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Research Article

Twenty years of gender equality research: A scoping review based on a new semantic indicator

Contributed equally to this work with: Paola Belingheri, Filippo Chiarello, Andrea Fronzetti Colladon, Paola Rovelli

Roles Conceptualization, Formal analysis, Funding acquisition, Visualization, Writing – original draft, Writing – review & editing

Affiliation Dipartimento di Ingegneria dell’Energia, dei Sistemi, del Territorio e delle Costruzioni, Università degli Studi di Pisa, Largo L. Lazzarino, Pisa, Italy

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Visualization, Writing – original draft, Writing – review & editing

Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Department of Engineering, University of Perugia, Perugia, Italy, Department of Management, Kozminski University, Warsaw, Poland

Roles Conceptualization, Formal analysis, Funding acquisition, Writing – original draft, Writing – review & editing

Affiliation Faculty of Economics and Management, Centre for Family Business Management, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy

• Paola Belingheri, 
• Filippo Chiarello, 
• Andrea Fronzetti Colladon, 
• Paola Rovelli

• Published: September 21, 2021
• https://doi.org/10.1371/journal.pone.0256474
• Reader Comments

9 Nov 2021: The PLOS ONE Staff (2021) Correction: Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLOS ONE 16(11): e0259930. https://doi.org/10.1371/journal.pone.0259930 View correction

Gender equality is a major problem that places women at a disadvantage thereby stymieing economic growth and societal advancement. In the last two decades, extensive research has been conducted on gender related issues, studying both their antecedents and consequences. However, existing literature reviews fail to provide a comprehensive and clear picture of what has been studied so far, which could guide scholars in their future research. Our paper offers a scoping review of a large portion of the research that has been published over the last 22 years, on gender equality and related issues, with a specific focus on business and economics studies. Combining innovative methods drawn from both network analysis and text mining, we provide a synthesis of 15,465 scientific articles. We identify 27 main research topics, we measure their relevance from a semantic point of view and the relationships among them, highlighting the importance of each topic in the overall gender discourse. We find that prominent research topics mostly relate to women in the workforce–e.g., concerning compensation, role, education, decision-making and career progression. However, some of them are losing momentum, and some other research trends–for example related to female entrepreneurship, leadership and participation in the board of directors–are on the rise. Besides introducing a novel methodology to review broad literature streams, our paper offers a map of the main gender-research trends and presents the most popular and the emerging themes, as well as their intersections, outlining important avenues for future research.

Citation: Belingheri P, Chiarello F, Fronzetti Colladon A, Rovelli P (2021) Twenty years of gender equality research: A scoping review based on a new semantic indicator. PLoS ONE 16(9): e0256474. https://doi.org/10.1371/journal.pone.0256474

Editor: Elisa Ughetto, Politecnico di Torino, ITALY

Received: June 25, 2021; Accepted: August 6, 2021; Published: September 21, 2021

Copyright: © 2021 Belingheri 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: All relevant data are within the manuscript and its supporting information files. The only exception is the text of the abstracts (over 15,000) that we have downloaded from Scopus. These abstracts can be retrieved from Scopus, but we do not have permission to redistribute them.

Funding: P.B and F.C.: Grant of the Department of Energy, Systems, Territory and Construction of the University of Pisa (DESTEC) for the project “Measuring Gender Bias with Semantic Analysis: The Development of an Assessment Tool and its Application in the European Space Industry. P.B., F.C., A.F.C., P.R.: Grant of the Italian Association of Management Engineering (AiIG), “Misure di sostegno ai soci giovani AiIG” 2020, for the project “Gender Equality Through Data Intelligence (GEDI)”. F.C.: EU project ASSETs+ Project (Alliance for Strategic Skills addressing Emerging Technologies in Defence) EAC/A03/2018 - Erasmus+ programme, Sector Skills Alliances, Lot 3: Sector Skills Alliance for implementing a new strategic approach (Blueprint) to sectoral cooperation on skills G.A. NUMBER: 612678-EPP-1-2019-1-IT-EPPKA2-SSA-B.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The persistent gender inequalities that currently exist across the developed and developing world are receiving increasing attention from economists, policymakers, and the general public [e.g., 1 – 3 ]. Economic studies have indicated that women’s education and entry into the workforce contributes to social and economic well-being [e.g., 4 , 5 ], while their exclusion from the labor market and from managerial positions has an impact on overall labor productivity and income per capita [ 6 , 7 ]. The United Nations selected gender equality, with an emphasis on female education, as part of the Millennium Development Goals [ 8 ], and gender equality at-large as one of the 17 Sustainable Development Goals (SDGs) to be achieved by 2030 [ 9 ]. These latter objectives involve not only developing nations, but rather all countries, to achieve economic, social and environmental well-being.

As is the case with many SDGs, gender equality is still far from being achieved and persists across education, access to opportunities, or presence in decision-making positions [ 7 , 10 , 11 ]. As we enter the last decade for the SDGs’ implementation, and while we are battling a global health pandemic, effective and efficient action becomes paramount to reach this ambitious goal.

Scholars have dedicated a massive effort towards understanding gender equality, its determinants, its consequences for women and society, and the appropriate actions and policies to advance women’s equality. Many topics have been covered, ranging from women’s education and human capital [ 12 , 13 ] and their role in society [e.g., 14 , 15 ], to their appointment in firms’ top ranked positions [e.g., 16 , 17 ] and performance implications [e.g., 18 , 19 ]. Despite some attempts, extant literature reviews provide a narrow view on these issues, restricted to specific topics–e.g., female students’ presence in STEM fields [ 20 ], educational gender inequality [ 5 ], the gender pay gap [ 21 ], the glass ceiling effect [ 22 ], leadership [ 23 ], entrepreneurship [ 24 ], women’s presence on the board of directors [ 25 , 26 ], diversity management [ 27 ], gender stereotypes in advertisement [ 28 ], or specific professions [ 29 ]. A comprehensive view on gender-related research, taking stock of key findings and under-studied topics is thus lacking.

Extant literature has also highlighted that gender issues, and their economic and social ramifications, are complex topics that involve a large number of possible antecedents and outcomes [ 7 ]. Indeed, gender equality actions are most effective when implemented in unison with other SDGs (e.g., with SDG 8, see [ 30 ]) in a synergetic perspective [ 10 ]. Many bodies of literature (e.g., business, economics, development studies, sociology and psychology) approach the problem of achieving gender equality from different perspectives–often addressing specific and narrow aspects. This sometimes leads to a lack of clarity about how different issues, circumstances, and solutions may be related in precipitating or mitigating gender inequality or its effects. As the number of papers grows at an increasing pace, this issue is exacerbated and there is a need to step back and survey the body of gender equality literature as a whole. There is also a need to examine synergies between different topics and approaches, as well as gaps in our understanding of how different problems and solutions work together. Considering the important topic of women’s economic and social empowerment, this paper aims to fill this gap by answering the following research question: what are the most relevant findings in the literature on gender equality and how do they relate to each other ?

To do so, we conduct a scoping review [ 31 ], providing a synthesis of 15,465 articles dealing with gender equity related issues published in the last twenty-two years, covering both the periods of the MDGs and the SDGs (i.e., 2000 to mid 2021) in all the journals indexed in the Academic Journal Guide’s 2018 ranking of business and economics journals. Given the huge amount of research conducted on the topic, we adopt an innovative methodology, which relies on social network analysis and text mining. These techniques are increasingly adopted when surveying large bodies of text. Recently, they were applied to perform analysis of online gender communication differences [ 32 ] and gender behaviors in online technology communities [ 33 ], to identify and classify sexual harassment instances in academia [ 34 ], and to evaluate the gender inclusivity of disaster management policies [ 35 ].

Applied to the title, abstracts and keywords of the articles in our sample, this methodology allows us to identify a set of 27 recurrent topics within which we automatically classify the papers. Introducing additional novelty, by means of the Semantic Brand Score (SBS) indicator [ 36 ] and the SBS BI app [ 37 ], we assess the importance of each topic in the overall gender equality discourse and its relationships with the other topics, as well as trends over time, with a more accurate description than that offered by traditional literature reviews relying solely on the number of papers presented in each topic.

This methodology, applied to gender equality research spanning the past twenty-two years, enables two key contributions. First, we extract the main message that each document is conveying and how this is connected to other themes in literature, providing a rich picture of the topics that are at the center of the discourse, as well as of the emerging topics. Second, by examining the semantic relationship between topics and how tightly their discourses are linked, we can identify the key relationships and connections between different topics. This semi-automatic methodology is also highly reproducible with minimum effort.

This literature review is organized as follows. In the next section, we present how we selected relevant papers and how we analyzed them through text mining and social network analysis. We then illustrate the importance of 27 selected research topics, measured by means of the SBS indicator. In the results section, we present an overview of the literature based on the SBS results–followed by an in-depth narrative analysis of the top 10 topics (i.e., those with the highest SBS) and their connections. Subsequently, we highlight a series of under-studied connections between the topics where there is potential for future research. Through this analysis, we build a map of the main gender-research trends in the last twenty-two years–presenting the most popular themes. We conclude by highlighting key areas on which research should focused in the future.

Our aim is to map a broad topic, gender equality research, that has been approached through a host of different angles and through different disciplines. Scoping reviews are the most appropriate as they provide the freedom to map different themes and identify literature gaps, thereby guiding the recommendation of new research agendas [ 38 ].

Several practical approaches have been proposed to identify and assess the underlying topics of a specific field using big data [ 39 – 41 ], but many of them fail without proper paper retrieval and text preprocessing. This is specifically true for a research field such as the gender-related one, which comprises the work of scholars from different backgrounds. In this section, we illustrate a novel approach for the analysis of scientific (gender-related) papers that relies on methods and tools of social network analysis and text mining. Our procedure has four main steps: (1) data collection, (2) text preprocessing, (3) keywords extraction and classification, and (4) evaluation of semantic importance and image.

Data collection

In this study, we analyze 22 years of literature on gender-related research. Following established practice for scoping reviews [ 42 ], our data collection consisted of two main steps, which we summarize here below.

Firstly, we retrieved from the Scopus database all the articles written in English that contained the term “gender” in their title, abstract or keywords and were published in a journal listed in the Academic Journal Guide 2018 ranking of the Chartered Association of Business Schools (CABS) ( https://charteredabs.org/wp-content/uploads/2018/03/AJG2018-Methodology.pdf ), considering the time period from Jan 2000 to May 2021. We used this information considering that abstracts, titles and keywords represent the most informative part of a paper, while using the full-text would increase the signal-to-noise ratio for information extraction. Indeed, these textual elements already demonstrated to be reliable sources of information for the task of domain lexicon extraction [ 43 , 44 ]. We chose Scopus as source of literature because of its popularity, its update rate, and because it offers an API to ease the querying process. Indeed, while it does not allow to retrieve the full text of scientific articles, the Scopus API offers access to titles, abstracts, citation information and metadata for all its indexed scholarly journals. Moreover, we decided to focus on the journals listed in the AJG 2018 ranking because we were interested in reviewing business and economics related gender studies only. The AJG is indeed widely used by universities and business schools as a reference point for journal and research rigor and quality. This first step, executed in June 2021, returned more than 55,000 papers.

