Gender Equality and Equity in Intensive Care

• In ICU
• Tue, 21 Apr 2026

An international study addressed gender equality and equity in intensive care medicine (ICM), a field where disparities persist despite increasing workforce diversity. The authors highlight that although women now comprise a substantial proportion of healthcare workers, leadership roles in intensive care remain disproportionately occupied by men. 

Research has largely focused on binary sex classifications, with insufficient attention to gender identity and the experiences of gender minorities. The study distinguishes between equality (treating all individuals the same) and equity (providing tailored support to address structural barriers affecting different groups).

To develop guidance in this evolving area, a 12-member Steering Committee and 46 international panellists from 32 countries (including 43% from low- and middle-income countries) participated. The panel represented a wide range of intensive care professionals, including physicians, nurses, researchers, and trainees. Over six iterative rounds, panellists evaluated 57 statements across ten domains of professional life. 

The study achieved a 100% response rate in all rounds, reflecting strong engagement. Consensus and stability were reached on 43 of 57 statements (75%), leading to the development of 37 professional practice guidance statements. Consensus was higher for equality-focused statements (85.2%) than for equity-focused ones (66.7%), suggesting that while equal treatment is broadly accepted, targeted measures to address disparities remain more contentious. Areas lacking consensus, particularly in academia, workplace dynamics, and multiprofessional meetings, highlight ongoing uncertainty and the need for further research.

Across the ten domains, several key themes emerged. In addressing intensive care professionals, the panel strongly supported the use of gender-neutral language and respectful forms of address, including appropriate titles and pronouns. Misgendering and inconsistent professional address were recognised as contributors to bias, stress, and burnout. Practical strategies such as standardised use of professional titles and visible identification badges were recommended to promote respectful communication.

In multiprofessional meetings, the panel endorsed gender diversity among speakers, organisers, and committees, acknowledging that diverse representation enhances discussion and reflects equitable practice. While there was agreement on promoting diversity, there was no consensus on prohibiting single-gender panels outright. The inclusion of dedicated Diversity, Equity, and Inclusion (DEI) sessions at major meetings was strongly supported to raise awareness and foster inclusivity.

Within the workplace, the panel reached strong consensus on the principle of pay parity for individuals with equivalent roles and qualifications, irrespective of gender. Transparent recruitment processes, objective evaluation criteria, and avoidance of discriminatory interview questions were emphasised. The panel also supported equitable access to career development opportunities, alongside targeted support, such as flexible working arrangements and mentorship, for individuals facing structural barriers, including caregiving responsibilities. These recommendations reflect recognition that institutional and interpersonal factors contribute significantly to gender disparities.

In leadership and career progression, merit-based promotion and equal access to leadership roles were endorsed, alongside targeted mentorship and training programmes for underrepresented groups. Evidence cited in the article demonstrates persistent underrepresentation of women in leadership positions within intensive care organisations, underscoring the need for both equality and equity measures.

The domain of academia revealed similar patterns. The panel supported equal opportunities for research funding, mentorship, and publication, while also advocating targeted initiatives to support underrepresented genders. Persistent disparities were noted in authorship, grant funding, and leadership of clinical trials. The panel also recommended gender diversity in journal editorial boards and peer review processes, as well as mentorship programmes to enhance academic participation.

For trainees and educators, the panel emphasised the importance of structured assessment methods and implicit bias training to reduce disparities in evaluation and opportunities. Regular review of curricula to ensure inclusivity and non-discrimination was also recommended. These measures aim to address documented inequities in training experiences and outcomes.

The study also addressed professional misconduct, highlighting that gender-based harassment and discrimination disproportionately affect women and gender minorities. The panel strongly supported the development of specific policies, codes of conduct, and robust reporting mechanisms to address such issues.

In professional societies, the panel advocated transparent processes to ensure equal access to leadership and governance roles, although consensus was not reached on targeted opportunities for underrepresented groups. Similarly, in environmental and logistical domains, the panel supported the creation of safe, inclusive workplaces, including facilities such as childcare, gender-neutral restrooms, and supportive infrastructure.

The importance of gender metrics was also highlighted. The panel recommended systematic collection and reporting of gender-related data across institutions, training programmes, journals, and professional societies. Such metrics are essential for monitoring progress and informing policy development.

The panel emphasised the need for ongoing education and policy development to promote gender equality and equity. Training to recognise and address bias, integration of inclusivity into curricula, and early-career exposure to these principles were identified as critical strategies for cultural change.

Source: Intensive Care Medicine

Image Credit: iStock