gender distribution of first and last authors in Brazilian surgical journals. All publications between 2015 and 2019 from the five Brazilian surgical journals with the highest impact factor were reviewed. The first and last authors’ names were extracted from each article and a predictive algorithm was used to classify the gender of each author. Authors were further classified by surgical field and geographic region to inves- tigate patterns of female authorship among journals, specialties, and region over the study period. Multivariable logistic regression was then used to identify factors independently associated with female authorship. 1844 articles were analyzed; 23% (426/1844) articles had female first authors, and 20% (348/1748) had female last authors. Acta Ciru´ rgica Brasi- leira was observed to have the highest rates for both first and last female authors (37%, 138/ 371; 26%, 95/370)) and Revista Brasileira de Ortopedia (9%, 48/542; 10%, 54/522) had the lowest rates. Papers with a woman senior author were twice as likely to have a woman first author (OR 1.98, 95% CI 1.51–2.58, p�0.01). Women’s representation in medicine is increasing in Brazil, yet women remain underrepresented as the first and last authors in the Brazilian surgical literature. Our results highlight the importance of senior women mentor- ship in academic surgery and demonstrate that promoting female surgeon senior authorship through academic and financial support will positively impact the number of female first authors. PLOS GLOBAL PUBLIC HEALTH PLOS Global Public Health | https://doi.org/10.1371/journal.pgph.0000294 April 27, 2022 1 / 15 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Graner M, Buda AM, Moura CB, Campos L, Faria I, Truche P, et al. (2022) Is authorship by women in Brazilian academic surgery increasing? A five-year retrospective analysis. PLOS Glob Public Health 2(4): e0000294. https://doi.org/ 10.1371/journal.pgph.0000294 Editor: Veena Sriram, The University of British Columbia, CANADA Received: June 1, 2021 Accepted: March 2, 2022 Published: April 27, 2022 Copyright: © 2022 Graner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All datasets used and/or analyzed during the current study are presented in the main manuscript. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.