Gender equity in the global rheumatology workforce: results of the Coalition for Health and Gender Equity (CHANGE) survey

Gupta L 1 , Sarkar M 2 , Ovseiko P 3 , Gossec L 4 , Talreja T 5 , Day J 6 Show all authors , Traboco L 7 , Russell AM 8 , Haq SA 9 , Hill CL 10 , Dey D 11 , Hassan N 12 , Babini AM 13 , Gonzalez AMA 14 , Gutiérrez CET 15 , Duftner C 16 , Alpizar-Rodríguez D 17 , Badsha H 18 , Nikiphorou E 19 , Harifi G 20 , Hmamouchi I 21 , Von Feldt J 22 , Farani JB 23 , Kalla AA 24 , Rahulan LM 25 , Andreoli L 26 , Souza MP 27 , Palominos PE 28 , Nakashima R 29 , Tanaka Y 30 , Bautista-Molano W 31 , Agarwal V 25 , Ziade N 32 , Wright G 33 , Coates LC 34 , CHANGE Study Group

Affiliations 

  • 1 Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK; School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, UK; Francis Crick Institute, London, UK. Electronic address: drlatikagupta@gmail.com
  • 2 Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
  • 3 Radcliffe Department of Medicine, University of Oxford, Oxford, UK
  • 4 Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Team Pepites, Paris, France; AP-HP, Pitié-Salpêtrière hospital, Rheumatology department, Paris, France
  • 5 Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India
  • 6 Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia; Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia
  • 7 Section of Rheumatology, St Luke's Medical Center-Global City, Philippines; University of the Philippines, Manila, Medical Informatics Unit (Grad Student) Philippines
  • 8 School of Health Sciences, College of Medicine and Health, University of Birmingham, UK; ILD Specialist Regional Service Birmingham Chest Clinic University Hospitals Birmingham NHS Foundation Trust, UK; Faculty of Health and Medical Sciences, University of Adelaide, Australia
  • 9 Rheumatology, Green Life Center for Rheumatic Care and Research, Dhaka, Bangladesh
  • 10 The University of Adelaide, Adelaide, South Australia, Australia; Department of Rheumatology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
  • 11 Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, Korle-Bu, Accra, Ghana
  • 12 Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, UK; Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, UK
  • 13 Rheumatology Unit, Hospital Italiano de Cordoba, Cordoba, Argentina
  • 14 Department of Rheumatology, Faculty of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
  • 15 General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Colombia
  • 16 Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Tirol, Austria
  • 17 Division of Rheumatology, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, Mexico
  • 18 Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
  • 19 Centre for Rheumatic Diseases and Centre for Education, Faculty of Life Sciences & Medicine, King's College London, London, UK; Rheumatology Department, King's College Hospital, London, UK
  • 20 King's College Hospital, Dubai, United Arab Emirates; Mohammed Bin Rashid University of Medicine and health sciences (MBRU), Dubai, UAE
  • 21 Health Sciences Research Center (CReSS), Faculty of Medicine, International University of Rabat (UIR), Morocco
  • 22 University of Pennsylvania, Philadelphia, PA, USA
  • 23 Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
  • 24 Chief of Rheumatology Unit, Groote Schuur Hospital, South Africa
  • 25 Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  • 26 Rheumatology and Clinical Immunology Unit, ASST Spedali, Civili and University of Brescia, 25123, Brescia, Italy; The Danish Centre for Expertise in Rheumatology (CeViG), Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
  • 27 Post Graduate Programme in Sciences Applied to Adult Health Care, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
  • 28 Hospital Lifeplus Litoral Norte, Rua Elias João de Medeiros, 2001, zip code 95588-000, Xangri-lá, Rio Grande do Sul, Brazil
  • 29 Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
  • 30 The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, 807-8555, Japan
  • 31 Clinical Immunology Group, School of Medicine, Universidad Militar Nueva Granada, Bogotá, Colombia; Cellular and Molecular Immunology Group (InmuBo), Universidad El Bosque, Bogotá, Colombia; Department of Rheumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • 32 Rheumatology Department, Hôtel-Dieu de France Hospital, Saint Joseph's University, Beirut, Lebanon
  • 33 Association of Women in Rheumatology, GRACE C WRIGHT MD PC, 345 E 37th Street, Suite 303C, New York, NY, 10016, USA
  • 34 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
Semin Arthritis Rheum, 2026 Oct 28;81:153092.
PMID: 42981725 DOI: 10.1016/j.semarthrit.2026.153092

Abstract

BACKGROUND/PURPOSE: Gender equity remains an elusive goal across many specialist medical fields. The Coalition for Health and Gender Equity (CHANGE) conducted a comprehensive global survey assessing gender equity within the international rheumatology workforce.

METHODS: A cross-sectional online survey of rheumatologists and allied health professionals was conducted between January 2023 and May 2024. The 38-item survey covered demographics, gender discrimination, sexual harassment, work-family interface, and career advancement. It was translated into eight languages and disseminated through professional organisations, mailing lists and social media channels in 105 countries. Analyses included descriptive statistics and comparative tests, with gender differences evaluated after adjustment for years of work experience. Subgroup analyses included country Human Development Index (HDI), professional roles, and caregiving responsibilities, with statistical significance set at p<0.05.

RESULTS: Among 1,945 respondents (66.4% female), pronounced gender-based disparities were observed. Male professionals demonstrated higher rates of full-time employment, leadership positions, and clinical experience. Female rheumatology professionals more frequently encountered career barriers, including tasks below their expertise, hostility from colleagues, lacking leadership training opportunities, lower remuneration, and difficulties securing research funding. Women reported greater domestic responsibilities (47.5% vs 36.2%, p<0.001) and higher work-family conflict, with nearly four times the odds of experiencing sexual harassment and double the odds of experiencing bullying. Perceived experiences were more pronounced among respondents from high-HDI countries and those with caregiving responsibilities, but did not differ by professional role.

CONCLUSION: This global survey provides compelling evidence of gender disparities in rheumatology, necessitating coordinated, evidence-based interventions to address structural barriers and promote inclusive cultures.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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