In the second step–because a look at the papers showed very sparse results, many of which were not in line with the topic of this literature review (e.g., papers dealing with health care or medical issues, where the word gender indicates the gender of the patients)–we applied further inclusion criteria to make the sample more focused on the topic of this literature review (i.e., women’s gender equality issues). Specifically, we only retained those papers mentioning, in their title and/or abstract, both gender-related keywords (e.g., daughter, female, mother) and keywords referring to bias and equality issues (e.g., equality, bias, diversity, inclusion). After text pre-processing (see next section), keywords were first identified from a frequency-weighted list of words found in the titles, abstracts and keywords in the initial list of papers, extracted through text mining (following the same approach as [ 43 ]). They were selected by two of the co-authors independently, following respectively a bottom up and a top-down approach. The bottom-up approach consisted of examining the words found in the frequency-weighted list and classifying those related to gender and equality. The top-down approach consisted in searching in the word list for notable gender and equality-related words. Table 1 reports the sets of keywords we considered, together with some examples of words that were used to search for their presence in the dataset (a full list is provided in the S1 Text ). At end of this second step, we obtained a final sample of 15,465 relevant papers.

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https://doi.org/10.1371/journal.pone.0256474.t001

Text processing and keyword extraction

Text preprocessing aims at structuring text into a form that can be analyzed by statistical models. In the present section, we describe the preprocessing steps we applied to paper titles and abstracts, which, as explained below, partially follow a standard text preprocessing pipeline [ 45 ]. These activities have been performed using the R package udpipe [ 46 ].

The first step is n-gram extraction (i.e., a sequence of words from a given text sample) to identify which n-grams are important in the analysis, since domain-specific lexicons are often composed by bi-grams and tri-grams [ 47 ]. Multi-word extraction is usually implemented with statistics and linguistic rules, thus using the statistical properties of n-grams or machine learning approaches [ 48 ]. However, for the present paper, we used Scopus metadata in order to have a more effective and efficient n-grams collection approach [ 49 ]. We used the keywords of each paper in order to tag n-grams with their associated keywords automatically. Using this greedy approach, it was possible to collect all the keywords listed by the authors of the papers. From this list, we extracted only keywords composed by two, three and four words, we removed all the acronyms and rare keywords (i.e., appearing in less than 1% of papers), and we clustered keywords showing a high orthographic similarity–measured using a Levenshtein distance [ 50 ] lower than 2, considering these groups of keywords as representing same concepts, but expressed with different spelling. After tagging the n-grams in the abstracts, we followed a common data preparation pipeline that consists of the following steps: (i) tokenization, that splits the text into tokens (i.e., single words and previously tagged multi-words); (ii) removal of stop-words (i.e. those words that add little meaning to the text, usually being very common and short functional words–such as “and”, “or”, or “of”); (iii) parts-of-speech tagging, that is providing information concerning the morphological role of a word and its morphosyntactic context (e.g., if the token is a determiner, the next token is a noun or an adjective with very high confidence, [ 51 ]); and (iv) lemmatization, which consists in substituting each word with its dictionary form (or lemma). The output of the latter step allows grouping together the inflected forms of a word. For example, the verbs “am”, “are”, and “is” have the shared lemma “be”, or the nouns “cat” and “cats” both share the lemma “cat”. We preferred lemmatization over stemming [ 52 ] in order to obtain more interpretable results.

In addition, we identified a further set of keywords (with respect to those listed in the “keywords” field) by applying a series of automatic words unification and removal steps, as suggested in past research [ 53 , 54 ]. We removed: sparse terms (i.e., occurring in less than 0.1% of all documents), common terms (i.e., occurring in more than 10% of all documents) and retained only nouns and adjectives. It is relevant to notice that no document was lost due to these steps. We then used the TF-IDF function [ 55 ] to produce a new list of keywords. We additionally tested other approaches for the identification and clustering of keywords–such as TextRank [ 56 ] or Latent Dirichlet Allocation [ 57 ]–without obtaining more informative results.

Classification of research topics

To guide the literature analysis, two experts met regularly to examine the sample of collected papers and to identify the main topics and trends in gender research. Initially, they conducted brainstorming sessions on the topics they expected to find, due to their knowledge of the literature. This led to an initial list of topics. Subsequently, the experts worked independently, also supported by the keywords in paper titles and abstracts extracted with the procedure described above.

Considering all this information, each expert identified and clustered relevant keywords into topics. At the end of the process, the two assignments were compared and exhibited a 92% agreement. Another meeting was held to discuss discordant cases and reach a consensus. This resulted in a list of 27 topics, briefly introduced in Table 2 and subsequently detailed in the following sections.

https://doi.org/10.1371/journal.pone.0256474.t002

Evaluation of semantic importance

Working on the lemmatized corpus of the 15,465 papers included in our sample, we proceeded with the evaluation of semantic importance trends for each topic and with the analysis of their connections and prevalent textual associations. To this aim, we used the Semantic Brand Score indicator [ 36 ], calculated through the SBS BI webapp [ 37 ] that also produced a brand image report for each topic. For this study we relied on the computing resources of the ENEA/CRESCO infrastructure [ 58 ].

The Semantic Brand Score (SBS) is a measure of semantic importance that combines methods of social network analysis and text mining. It is usually applied for the analysis of (big) textual data to evaluate the importance of one or more brands, names, words, or sets of keywords [ 36 ]. Indeed, the concept of “brand” is intended in a flexible way and goes beyond products or commercial brands. In this study, we evaluate the SBS time-trends of the keywords defining the research topics discussed in the previous section. Semantic importance comprises the three dimensions of topic prevalence, diversity and connectivity. Prevalence measures how frequently a research topic is used in the discourse. The more a topic is mentioned by scientific articles, the more the research community will be aware of it, with possible increase of future studies; this construct is partly related to that of brand awareness [ 59 ]. This effect is even stronger, considering that we are analyzing the title, abstract and keywords of the papers, i.e. the parts that have the highest visibility. A very important characteristic of the SBS is that it considers the relationships among words in a text. Topic importance is not just a matter of how frequently a topic is mentioned, but also of the associations a topic has in the text. Specifically, texts are transformed into networks of co-occurring words, and relationships are studied through social network analysis [ 60 ]. This step is necessary to calculate the other two dimensions of our semantic importance indicator. Accordingly, a social network of words is generated for each time period considered in the analysis–i.e., a graph made of n nodes (words) and E edges weighted by co-occurrence frequency, with W being the set of edge weights. The keywords representing each topic were clustered into single nodes.

The construct of diversity relates to that of brand image [ 59 ], in the sense that it considers the richness and distinctiveness of textual (topic) associations. Considering the above-mentioned networks, we calculated diversity using the distinctiveness centrality metric–as in the formula presented by Fronzetti Colladon and Naldi [ 61 ].

Lastly, connectivity was measured as the weighted betweenness centrality [ 62 , 63 ] of each research topic node. We used the formula presented by Wasserman and Faust [ 60 ]. The dimension of connectivity represents the “brokerage power” of each research topic–i.e., how much it can serve as a bridge to connect other terms (and ultimately topics) in the discourse [ 36 ].

The SBS is the final composite indicator obtained by summing the standardized scores of prevalence, diversity and connectivity. Standardization was carried out considering all the words in the corpus, for each specific timeframe.

This methodology, applied to a large and heterogeneous body of text, enables to automatically identify two important sets of information that add value to the literature review. Firstly, the relevance of each topic in literature is measured through a composite indicator of semantic importance, rather than simply looking at word frequencies. This provides a much richer picture of the topics that are at the center of the discourse, as well as of the topics that are emerging in the literature. Secondly, it enables to examine the extent of the semantic relationship between topics, looking at how tightly their discourses are linked. In a field such as gender equality, where many topics are closely linked to each other and present overlaps in issues and solutions, this methodology offers a novel perspective with respect to traditional literature reviews. In addition, it ensures reproducibility over time and the possibility to semi-automatically update the analysis, as new papers become available.

Overview of main topics

In terms of descriptive textual statistics, our corpus is made of 15,465 text documents, consisting of a total of 2,685,893 lemmatized tokens (words) and 32,279 types. As a result, the type-token ratio is 1.2%. The number of hapaxes is 12,141, with a hapax-token ratio of 37.61%.

Fig 1 shows the list of 27 topics by decreasing SBS. The most researched topic is compensation , exceeding all others in prevalence, diversity, and connectivity. This means it is not only mentioned more often than other topics, but it is also connected to a greater number of other topics and is central to the discourse on gender equality. The next four topics are, in order of SBS, role , education , decision-making , and career progression . These topics, except for education , all concern women in the workforce. Between these first five topics and the following ones there is a clear drop in SBS scores. In particular, the topics that follow have a lower connectivity than the first five. They are hiring , performance , behavior , organization , and human capital . Again, except for behavior and human capital , the other three topics are purely related to women in the workforce. After another drop-off, the following topics deal prevalently with women in society. This trend highlights that research on gender in business journals has so far mainly paid attention to the conditions that women experience in business contexts, while also devoting some attention to women in society.

https://doi.org/10.1371/journal.pone.0256474.g001

Fig 2 shows the SBS time series of the top 10 topics. While there has been a general increase in the number of Scopus-indexed publications in the last decade, we notice that some SBS trends remain steady, or even decrease. In particular, we observe that the main topic of the last twenty-two years, compensation , is losing momentum. Since 2016, it has been surpassed by decision-making , education and role , which may indicate that literature is increasingly attempting to identify root causes of compensation inequalities. Moreover, in the last two years, the topics of hiring , performance , and organization are experiencing the largest importance increase.

https://doi.org/10.1371/journal.pone.0256474.g002

Fig 3 shows the SBS time trends of the remaining 17 topics (i.e., those not in the top 10). As we can see from the graph, there are some that maintain a steady trend–such as reputation , management , networks and governance , which also seem to have little importance. More relevant topics with average stationary trends (except for the last two years) are culture , family , and parenting . The feminine topic is among the most important here, and one of those that exhibit the larger variations over time (similarly to leadership ). On the other hand, the are some topics that, even if not among the most important, show increasing SBS trends; therefore, they could be considered as emerging topics and could become popular in the near future. These are entrepreneurship , leadership , board of directors , and sustainability . These emerging topics are also interesting to anticipate future trends in gender equality research that are conducive to overall equality in society.

https://doi.org/10.1371/journal.pone.0256474.g003

In addition to the SBS score of the different topics, the network of terms they are associated to enables to gauge the extent to which their images (textual associations) overlap or differ ( Fig 4 ).

https://doi.org/10.1371/journal.pone.0256474.g004

There is a central cluster of topics with high similarity, which are all connected with women in the workforce. The cluster includes topics such as organization , decision-making , performance , hiring , human capital , education and compensation . In addition, the topic of well-being is found within this cluster, suggesting that women’s equality in the workforce is associated to well-being considerations. The emerging topics of entrepreneurship and leadership are also closely connected with each other, possibly implying that leadership is a much-researched quality in female entrepreneurship. Topics that are relatively more distant include personality , politics , feminine , empowerment , management , board of directors , reputation , governance , parenting , masculine and network .

