López-Padilla et al.1 have published a comprehensive bibliometric study on female authorship in ARCHIVOS DE BRONCONEUMOLOGÍA. They conclude with some optimism that in recent years more women have appeared in the first and middle positions of the list of authors, but not in the last position. This is statistically true: we can see that between 2006–2010, 31.2% of the original articles had a woman as the first author, and in recent years (2016–2018) this figure had increased to 34.5%. However, an entirely opposite conclusion could have been drawn from the same results. According to data from the article itself, the proportion of registered women doctors in 2006 was 42% and in 2016 it was almost 50%. This allows for a less optimistic interpretation, because if the proportion of female doctors is taken into account, the percentage of women as first authors should have been 37% in the last period to maintain the previous ratio. In other words, there are proportionately fewer women as first authors in the period 2016–2018 than in previous years.

This is quite similar to the trends previously observed in editorials2. These articles reflect the prestige or scientific influence of their authors, because they are written at the behest of the editorial committees3. In a study on women authors of editorials, we found that only 16% of the editorials published in Archivos de Bronconeumología were authored by women at first author, and that this percentage did not change significantly in the different periods2. Although gender inequality in authorship occurs in virtually all journals and scientific fields3, the data from Archivos de Bronconeumología are not particularly satisfactory. For example, in Medicina Clínica, a Spanish journal that publishes articles from multiple medical specialties, women were included as authors of 40% of scientific documents, but once again were the first authors of only 18% of the editorials4.

Several factors affecting the inequality of women in health care have been identified, including hierarchy and leadership models with a traditionally male bent5. However, it is striking that this occurs in a specialty such as pulmonology, which has or has had numerous women chairs in their national and regional scientific societies and in positions of authority in the healthcare field. As evidence of the scientific prestige of women pulmonologists, current data (June 2020) from the SEPAR website show more women than men on the scientific committees of the society’s working groups. However, we find that they rarely participate as first authors1,2.

Structural, organizational and personal barriers that hinder women’s access to positions of responsibility in scientific activities6 and offer them less recognition by scientific societies7 have been described. It appears that one of the main reasons why women find it hard to publish scientific articles could be differences in the freedom to control work time8, a term that can range from subjective perceptions to family burdens and domestic obligations.

Data on female participation in the leadership of scientific publications, even with the most optimistic of interpretations, are disappointing. The reasons for this must be identified and concrete measures should perhaps be proposed to facilitate the management of work time and to promote the visibility of women researchers when editorials are requested. International protocols have been proposed to address this issue by identifying cultural factors, country-specific factors, and other interdisciplinary factors9. Some journals have already developed editorial policies to promote the visibility of women in scientific publications10.