The following sections describe the top 10 topics and their main associations in literature (see Table 3 ), while providing a brief overview of the emerging topics.

https://doi.org/10.1371/journal.pone.0256474.t003

Compensation.

The topic of compensation is related to the topics of role , hiring , education and career progression , however, also sees a very high association with the words gap and inequality . Indeed, a well-known debate in degrowth economics centers around whether and how to adequately compensate women for their childbearing, childrearing, caregiver and household work [e.g., 30 ].

Even in paid work, women continue being offered lower compensations than their male counterparts who have the same job or cover the same role [ 64 – 67 ]. This severe inequality has been widely studied by scholars over the last twenty-two years. Dealing with this topic, some specific roles have been addressed. Specifically, research highlighted differences in compensation between female and male CEOs [e.g., 68 ], top executives [e.g., 69 ], and boards’ directors [e.g., 70 ]. Scholars investigated the determinants of these gaps, such as the gender composition of the board [e.g., 71 – 73 ] or women’s individual characteristics [e.g., 71 , 74 ].

Among these individual characteristics, education plays a relevant role [ 75 ]. Education is indeed presented as the solution for women, not only to achieve top executive roles, but also to reduce wage inequality [e.g., 76 , 77 ]. Past research has highlighted education influences on gender wage gaps, specifically referring to gender differences in skills [e.g., 78 ], college majors [e.g., 79 ], and college selectivity [e.g., 80 ].

Finally, the wage gap issue is strictly interrelated with hiring –e.g., looking at whether being a mother affects hiring and compensation [e.g., 65 , 81 ] or relating compensation to unemployment [e.g., 82 ]–and career progression –for instance looking at meritocracy [ 83 , 84 ] or the characteristics of the boss for whom women work [e.g., 85 ].

The roles covered by women have been deeply investigated. Scholars have focused on the role of women in their families and the society as a whole [e.g., 14 , 15 ], and, more widely, in business contexts [e.g., 18 , 81 ]. Indeed, despite still lagging behind their male counterparts [e.g., 86 , 87 ], in the last decade there has been an increase in top ranked positions achieved by women [e.g., 88 , 89 ]. Following this phenomenon, scholars have posed greater attention towards the presence of women in the board of directors [e.g., 16 , 18 , 90 , 91 ], given the increasing pressure to appoint female directors that firms, especially listed ones, have experienced. Other scholars have focused on the presence of women covering the role of CEO [e.g., 17 , 92 ] or being part of the top management team [e.g., 93 ]. Irrespectively of the level of analysis, all these studies tried to uncover the antecedents of women’s presence among top managers [e.g., 92 , 94 ] and the consequences of having a them involved in the firm’s decision-making –e.g., on performance [e.g., 19 , 95 , 96 ], risk [e.g., 97 , 98 ], and corporate social responsibility [e.g., 99 , 100 ].

Besides studying the difficulties and discriminations faced by women in getting a job [ 81 , 101 ], and, more specifically in the hiring , appointment, or career progression to these apical roles [e.g., 70 , 83 ], the majority of research of women’s roles dealt with compensation issues. Specifically, scholars highlight the pay-gap that still exists between women and men, both in general [e.g., 64 , 65 ], as well as referring to boards’ directors [e.g., 70 , 102 ], CEOs and executives [e.g., 69 , 103 , 104 ].

Finally, other scholars focused on the behavior of women when dealing with business. In this sense, particular attention has been paid to leadership and entrepreneurial behaviors. The former quite overlaps with dealing with the roles mentioned above, but also includes aspects such as leaders being stereotyped as masculine [e.g., 105 ], the need for greater exposure to female leaders to reduce biases [e.g., 106 ], or female leaders acting as queen bees [e.g., 107 ]. Regarding entrepreneurship , scholars mainly investigated women’s entrepreneurial entry [e.g., 108 , 109 ], differences between female and male entrepreneurs in the evaluations and funding received from investors [e.g., 110 , 111 ], and their performance gap [e.g., 112 , 113 ].

Education has long been recognized as key to social advancement and economic stability [ 114 ], for job progression and also a barrier to gender equality, especially in STEM-related fields. Research on education and gender equality is mostly linked with the topics of compensation , human capital , career progression , hiring , parenting and decision-making .

Education contributes to a higher human capital [ 115 ] and constitutes an investment on the part of women towards their future. In this context, literature points to the gender gap in educational attainment, and the consequences for women from a social, economic, personal and professional standpoint. Women are found to have less access to formal education and information, especially in emerging countries, which in turn may cause them to lose social and economic opportunities [e.g., 12 , 116 – 119 ]. Education in local and rural communities is also paramount to communicate the benefits of female empowerment , contributing to overall societal well-being [e.g., 120 ].

Once women access education, the image they have of the world and their place in society (i.e., habitus) affects their education performance [ 13 ] and is passed on to their children. These situations reinforce gender stereotypes, which become self-fulfilling prophecies that may negatively affect female students’ performance by lowering their confidence and heightening their anxiety [ 121 , 122 ]. Besides formal education, also the information that women are exposed to on a daily basis contributes to their human capital . Digital inequalities, for instance, stems from men spending more time online and acquiring higher digital skills than women [ 123 ].

Education is also a factor that should boost employability of candidates and thus hiring , career progression and compensation , however the relationship between these factors is not straightforward [ 115 ]. First, educational choices ( decision-making ) are influenced by variables such as self-efficacy and the presence of barriers, irrespectively of the career opportunities they offer, especially in STEM [ 124 ]. This brings additional difficulties to women’s enrollment and persistence in scientific and technical fields of study due to stereotypes and biases [ 125 , 126 ]. Moreover, access to education does not automatically translate into job opportunities for women and minority groups [ 127 , 128 ] or into female access to managerial positions [ 129 ].

Finally, parenting is reported as an antecedent of education [e.g., 130 ], with much of the literature focusing on the role of parents’ education on the opportunities afforded to children to enroll in education [ 131 – 134 ] and the role of parenting in their offspring’s perception of study fields and attitudes towards learning [ 135 – 138 ]. Parental education is also a predictor of the other related topics, namely human capital and compensation [ 139 ].

Decision-making.

This literature mainly points to the fact that women are thought to make decisions differently than men. Women have indeed different priorities, such as they care more about people’s well-being, working with people or helping others, rather than maximizing their personal (or their firm’s) gain [ 140 ]. In other words, women typically present more communal than agentic behaviors, which are instead more frequent among men [ 141 ]. These different attitude, behavior and preferences in turn affect the decisions they make [e.g., 142 ] and the decision-making of the firm in which they work [e.g., 143 ].

At the individual level, gender affects, for instance, career aspirations [e.g., 144 ] and choices [e.g., 142 , 145 ], or the decision of creating a venture [e.g., 108 , 109 , 146 ]. Moreover, in everyday life, women and men make different decisions regarding partners [e.g., 147 ], childcare [e.g., 148 ], education [e.g., 149 ], attention to the environment [e.g., 150 ] and politics [e.g., 151 ].

At the firm level, scholars highlighted, for example, how the presence of women in the board affects corporate decisions [e.g., 152 , 153 ], that female CEOs are more conservative in accounting decisions [e.g., 154 ], or that female CFOs tend to make more conservative decisions regarding the firm’s financial reporting [e.g., 155 ]. Nevertheless, firm level research also investigated decisions that, influenced by gender bias, affect women, such as those pertaining hiring [e.g., 156 , 157 ], compensation [e.g., 73 , 158 ], or the empowerment of women once appointed [ 159 ].

Career progression.

Once women have entered the workforce, the key aspect to achieve gender equality becomes career progression , including efforts toward overcoming the glass ceiling. Indeed, according to the SBS analysis, career progression is highly related to words such as work, social issues and equality. The topic with which it has the highest semantic overlap is role , followed by decision-making , hiring , education , compensation , leadership , human capital , and family .

Career progression implies an advancement in the hierarchical ladder of the firm, assigning managerial roles to women. Coherently, much of the literature has focused on identifying rationales for a greater female participation in the top management team and board of directors [e.g., 95 ] as well as the best criteria to ensure that the decision-makers promote the most valuable employees irrespectively of their individual characteristics, such as gender [e.g., 84 ]. The link between career progression , role and compensation is often provided in practice by performance appraisal exercises, frequently rooted in a culture of meritocracy that guides bonuses, salary increases and promotions. However, performance appraisals can actually mask gender-biased decisions where women are held to higher standards than their male colleagues [e.g., 83 , 84 , 95 , 160 , 161 ]. Women often have less opportunities to gain leadership experience and are less visible than their male colleagues, which constitute barriers to career advancement [e.g., 162 ]. Therefore, transparency and accountability, together with procedures that discourage discretionary choices, are paramount to achieve a fair career progression [e.g., 84 ], together with the relaxation of strict job boundaries in favor of cross-functional and self-directed tasks [e.g., 163 ].

In addition, a series of stereotypes about the type of leadership characteristics that are required for top management positions, which fit better with typical male and agentic attributes, are another key barrier to career advancement for women [e.g., 92 , 160 ].

Hiring is the entrance gateway for women into the workforce. Therefore, it is related to other workforce topics such as compensation , role , career progression , decision-making , human capital , performance , organization and education .

A first stream of literature focuses on the process leading up to candidates’ job applications, demonstrating that bias exists before positions are even opened, and it is perpetuated both by men and women through networking and gatekeeping practices [e.g., 164 , 165 ].

The hiring process itself is also subject to biases [ 166 ], for example gender-congruity bias that leads to men being preferred candidates in male-dominated sectors [e.g., 167 ], women being hired in positions with higher risk of failure [e.g., 168 ] and limited transparency and accountability afforded by written processes and procedures [e.g., 164 ] that all contribute to ascriptive inequality. In addition, providing incentives for evaluators to hire women may actually work to this end; however, this is not the case when supporting female candidates endangers higher-ranking male ones [ 169 ].

Another interesting perspective, instead, looks at top management teams’ composition and the effects on hiring practices, indicating that firms with more women in top management are less likely to lay off staff [e.g., 152 ].

Performance.

Several scholars posed their attention towards women’s performance, its consequences [e.g., 170 , 171 ] and the implications of having women in decision-making positions [e.g., 18 , 19 ].

At the individual level, research focused on differences in educational and academic performance between women and men, especially referring to the gender gap in STEM fields [e.g., 171 ]. The presence of stereotype threats–that is the expectation that the members of a social group (e.g., women) “must deal with the possibility of being judged or treated stereotypically, or of doing something that would confirm the stereotype” [ 172 ]–affects women’s interested in STEM [e.g., 173 ], as well as their cognitive ability tests, penalizing them [e.g., 174 ]. A stronger gender identification enhances this gap [e.g., 175 ], whereas mentoring and role models can be used as solutions to this problem [e.g., 121 ]. Despite the negative effect of stereotype threats on girls’ performance [ 176 ], female and male students perform equally in mathematics and related subjects [e.g., 177 ]. Moreover, while individuals’ performance at school and university generally affects their achievements and the field in which they end up working, evidence reveals that performance in math or other scientific subjects does not explain why fewer women enter STEM working fields; rather this gap depends on other aspects, such as culture, past working experiences, or self-efficacy [e.g., 170 ]. Finally, scholars have highlighted the penalization that women face for their positive performance, for instance when they succeed in traditionally male areas [e.g., 178 ]. This penalization is explained by the violation of gender-stereotypic prescriptions [e.g., 179 , 180 ], that is having women well performing in agentic areas, which are typical associated to men. Performance penalization can thus be overcome by clearly conveying communal characteristics and behaviors [ 178 ].

Evidence has been provided on how the involvement of women in boards of directors and decision-making positions affects firms’ performance. Nevertheless, results are mixed, with some studies showing positive effects on financial [ 19 , 181 , 182 ] and corporate social performance [ 99 , 182 , 183 ]. Other studies maintain a negative association [e.g., 18 ], and other again mixed [e.g., 184 ] or non-significant association [e.g., 185 ]. Also with respect to the presence of a female CEO, mixed results emerged so far, with some researches demonstrating a positive effect on firm’s performance [e.g., 96 , 186 ], while other obtaining only a limited evidence of this relationship [e.g., 103 ] or a negative one [e.g., 187 ].

Finally, some studies have investigated whether and how women’s performance affects their hiring [e.g., 101 ] and career progression [e.g., 83 , 160 ]. For instance, academic performance leads to different returns in hiring for women and men. Specifically, high-achieving men are called back significantly more often than high-achieving women, which are penalized when they have a major in mathematics; this result depends on employers’ gendered standards for applicants [e.g., 101 ]. Once appointed, performance ratings are more strongly related to promotions for women than men, and promoted women typically show higher past performance ratings than those of promoted men. This suggesting that women are subject to stricter standards for promotion [e.g., 160 ].

Behavioral aspects related to gender follow two main streams of literature. The first examines female personality and behavior in the workplace, and their alignment with cultural expectations or stereotypes [e.g., 188 ] as well as their impacts on equality. There is a common bias that depicts women as less agentic than males. Certain characteristics, such as those more congruent with male behaviors–e.g., self-promotion [e.g., 189 ], negotiation skills [e.g., 190 ] and general agentic behavior [e.g., 191 ]–, are less accepted in women. However, characteristics such as individualism in women have been found to promote greater gender equality in society [ 192 ]. In addition, behaviors such as display of emotions [e.g., 193 ], which are stereotypically female, work against women’s acceptance in the workplace, requiring women to carefully moderate their behavior to avoid exclusion. A counter-intuitive result is that women and minorities, which are more marginalized in the workplace, tend to be better problem-solvers in innovation competitions due to their different knowledge bases [ 194 ].

The other side of the coin is examined in a parallel literature stream on behavior towards women in the workplace. As a result of biases, prejudices and stereotypes, women may experience adverse behavior from their colleagues, such as incivility and harassment, which undermine their well-being [e.g., 195 , 196 ]. Biases that go beyond gender, such as for overweight people, are also more strongly applied to women [ 197 ].

Organization.

The role of women and gender bias in organizations has been studied from different perspectives, which mirror those presented in detail in the following sections. Specifically, most research highlighted the stereotypical view of leaders [e.g., 105 ] and the roles played by women within firms, for instance referring to presence in the board of directors [e.g., 18 , 90 , 91 ], appointment as CEOs [e.g., 16 ], or top executives [e.g., 93 ].

Scholars have investigated antecedents and consequences of the presence of women in these apical roles. On the one side they looked at hiring and career progression [e.g., 83 , 92 , 160 , 168 , 198 ], finding women typically disadvantaged with respect to their male counterparts. On the other side, they studied women’s leadership styles and influence on the firm’s decision-making [e.g., 152 , 154 , 155 , 199 ], with implications for performance [e.g., 18 , 19 , 96 ].

Human capital.

Human capital is a transverse topic that touches upon many different aspects of female gender equality. As such, it has the most associations with other topics, starting with education as mentioned above, with career-related topics such as role , decision-making , hiring , career progression , performance , compensation , leadership and organization . Another topic with which there is a close connection is behavior . In general, human capital is approached both from the education standpoint but also from the perspective of social capital.

The behavioral aspect in human capital comprises research related to gender differences for example in cultural and religious beliefs that influence women’s attitudes and perceptions towards STEM subjects [ 142 , 200 – 202 ], towards employment [ 203 ] or towards environmental issues [ 150 , 204 ]. These cultural differences also emerge in the context of globalization which may accelerate gender equality in the workforce [ 205 , 206 ]. Gender differences also appear in behaviors such as motivation [ 207 ], and in negotiation [ 190 ], and have repercussions on women’s decision-making related to their careers. The so-called gender equality paradox sees women in countries with lower gender equality more likely to pursue studies and careers in STEM fields, whereas the gap in STEM enrollment widens as countries achieve greater equality in society [ 171 ].

Career progression is modeled by literature as a choice-process where personal preferences, culture and decision-making affect the chosen path and the outcomes. Some literature highlights how women tend to self-select into different professions than men, often due to stereotypes rather than actual ability to perform in these professions [ 142 , 144 ]. These stereotypes also affect the perceptions of female performance or the amount of human capital required to equal male performance [ 110 , 193 , 208 ], particularly for mothers [ 81 ]. It is therefore often assumed that women are better suited to less visible and less leadership -oriented roles [ 209 ]. Women also express differing preferences towards work-family balance, which affect whether and how they pursue human capital gains [ 210 ], and ultimately their career progression and salary .

On the other hand, men are often unaware of gendered processes and behaviors that they carry forward in their interactions and decision-making [ 211 , 212 ]. Therefore, initiatives aimed at increasing managers’ human capital –by raising awareness of gender disparities in their organizations and engaging them in diversity promotion–are essential steps to counter gender bias and segregation [ 213 ].

Emerging topics: Leadership and entrepreneurship

Among the emerging topics, the most pervasive one is women reaching leadership positions in the workforce and in society. This is still a rare occurrence for two main types of factors, on the one hand, bias and discrimination make it harder for women to access leadership positions [e.g., 214 – 216 ], on the other hand, the competitive nature and high pressure associated with leadership positions, coupled with the lack of women currently represented, reduce women’s desire to achieve them [e.g., 209 , 217 ]. Women are more effective leaders when they have access to education, resources and a diverse environment with representation [e.g., 218 , 219 ].

One sector where there is potential for women to carve out a leadership role is entrepreneurship . Although at the start of the millennium the discourse on entrepreneurship was found to be “discriminatory, gender-biased, ethnocentrically determined and ideologically controlled” [ 220 ], an increasing body of literature is studying how to stimulate female entrepreneurship as an alternative pathway to wealth, leadership and empowerment [e.g., 221 ]. Many barriers exist for women to access entrepreneurship, including the institutional and legal environment, social and cultural factors, access to knowledge and resources, and individual behavior [e.g., 222 , 223 ]. Education has been found to raise women’s entrepreneurial intentions [e.g., 224 ], although this effect is smaller than for men [e.g., 109 ]. In addition, increasing self-efficacy and risk-taking behavior constitute important success factors [e.g., 225 ].

Finally, the topic of sustainability is worth mentioning, as it is the primary objective of the SDGs and is closely associated with societal well-being. As society grapples with the effects of climate change and increasing depletion of natural resources, a narrative has emerged on women and their greater link to the environment [ 226 ]. Studies in developed countries have found some support for women leaders’ attention to sustainability issues in firms [e.g., 227 – 229 ], and smaller resource consumption by women [ 230 ]. At the same time, women will likely be more affected by the consequences of climate change [e.g., 230 ] but often lack the decision-making power to influence local decision-making on resource management and environmental policies [e.g., 231 ].

Research gaps and conclusions

Research on gender equality has advanced rapidly in the past decades, with a steady increase in publications, both in mainstream topics related to women in education and the workforce, and in emerging topics. Through a novel approach combining methods of text mining and social network analysis, we examined a comprehensive body of literature comprising 15,465 papers published between 2000 and mid 2021 on topics related to gender equality. We identified a set of 27 topics addressed by the literature and examined their connections.

At the highest level of abstraction, it is worth noting that papers abound on the identification of issues related to gender inequalities and imbalances in the workforce and in society. Literature has thoroughly examined the (unconscious) biases, barriers, stereotypes, and discriminatory behaviors that women are facing as a result of their gender. Instead, there are much fewer papers that discuss or demonstrate effective solutions to overcome gender bias [e.g., 121 , 143 , 145 , 163 , 194 , 213 , 232 ]. This is partly due to the relative ease in studying the status quo, as opposed to studying changes in the status quo. However, we observed a shift in the more recent years towards solution seeking in this domain, which we strongly encourage future researchers to focus on. In the future, we may focus on collecting and mapping pro-active contributions to gender studies, using additional Natural Language Processing techniques, able to measure the sentiment of scientific papers [ 43 ].

All of the mainstream topics identified in our literature review are closely related, and there is a wealth of insights looking at the intersection between issues such as education and career progression or human capital and role . However, emerging topics are worthy of being furtherly explored. It would be interesting to see more work on the topic of female entrepreneurship , exploring aspects such as education , personality , governance , management and leadership . For instance, how can education support female entrepreneurship? How can self-efficacy and risk-taking behaviors be taught or enhanced? What are the differences in managerial and governance styles of female entrepreneurs? Which personality traits are associated with successful entrepreneurs? Which traits are preferred by venture capitalists and funding bodies?

The emerging topic of sustainability also deserves further attention, as our society struggles with climate change and its consequences. It would be interesting to see more research on the intersection between sustainability and entrepreneurship , looking at how female entrepreneurs are tackling sustainability issues, examining both their business models and their company governance . In addition, scholars are suggested to dig deeper into the relationship between family values and behaviors.

Moreover, it would be relevant to understand how women’s networks (social capital), or the composition and structure of social networks involving both women and men, enable them to increase their remuneration and reach top corporate positions, participate in key decision-making bodies, and have a voice in communities. Furthermore, the achievement of gender equality might significantly change firm networks and ecosystems, with important implications for their performance and survival.

Similarly, research at the nexus of (corporate) governance , career progression , compensation and female empowerment could yield useful insights–for example discussing how enterprises, institutions and countries are managed and the impact for women and other minorities. Are there specific governance structures that favor diversity and inclusion?

Lastly, we foresee an emerging stream of research pertaining how the spread of the COVID-19 pandemic challenged women, especially in the workforce, by making gender biases more evident.

For our analysis, we considered a set of 15,465 articles downloaded from the Scopus database (which is the largest abstract and citation database of peer-reviewed literature). As we were interested in reviewing business and economics related gender studies, we only considered those papers published in journals listed in the Academic Journal Guide (AJG) 2018 ranking of the Chartered Association of Business Schools (CABS). All the journals listed in this ranking are also indexed by Scopus. Therefore, looking at a single database (i.e., Scopus) should not be considered a limitation of our study. However, future research could consider different databases and inclusion criteria.

With our literature review, we offer researchers a comprehensive map of major gender-related research trends over the past twenty-two years. This can serve as a lens to look to the future, contributing to the achievement of SDG5. Researchers may use our study as a starting point to identify key themes addressed in the literature. In addition, our methodological approach–based on the use of the Semantic Brand Score and its webapp–could support scholars interested in reviewing other areas of research.

Supporting information

S1 text. keywords used for paper selection..

https://doi.org/10.1371/journal.pone.0256474.s001

Acknowledgments

The computing resources and the related technical support used for this work have been provided by CRESCO/ENEAGRID High Performance Computing infrastructure and its staff. CRESCO/ENEAGRID High Performance Computing infrastructure is funded by ENEA, the Italian National Agency for New Technologies, Energy and Sustainable Economic Development and by Italian and European research programmes (see http://www.cresco.enea.it/english for information).

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Gender inequality as a barrier to economic growth: a review of the theoretical literature

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• Volume 19 , pages 581–614, ( 2021 )

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In this article, we survey the theoretical literature investigating the role of gender inequality in economic development. The vast majority of theories reviewed argue that gender inequality is a barrier to development, particularly over the long run. Among the many plausible mechanisms through which inequality between men and women affects the aggregate economy, the role of women for fertility decisions and human capital investments is particularly emphasized in the literature. Yet, we believe the body of theories could be expanded in several directions.

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1 Introduction

Theories of long-run economic development have increasingly relied on two central forces: population growth and human capital accumulation. Both forces depend on decisions made primarily within households: population growth is partially determined by households’ fertility choices (e.g., Becker & Barro 1988 ), while human capital accumulation is partially dependent on parental investments in child education and health (e.g., Lucas 1988 ).

In an earlier survey of the literature linking family decisions to economic growth, Grimm ( 2003 ) laments that “[m]ost models ignore the two-sex issue. Parents are modeled as a fictive asexual human being” (p. 154). Footnote 1 Since then, however, economists are increasingly recognizing that gender plays a fundamental role in how households reproduce and care for their children. As a result, many models of economic growth are now populated with men and women. The “fictive asexual human being” is a dying species. In this article, we survey this rich new landscape in theoretical macroeconomics, reviewing, in particular, micro-founded theories where gender inequality affects economic development.

For the purpose of this survey, gender inequality is defined as any exogenously imposed difference between male and female economic agents that, by shaping their behavior, has implications for aggregate economic growth. In practice, gender inequality is typically modeled as differences between men and women in endowments, constraints, or preferences.

Many articles review the literature on gender inequality and economic growth. Footnote 2 Typically, both the theoretical and empirical literature are discussed, but, in almost all cases, the vast empirical literature receives most of the attention. In addition, some of the surveys examine both sides of the two-way relationship between gender inequality and economic growth: gender equality as a cause of economic growth and economic growth as a cause of gender equality. As a result, most surveys end up only scratching the surface of each of these distinct strands of literature.

There is, by now, a large and insightful body of micro-founded theories exploring how gender equality affects economic growth. In our view, these theories merit a separate review. Moreover, they have not received sufficient attention in empirical work, which has largely developed independently (see also Cuberes & Teignier 2014 ). By reviewing the theoretical literature, we hope to motivate empirical researchers in finding new ways of putting these theories to test. In doing so, our work complements several existing surveys. Doepke & Tertilt ( 2016 ) review the theoretical literature that incorporates families in macroeconomic models, without focusing exclusively on models that include gender inequality, as we do. Greenwood, Guner and Vandenbroucke ( 2017 ), in turn, review the theoretical literature from the opposite direction; they study how macroeconomic models can explain changes in family outcomes. Doepke, Tertilt and Voena ( 2012 ) survey the political economy of women’s rights, but without focusing explicitly on their impact on economic development.

To be precise, the scope of this survey consists of micro-founded macroeconomic models where gender inequality (in endowments, constraints, preferences) affects economic growth—either by influencing the economy’s growth rate or shaping the transition paths between multiple income equilibria. As a result, this survey does not cover several upstream fields of partial-equilibrium micro models, where gender inequality affects several intermediate growth-related outcomes, such as labor supply, education, health. Additionally, by focusing on micro-founded macro models, we do not review studies in heterodox macroeconomics, including the feminist economics tradition using structuralist, demand-driven models. For recent overviews of this literature, see Kabeer ( 2016 ) and Seguino ( 2013 , 2020 ). Overall, we find very little dialogue between the neoclassical and feminist heterodox literatures. In this review, we will show that actually these two traditions have several points of contact and reach similar conclusions in many areas, albeit following distinct intellectual routes.

Although the incorporation of gender in macroeconomic models of economic growth is a recent development, the main gendered ingredients of those models are not new. They were developed in at least two strands of literature. First, since the 1960s, “new home economics” has applied the analytical toolbox of rational choice theory to decisions being made within the boundaries of the family (see, e.g., Becker 1960 , 1981 ). Footnote 3 A second literature strand, mostly based on empirical work at the micro level in developing countries, described clear patterns of gender-specific behavior within households that differed across regions of the developing world (see, e.g., Boserup 1970 ). Footnote 4 As we shall see, most of the (micro-founded) macroeconomic models reviewed in this article use several analytical mechanisms from "new home economics”; these mechanisms can typically rationalize several of the gender-specific regularities observed in early studies of developing countries. The growth theorist is then left to explore the aggregate implications for economic development.

The first models we present focus on gender discrimination in (or on access to) the labor market as a distortionary tax on talent. If talent is randomly distributed in the population, men and women are imperfect substitutes in aggregate production, and, as a consequence, gender inequality (as long as determined by non-market processes) will misallocate talent and lower incentives for female human capital formation. These theories do not rely on typical household functions such as reproduction and childrearing. Therefore, in these models, individuals are not organized into households. We review this literature in section 2 .

From there, we proceed to theories where the household is the unit of analysis. In sections 3 and 4 , we cover models that take the household as given and avoid marriage markets or other household formation institutions. This is a world where marriage (or cohabitation) is universal, consensual, and monogamous; families are nuclear, and spouses are matched randomly. The first articles in this tradition model the household as a unitary entity with joint preferences and interests, and with an efficient and centralized decision making process. Footnote 5 These theories posit how men and women specialize into different activities and how parents interact with their children. Section 3 reviews these theories. Over time, the literature has incorporated intra-household dynamics. Now, family members are allowed to have different preferences and interests; they bargain, either cooperatively or not, over family decisions. Now, the theorist recognizes power asymmetries between family members and analyzes how spouses bargain over decisions. Footnote 6 These articles are surveyed in section 4 .

The final set of articles we survey take into account how households are formed. These theories show how gender inequality can influence economic growth and long-run development through marriage market institutions and family formation patterns. Among other topics, this literature has studied ages at first marriage, relative supply of potential partners, monogamy and polygyny, arranged and consensual marriages, and divorce risk. Upon marriage, these models assume different bargaining processes between the spouses, or even unitary households, but they all recognize, in one way or another, that marriage, labor supply, consumption, and investment decisions are interdependent. We review these theories in section 5 .

Table 1 offers a schematic overview of the literature. To improve readability, the table only includes studies that we review in detail, with articles listed in order of appearance in the text. The table also abstracts from models’ extensions and sensitivity checks, and focuses exclusively on the causal pathways leading from gender inequality to economic growth.

The vast majority of theories reviewed argue that gender inequality is a barrier to economic development, particularly over the long run. The focus on long-run supply-side models reflects a recent effort by growth theorists to incorporate two stylized facts of economic development in the last two centuries: (i) a strong positive association between gender equality and income per capita (Fig. 1 ), and (ii) a strong association between the timing of the fertility transition and income per capita (Fig. 2 ). Footnote 7 Models that endogenize a fertility transition are able to generate a transition from a Malthusian regime of stagnation to a modern regime of sustained economic growth, thus replicating the development experience of human societies in the very long run (e.g., Galor 2005a , b ; Guinnane 2011 ). In contrast, demand-driven models in the heterodox and feminist traditions have often argued that gender wage discrimination and gendered sectoral and occupational segregation can be conducive to economic growth in semi-industrialized export-oriented economies. Footnote 8 In these settings—that fit well the experience of East and Southeast Asian economies—gender wage discrimination in female-intensive export industries reduces production costs and boosts exports, profits, and investment (Blecker & Seguino 2002 ; Seguino 2010 ).

Income level and gender equality. Income is the natural log of per capita GDP (PPP-adjusted). The Gender Development Index is the ratio of gender-specific Human Development Indexes: female HDI/male HDI. Data are for the year 2000. Sources: UNDP

Income level and timing of the fertility transition. Income is the natural log of per capita GDP (PPP-adjusted) in 2000. Years since fertility transition are the number of years between 2000 and the onset year of the fertility decline. See Reher ( 2004 ) for details. Sources: UNDP and Reher ( 2004 )

In most long-run, supply-side models reviewed here, irrespectively of the underlying source of gender differences (e.g., biology, socialization, discrimination), the opportunity cost of women’s time in foregone labor market earnings is lower than that of men. This gender gap in the value of time affects economic growth through two main mechanisms. First, when the labor market value of women’s time is relatively low, women will be in charge of childrearing and domestic work in the family. A low value of female time means that children are cheap. Fertility will be high, and economic growth will be low, both because population growth has a direct negative impact on long-run economic performance and because human capital accumulates at a slower pace (through the quantity-quality trade-off). Second, if parents expect relatively low returns to female education, due to women specializing in domestic activities, they will invest relatively less in the education of girls. In the words of Harriet Martineau, one of the first to describe this mechanism, “as women have none of the objects in life for which an enlarged education is considered requisite, the education is not given” (Martineau 1837 , p. 107). In the long run, lower human capital investments (on girls) lead to slower economic development.

Overall, gender inequality can be conceptualized as a source of inefficiency, to the extent that it results in the misallocation of productive factors, such as talent or labor, and as a source of negative externalities, when it leads to higher fertility, skewed sex ratios, or lower human capital accumulation.

We conclude, in section 6 , by examining the limitations of the current literature and pointing ways forward. Among them, we suggest deeper investigations of the role of (endogenous) technological change on gender inequality, as well as greater attention to the role and interests of men in affecting gender inequality and its impact on growth.

2 Gender discrimination and misallocation of talent

Perhaps the single most intuitive argument for why gender discrimination leads to aggregate inefficiency and hampers economic growth concerns the allocation of talent. Assume that talent is randomly distributed in the population. Then, an economy that curbs women’s access to education, market employment, or certain occupations draws talent from a smaller pool than an economy without such restrictions. Gender inequality can thus be viewed as a distortionary tax on talent. Indeed, occupational choice models with heterogeneous talent (as in Roy 1951 ) show that exogenous barriers to women’s participation in the labor market or access to certain occupations reduce aggregate productivity and per capita output (Cuberes & Teignier 2016 , 2017 ; Esteve-Volart 2009 ; Hsieh, Hurst, Jones and Klenow 2019 ).

Hsieh et al. ( 2019 ) represent the US economy with a model where individuals sort into occupations based on innate ability. Footnote 9 Gender and race identity, however, are a source of discrimination, with three forces preventing women and black men from choosing the occupations best fitting their comparative advantage. First, these groups face labor market discrimination, which is modeled as a tax on wages and can vary by occupation. Second, there is discrimination in human capital formation, with the costs of occupation-specific human capital being higher for certain groups. This cost penalty is a composite term encompassing discrimination or quality differentials in private or public inputs into children’s human capital. The third force are group-specific social norms that generate utility premia or penalties across occupations. Footnote 10

Assuming that the distribution of innate ability across race and gender is constant over time, Hsieh et al. ( 2019 ) investigate and quantify how declines in labor market discrimination, barriers to human capital formation, and changing social norms affect aggregate output and productivity in the United States, between 1960 and 2010. Over that period, their general equilibrium model suggests that around 40 percent of growth in per capita GDP and 90 percent of growth in labor force participation can be attributed to reductions in the misallocation of talent across occupations. Declining in barriers to human capital formation account for most of these effects, followed by declining labor market discrimination. Changing social norms, on the other hand, explain only a residual share of aggregate changes.

Two main mechanisms drive these results. First, falling discrimination improves efficiency through a better match between individual ability and occupation. Second, because discrimination is higher in high-skill occupations, when discrimination decreases, high-ability women and black men invest more in human capital and supply more labor to the market. Overall, better allocation of talent, rising labor supply, and faster human capital accumulation raise aggregate growth and productivity.

Other occupational choice models assuming gender inequality in access to the labor market or certain occupations reach similar conclusions. In addition to the mechanisms in Hsieh et al. ( 2019 ), barriers to women’s work in managerial or entrepreneurial occupations reduce average talent in these positions, resulting in aggregate losses in innovation, technology adoption, and productivity (Cuberes & Teignier 2016 , 2017 ; Esteve-Volart 2009 ). The argument can be readily applied to talent misallocation across sectors (Lee 2020 ). In Lee’s model, female workers face discrimination in the non-agricultural sector. As a result, talented women end up sorting into ill-suited agricultural activities. This distortion reduces aggregate productivity in agriculture. Footnote 11

To sum up, when talent is randomly distributed in the population, barriers to women’s education, employment, or occupational choice effectively reduce the pool of talent in the economy. According to these models, dismantling these gendered barriers can have an immediate positive effect on economic growth.

3 Unitary households: parents and children

In this section, we review models built upon unitary households. A unitary household maximizes a joint utility function subject to pooled household resources. Intra-household decision making is assumed away; the household is effectively a black-box. In this class of models, gender inequality stems from a variety of sources. It is rooted in differences in physical strength (Galor & Weil 1996 ; Hiller 2014 ; Kimura & Yasui 2010 ) or health (Bloom et al. 2015 ); it is embedded in social norms (Hiller 2014 ; Lagerlöf 2003 ), labor market discrimination (Cavalcanti & Tavares 2016 ), or son preference (Zhang, Zhang and Li 1999 ). In all these models, gender inequality is a barrier to long-run economic development.

Galor & Weil ( 1996 ) model an economy with three factors of production: capital, physical labor (“brawn”), and mental labor (“brain”). Men and women are equally endowed with brains, but men have more brawn. In economies starting with very low levels of capital per worker, women fully specialize in childrearing because their opportunity cost in terms of foregone market earnings is lower than men’s. Over time, the stock of capital per worker builds up due to exogenous technological progress. The degree of complementarity between capital and mental labor is higher than that between capital and physical labor; as the economy accumulates capital per worker, the returns to brain rise relative to the returns to brawn. As a result, the relative wages of women rise, increasing the opportunity cost of childrearing. This negative substitution effect dominates the positive income effect on the demand for children and fertility falls. Footnote 12 As fertility falls, capital per worker accumulates faster creating a positive feedback loop that generates a fertility transition and kick starts a process of sustained economic growth.

The model has multiple stable equilibria. An economy starting from a low level of capital per worker is caught in a Malthusian poverty trap of high fertility, low income per capita, and low relative wages for women. In contrast, an economy starting from a sufficiently high level of capital per worker will converge to a virtuous equilibrium of low fertility, high income per capita, and high relative wages for women. Through exogenous technological progress, the economy can move from the low to the high equilibrium.

Gender inequality in labor market access or returns to brain can slow down or even prevent the escape from the Malthusian equilibrium. Wage discrimination or barriers to employment would work against the rise of relative female wages and, therefore, slow down the takeoff to modern economic growth.

The Galor and Weil model predicts how female labor supply and fertility evolve in the course of development. First, (married) women start participating in market work and only afterwards does fertility start declining. Historically, however, in the US and Western Europe, the decline in fertility occurred before women’s participation rates in the labor market started their dramatic increase. In addition, these regions experienced a mid-twentieth century baby boom which seems at odds with Galor and Weil’s theory.

Both these stylized facts can be addressed by adding home production to the modeling, as do Kimura & Yasui ( 2010 ). In their article, as capital per worker accumulates, the market wage for brains rises and the economy moves through four stages of development. In the first stage, with a sufficiently low market wage, both husband and wife are fully dedicated to home production and childrearing. The household does not supply labor to the market; fertility is high and constant. In the second stage, as the wage rate increases, men enter the labor market (supplying both brawn and brain), whereas women remain fully engaged in home production and childrearing. But as men partially withdraw from home production, women have to replace them. As a result, their time cost of childrearing goes up. At this stage of development, the negative substitution effect of rising wages on fertility dominates the positive income effect. Fertility starts declining, even though women have not yet entered the labor market. The third stage arrives when men stop working in home production. There is complete specialization of labor by gender; men only do market work, and women only do home production and childrearing. As the market wage rises for men, the positive income effect becomes dominant and fertility increases; this mimics the baby-boom period of the mid-twentieth century. In the fourth and final stage, once sufficient capital is accumulated, women enter the market sector as wage-earners. The negative substitution effect of rising female opportunity costs dominates once again, and fertility declines. The economy moves from a “breadwinner model” to a “dual-earnings model”.

Another important form of gender inequality is discrimination against women in the form of lower wages, holding male and female productivity constant. Cavalcanti & Tavares ( 2016 ) estimate the aggregate effects of wage discrimination using a model-based general equilibrium representation of the US economy. In their model, women are assumed to be more productive in childrearing than men, so they pay the full time cost of this activity. In the labor market, even though men and women are equally productive, women receive only a fraction of the male wage rate—this is the wage discrimination assumption. Wage discrimination works as a tax on female labor supply. Because women work less than they would without discrimination, there is a negative level effect on per capita output. In addition, there is a second negative effect of wage discrimination operating through endogenous fertility. Since lower wages reduce women’s opportunity costs of childrearing, fertility is relatively high, and output per capita is relatively low. The authors calibrate the model to US steady state parameters and estimate large negative output costs of the gender wage gap. Reducing wage discrimination against women by 50 percent would raise per capita income by 35 percent, in the long run.

Human capital accumulation plays no role in Galor & Weil ( 1996 ), Kimura & Yasui ( 2010 ), and Cavalcanti & Tavares ( 2016 ). Each person is exogenously endowed with a unit of brains. The fundamental trade-off in the these models is between the income and substitution effects of rising wages on the demand for children. When Lagerlöf ( 2003 ) adds education investments to a gender-based model, an additional trade-off emerges: that between the quantity and the quality of children.

Lagerlöf ( 2003 ) models gender inequality as a social norm: on average, men have higher human capital than women. Confronted with this fact, parents play a coordination game in which it is optimal for them to reproduce the inequality in the next generation. The reason is that parents expect the future husbands of their daughters to be, on average, relatively more educated than the future wives of their sons. Because, in the model, parents care for the total income of their children’s future households, they respond by investing relatively less in daughters’ human capital. Here, gender inequality does not arise from some intrinsic difference between men and women. It is instead the result of a coordination failure: “[i]f everyone else behaves in a discriminatory manner, it is optimal for the atomistic player to do the same” (Lagerlöf 2003 , p. 404).

With lower human capital, women earn lower wages than men and are therefore solely responsible for the time cost of childrearing. But if, exogenously, the social norm becomes more gender egalitarian over time, the gender gap in parental educational investment decreases. As better educated girls grow up and become mothers, their opportunity costs of childrearing are higher. Parents trade-off the quantity of children by their quality; fertility falls and human capital accumulates. However, rising wages have an offsetting positive income effect on fertility because parents pay a (fixed) “goods cost” per child. The goods cost is proportionally more important in poor societies than in richer ones. As a result, in poor economies, growth takes off slowly because the positive income effect offsets a large chunk of the negative substitution effect. As economies grow richer, the positive income effect vanishes (as a share of total income), and fertility declines faster. That is, growth accelerates over time even if gender equality increases only linearly.

The natural next step is to model how the social norm on gender roles evolves endogenously during the course of development. Hiller ( 2014 ) develops such a model by combining two main ingredients: a gender gap in the endowments of brawn (as in Galor & Weil 1996 ) generates a social norm, which each parental couple takes as given (as in Lagerlöf 2003 ). The social norm evolves endogenously, but slowly; it tracks the gender ratio of labor supply in the market, but with a small elasticity. When the male-female ratio in labor supply decreases, stereotypes adjust and the norm becomes less discriminatory against women.

The model generates a U-shaped relationship between economic development and female labor force participation. Footnote 13 In the preindustrial stage, there is no education and all labor activities are unskilled, i.e., produced with brawn. Because men have a comparative advantage in brawn, they supply more labor to the market than women, who specialize in home production. This gender gap in labor supply creates a social norm that favors boys over girls. Over time, exogenous skill-biased technological progress raises the relative returns to brains, inducing parents to invest in their children’s education. At the beginning, however, because of the social norm, only boys become educated. The economy accumulates human capital and grows, generating a positive income effect that, in isolation, would eventually drive up parental investments in girls’ education. Footnote 14 But endogenous social norms move in the opposite direction. When only boys receive education, the gender gap in returns to market work increases, and women withdraw to home production. As female relative labor supply in the market drops, the social norm becomes more discriminatory against women. As a result, parents want to invest relatively less in their daughters’ education.

In the end, initial conditions determine which of the forces dominates, thereby shaping long-term outcomes. If, initially, the social norm is very discriminatory, its effect is stronger than the income effect; the economy becomes trapped in an equilibrium with high gender inequality and low per capita income. If, on the other hand, social norms are relatively egalitarian to begin with, then the income effect dominates, and the economy converges to an equilibrium with gender equality and high income per capita.

In the models reviewed so far, human capital or brain endowments can be understood as combining both education and health. Bloom et al. ( 2015 ) explicitly distinguish these two dimensions. Health affects labor market earnings because sick people are out of work more often (participation effect) and are less productive per hour of work (productivity effect). Female health is assumed to be worse than male health, implying that women’s effective wages are lower than men’s. As a result, women are solely responsible for childrearing. Footnote 15

The model produces two growth regimes: a Malthusian trap with high fertility and no educational investments; and a regime of sustained growth, declining fertility, and rising educational investments. Once wages reach a certain threshold, the economy goes through a fertility transition and education expansion, taking off from the Malthusian regime to the sustained growth regime.

Female health promotes growth in both regimes, and it affects the timing of the takeoff. The healthier women are, the earlier the economy takes off. The reason is that a healthier woman earns a higher effective wage and, consequently, faces higher opportunity costs of raising children. When female health improves, the rising opportunity costs of children reduce the wage threshold at which educational investments become attractive; the fertility transition and mass education periods occur earlier.

In contrast, improved male health slows down economic growth and delays the fertility transition. When men become healthier, there is only a income effect on the demand for children, without the negative substitution effect (because male childrearing time is already zero). The policy conclusion would be to redistribute health from men to women. However, the policy would impose a static utility cost on the household. Because women’s time allocation to market work is constrained by childrearing responsibilities (whereas men work full-time), the marginal effect of health on household income is larger for men than for women. From the household’s point of view, reducing the gender gap in health produces a trade-off between short-term income maximization and long-term economic development.

In an extension of the model, the authors endogeneize health investments, while keeping the assumption that women pay the full time cost of childrearing. Because women participate less in the labor market (due to childrearing duties), it is optimal for households to invest more in male health. A health gender gap emerges from rational household behavior that takes into account how time-constraints differ by gender; assuming taste-based discrimination against girls or gender-specific preferences is not necessary.

In the models reviewed so far, parents invest in their children’s human capital for purely altruistic reasons. This is captured in the models by assuming that parents derive utility directly from the quantity and quality of children. This is the classical representation of children as durable consumption goods (e.g., Becker 1960 ). In reality, of course, parents may also have egoistic motivations for investing in child quantity and quality. A typical example is that, when parents get old and retire, they receive support from their children. The quantity and quality of children will affect the size of old-age transfers and parents internalize this in their fertility and childcare behavior. According to this view, children are best understood as investment goods.

Zhang et al. ( 1999 ) build an endogenous growth model that incorporates the old-age support mechanism in parental decisions. Another innovative element of their model is that parents can choose the gender of their children. The implicit assumption is that sex selection technologies are freely available to all parents.

At birth, there is a gender gap in human capital endowment, favoring boys over girls. Footnote 16 In adulthood, a child’s human capital depends on the initial endowment and on the parents’ human capital. In addition, the probability that a child survives to adulthood is exogenous and can differ by gender.

Parents receive old-age support from children that survive until adulthood. The more human capital children have, the more old-age support they provide to their parents. Beyond this egoistic motive, parents also enjoy the quantity and the quality of children (altruistic motive). Son preference is modeled by boys having a higher relative weight in the altruistic-component of the parental utility function. In other words, in their enjoyment of children as consumer goods, parents enjoy “consuming” a son more than “consuming” a girl. Parents who prefer sons want more boys than girls. A larger preference for sons, a higher relative survival probability of boys, and a higher human capital endowment of boys positively affect the sex ratio at birth, because, in the parents’ perspective, all these forces increase the marginal utility of boys relative to girls.

Zhang et al. ( 1999 ) show that, if human capital transmission from parents to children is efficient enough, the economy grows endogenously. When boys have a higher human capital endowment than girls, and the survival probability of sons is not smaller than the survival probability of daughters, then only sons provide old-age support. Anticipating this, parents invest more in the human capital of their sons than on the human capital of their daughters. As a result, the gender gap in human capital at birth widens endogenously.

When only boys provide old-age support, an exogenous increase in son preference harms long-run economic growth. The reason is that, when son preference increases, parents enjoy each son relatively more and demand less old-age support from him. Other things equal, parents want to “consume” more sons now and less old-age support later. Because parents want more sons, the sex ratio at birth increases; but because each son provides less old-age support, human capital investments per son decrease (such that the gender gap in human capital narrows). At the aggregate level, the pace of human capital accumulation slows down and, in the long run, economic growth is lower. Thus, an exogenous increase in son preference increases the sex ratio at birth, and reduces human capital accumulation and long-run growth (although it narrows the gender gap in education).

In summary, in growth models with unitary households, gender inequality is closely linked to the division of labor between family members. If women earn relatively less in market activities, they specialize in childrearing and home production, while men specialize in market work. And precisely due to this division of labor, the returns to female educational investments are relatively low. These household behaviors translate into higher fertility and lower human capital and thus pose a barrier to long-run development.

4 Intra-household bargaining: husbands and wives

In this section, we review models populated with non-unitary households, where decisions are the result of bargaining between the spouses. There are two broad types of bargaining processes: non-cooperative, where spouses act independently or interact in a non-cooperative game that often leads to inefficient outcomes (e.g., Doepke & Tertilt 2019 , Heath & Tan 2020 ); and cooperative, where the spouses are assumed to achieve an efficient outcome (e.g., De la Croix & Vander Donckt 2010 ; Diebolt & Perrin 2013 ). As in the previous section, all of these non-unitary models take the household as given, thereby abstracting from marriage markets or other household formation institutions, which will be discussed separately in section 5 . When preferences differ by gender, bargaining between the spouses matters for economic growth. If women care more about child quality than men do and human capital accumulation is the main engine of growth, then empowering women leads to faster economic growth (Prettner & Strulik 2017 ). If, however, men and women have similar preferences but are imperfect substitutes in the production of household public goods, then empowering women has an ambiguous effect on economic growth (Doepke & Tertilt 2019 ).

A separate channel concerns the intergenerational transmission of human capital and woman’s role as the main caregiver of children. If the education of the mother matters more than the education of the father in the production of children’s human capital, then empowering women will be conducive to growth (Agénor 2017 ; Diebolt & Perrin 2013 ), with the returns to education playing a crucial role in the political economy of female empowerment (Doepke & Tertilt 2009 ).

However, different dimensions of gender inequality have different growth impacts along the development process (De la Croix & Vander Donckt 2010 ). Policies that improve gender equality across many dimensions can be particularly effective for economic growth by reaping complementarities and positive externalities (Agénor 2017 ).

The idea that women might have stronger preferences for child-related expenditures than men can be easily incorporated in a Beckerian model of fertility. The necessary assumption is that women place a higher weight on child quality (relative to child quantity) than men do. Prettner & Strulik ( 2017 ) build a unified growth theory model with collective households. Men and women have different preferences, but they achieve efficient cooperation based on (reduced-form) bargaining parameters. The authors study the effect of two types of preferences: (i) women are assumed to have a relative preference for child quality, while men have a relative preference for child quantity; and (ii) parents are assumed to have a relative preference for the education of sons over the education of daughters. In addition, it is assumed that the time cost of childcare borne by men cannot be above that borne by women (but it could be the same).

When women have a relative preference for child quality, increasing female empowerment speeds up the economy’s escape from a Malthusian trap of high fertility, low education, and low income per capita. When female empowerment increases (exogenously), a woman’s relative preference for child quality has a higher impact on household’s decisions. As a consequence, fertility falls, human capital accumulates, and the economy starts growing. The model also predicts that the more preferences for child quality differ between husband and wife, the more effective is female empowerment in raising long-run per capita income, because the sooner the economy escapes the Malthusian trap. This effect is not affected by whether parents have a preference for the education of boys relative to that of girls. If, however, men and women have similar preferences with respect to the quantity and quality of their children, then female empowerment does not affect the timing of the transition to the sustained growth regime.

Strulik ( 2019 ) goes one step further and endogeneizes why men seem to prefer having more children than women. The reason is a different preference for sexual activity: other things equal, men enjoy having sex more than women. Footnote 17 When cheap and effective contraception is not available, a higher male desire for sexual activity explains why men also prefer to have more children than women. In a traditional economy, where no contraception is available, fertility is high, while human capital and economic growth are low. When female bargaining power increases, couples reduce their sexual activity, fertility declines, and human capital accumulates faster. Faster human capital accumulation increases household income and, as a consequence, the demand for contraception goes up. As contraception use increases, fertility declines further. Eventually, the economy undergoes a fertility transition and moves to a modern regime with low fertility, widespread use of contraception, high human capital, and high economic growth. In the modern regime, because contraception is widely used, men’s desire for sex is decoupled from fertility. Both sex and children cost time and money. When the two are decoupled, men prefer to have more sex at the expense of the number of children. There is a reversal in the gender gap in desired fertility. When contraceptives are not available, men desire more children than women; once contraceptives are widely used, men desire fewer children than women. If women are more empowered, the transition from the traditional equilibrium to the modern equilibrium occurs faster.

Both Prettner & Strulik ( 2017 ) and Strulik ( 2019 ) rely on gender-specific preferences. In contrast, Doepke & Tertilt ( 2019 ) are able to explain gender-specific expenditure patterns without having to assume that men and women have different preferences. They set up a non-cooperative model of household decision making and ask whether more female control of household resources leads to higher child expenditures and, thus, to economic development. Footnote 18

In their model, household public goods are produced with two inputs: time and goods. Instead of a single home-produced good (as in most models), there is a continuum of household public goods whose production technologies differ. Some public goods are more time-intensive to produce, while others are more goods-intensive. Each specific public good can only be produced by one spouse—i.e., time and good inputs are not separable. Women face wage discrimination in the labor market, so their opportunity cost of time is lower than men’s. As a result, women specialize in the production of the most time-intensive household public goods (e.g., childrearing activities), while men specialize in the production of goods-intensive household public goods (e.g., housing infrastructure). Notice that, because the household is non-cooperative, there is not only a division of labor between husband and wife, but also a division of decision making, since ultimately each spouse decides how much to provide of his or her public goods.

When household resources are redistributed from men to women (i.e., from the high-wage spouse to the low-wage spouse), women provide more public goods, in relative terms. It is ambiguous, however, whether the total provision of public goods increases with the re-distributive transfer. In a classic model of gender-specific preferences, a wife increases child expenditures and her own private consumption at the expense of the husband’s private consumption. In Doepke & Tertilt ( 2019 ), however, the rise in child expenditures (and time-intensive public goods in general) comes at the expense of male consumption and male-provided public goods.

Parents contribute to the welfare of the next generation in two ways: via human capital investments (time-intensive, typically done by the mother) and bequests of physical capital (goods-intensive, typically done by the father). Transferring resources to women increases human capital, but reduces the stock of physical capital. The effect of such transfers on economic growth depends on whether the aggregate production function is relatively intensive in human capital or in physical capital. If aggregate production is relatively human capital intensive, then transfers to women boost economic growth; if it is relatively intensive in physical capital, then transfers to women may reduce economic growth.

There is an interesting paradox here. On the one hand, transfers to women will be growth-enhancing in economies where production is intensive in human capital. These would be more developed, knowledge intensive, service economies. On the other hand, the positive growth effect of transfers to women increases with the size of the gender wage gap, that is, decreases with female empowerment. But the more advanced, human capital intensive economies are also the ones with more female empowerment (i.e., lower gender wage gaps). In other words, in settings where human capital investments are relatively beneficial, the contribution of female empowerment to human capital accumulation is reduced. Overall, Doepke and Tertilt’s ( 2019 ) model predicts that female empowerment has at best a limited positive effect and at worst a negative effect on economic growth.

Heath & Tan ( 2020 ) argue that, in a non-cooperative household model, income transfers to women may increase female labor supply. Footnote 19 This result may appear counter-intuitive at first, because in collective household models unearned income unambiguously reduces labor supply through a negative income effect. In Heath and Tan’s model, husband and wife derive utility from leisure, consuming private goods, and consuming a household public good. The spouses decide separately on labor supply and monetary contributions to the household public good. Men and women are identical in preferences and behavior, but women have limited control over resources, with a share of their income being captured by the husband. Female control over resources (i.e., autonomy) depends positively on the wife’s relative contribution to household income. Thus, an income transfer to the wife, keeping husband unearned income constant, raises the fraction of her own income that she privately controls. This autonomy effect unambiguously increases women’s labor supply, because the wife can now reap an additional share of her wage bill. Whenever the autonomy effect dominates the (negative) income effect, female labor supply increases. The net effect will be heterogeneous over the wage distribution, but the authors show that aggregate female labor supply is always weakly larger after the income transfer.

Diebolt & Perrin ( 2013 ) assume cooperative bargaining between husband and wife, but do not rely on sex-specific preferences or differences in ability. Men and women are only distinguished by different uses of their time endowments, with females in charge of all childrearing activities. In line with this labor division, the authors further assume that only the mother’s human capital is inherited by the child at birth. On top of the inherited maternal endowment, individuals can accumulate human capital during adulthood, through schooling. The higher the initial human capital endowment, the more effective is the accumulation of human capital via schooling.

A woman’s bargaining power in marriage determines her share in total household consumption and is a function of the relative female human capital of the previous generation. An increase in the human capital of mothers relative to that of fathers has two effects. First, it raises the incentives for human capital accumulation of the next generation, because inherited maternal human capital makes schooling more effective. Second, it raises the bargaining power of the next generation of women and, because women’s consumption share increases, boosts the returns on women’s education. The second effect is not internalized in women’s time allocation decisions; it is an intergenerational externality. Thus, an exogenous increase in women’s bargaining power would promote economic growth by speeding up the accumulation of human capital across overlapping generations.

De la Croix & Vander Donckt ( 2010 ) contribute to the literature by clearly distinguishing between different gender gaps: a gap in the probability of survival, a wage gap, a social and institutional gap, and a gender education gap. The first three are exogenously given, while the fourth is determined within the model.

By assumption, men and women have identical preferences and ability, but women pay the full time cost of childrearing. As in a typical collective household model, bargaining power is partially determined by the spouses’ earnings potential (i.e., their levels of human capital and their wage rates). But there is also a component of bargaining power that is exogenous and captures social norms that discriminate against women—this is the social and institutional gender gap.

Husbands and wives bargain over fertility and human capital investments for their children. A standard Beckerian result emerges: parents invest relatively less in the education of girls, because girls will be more time-constrained than boys and, therefore, the female returns to education are lower in relative terms.

There are at least two regimes in the economy: a corner regime and an interior regime. The corner regime consists of maximum fertility, full gender specialization (no women in the labor market), and large gender gaps in education (no education for girls). Reducing the wage gap or the social and institutional gap does not help the economy escaping this regime. Women are not in labor force, so the wage gap is meaningless. The social and institutional gap will determine women’s share in household consumption, but does not affect fertility and growth. At this stage, the only effective instruments for escaping the corner regime are reducing the gender survival gap or reducing child mortality. Reducing the gender survival gap increases women’s lifespan, which increases their time budget and attracts them to the labor market. Reducing child mortality decreases the time costs of kids, therefore drawing women into the labor market. In both cases, fertility decreases.

In the interior regime, fertility is below the maximum, women’s labor supply is above zero, and both boys and girls receive education. In this regime, with endogenous bargaining power, reducing all gender gaps will boost economic growth. Footnote 20 Thus, depending on the growth regime, some gender gaps affect economic growth, while others do not. Accordingly, the policy-maker should tackle different dimensions of gender inequality at different stages of the development process.

Agénor ( 2017 ) presents a computable general equilibrium that includes many of the elements of gender inequality reviewed so far. An important contribution of the model is to explicitly add the government as an agent whose policies interact with family decisions and, therefore, will impact women’s time allocation. Workers produce a market good and a home good and are organized in collective households. Bargaining power depends on the spouses’ relative human capital levels. By assumption, there is gender discrimination in market wages against women. On top, mothers are exclusively responsible for home production and childrearing, which takes the form of time spent improving children’s health and education. But public investments in education and health also improve these outcomes during childhood. Likewise, public investment in public infrastructure contributes positively to home production. In particular, the ratio of public infrastructure capital stock to private capital stock is a substitute for women’s time in home production. The underlying idea is that improving sanitation, transportation, and other infrastructure reduces time spent in home production. Health status in adulthood depends on health status in childhood, which, in turn, relates positively to mother’s health, her time inputs into childrearing, and government spending. Children’s human capital depends on similar factors, except that mother’s human capital replaces her health as an input. Additionally, women are assumed to derive less utility from current consumption and more utility from children’s health relative to men. Wives are also assumed to live longer than their husbands, which further down-weights female’s emphasis on current consumption. The final gendered assumption is that mother’s time use is biased towards boys. This bias alone creates a gender gap in education and health. As adults, women’s relative lower health and human capital are translated into relative lower bargaining power in household decisions.

Agénor ( 2017 ) calibrates this rich setup for Benin, a low income country, and runs a series of policy experiments on different dimensions of gender inequality: a fall in childrearing costs, a fall in gender pay discrimination, a fall in son bias in mother’s time allocation, and an exogenous increase in female bargaining power. Footnote 21 Interestingly, despite all policies improving gender equality in separate dimensions, not all unambiguously stimulate economic growth. For example, falling childrearing costs raise savings and private investments, which are growth-enhancing, but increase fertility (as children become ‘cheaper’) and reduce maternal time investment per child, thus reducing growth. In contrast, a fall in gender pay discrimination always leads to higher growth, through higher household income that, in turn, boosts savings, tax revenues, and public spending. Higher public spending further contributes to improved health and education of the next generation. Lastly, Agénor ( 2017 ) simulates the effect of a combined policy that improves gender equality in all domains simultaneously. Due to complementarities and positive externalities across dimensions, the combined policy generates more economic growth than the sum of the individual policies. Footnote 22

In the models reviewed so far, men are passive observers of women’s empowerment. Doepke & Tertilt ( 2009 ) set up an interesting political economy model of women’s rights, where men make the decisive choice. Their model is motivated by the fact that, historically, the economic rights of women were expanded before their political rights. Because the granting of economic rights empowers women in the household, and this was done before women were allowed to participate in the political process, the relevant question is why did men willingly share their power with their wives?

Doepke & Tertilt ( 2009 ) answer this question by arguing that men face a fundamental trade-off. On the one hand, husbands would vote for their wives to have no rights whatsoever, because husbands prefer as much intra-household bargaining power as possible. But, on the other hand, fathers would vote for their daughters to have economic rights in their future households. In addition, fathers want their children to marry highly educated spouses, and grandfathers want their grandchildren to be highly educated. By assumption, men and women have different preferences, with women having a relative preference for child quality over quantity. Accordingly, men internalize that, when women become empowered, human capital investments increase, making their children and grandchildren better-off.

Skill-biased (exogenous) technological progress that raises the returns to education over time can shift male incentives along this trade-off. When the returns to education are low, men prefer to make all decisions on their own and deny all rights to women. But once the returns to education are sufficiently high, men voluntarily share their power with women by granting them economic rights. As a result, human capital investments increase and the economy grows faster.

In summary, gender inequality in labor market earnings often implies power asymmetries within the household, with men having more bargaining power than women. If preferences differ by gender and female preferences are more conducive to development, then empowering women is beneficial for growth. When preferences are the same and the bargaining process is non-cooperative, the implications are less clear-cut, and more context-specific. If, in addition, women’s empowerment is curtailed by law (e.g., restrictions on women’s economic rights), then it is important to understand the political economy of women’s rights, in which men are crucial actors.

5 Marriage markets and household formation

Two-sex models of economic growth have largely ignored how households are formed. The marriage market is not explicitly modeled: spouses are matched randomly, marriage is universal and monogamous, and families are nuclear. In reality, however, household formation patterns vary substantially across societies, with some of these differences extending far back in history. For example, Hajnal ( 1965 , 1982 ) described a distinct household formation pattern in preindustrial Northwestern Europe (often referred to as the “European Marriage Pattern”) characterized by: (i) late ages at first marriage for women, (ii) most marriages done under individual consent, and (iii) neolocality (i.e., upon marriage, the bride and the groom leave their parental households to form a new household). In contrast, marriage systems in China and India consisted of: (i) very early female ages at first marriage, (ii) arranged marriages, and (iii) patrilocality (i.e., the bride joins the parental household of the groom).

Economic historians argue that the “European Marriage Pattern” empowered women, encouraging their participation in market activities and reducing fertility levels. While some view this as one of the deep-rooted factors explaining Northwestern Europe’s earlier takeoff to sustained economic growth (e.g., Carmichael, de Pleijt, van Zanden and De Moor 2016 ; De Moor & Van Zanden 2010 ; Hartman 2004 ), others have downplayed the long-run significance of this marriage pattern (e.g., Dennison & Ogilvie 2014 ; Ruggles 2009 ). Despite this lively debate, the topic has been largely ignored by growth theorists. The few exceptions are Voigtländer and Voth ( 2013 ), Edlund and Lagerlöf ( 2006 ), and Tertilt ( 2005 , 2006 ).

After exploring different marriage institutions, we zoom in on contemporary monogamous and consensual marriage and review models where gender inequality affects economic growth through marriage markets that facilitate household formation (Du & Wei 2013 ; Grossbard & Pereira 2015 ; Grossbard-Shechtman 1984 ; Guvenen & Rendall 2015 ). In contrast with the previous two sections, where the household is the starting point of the analysis, the literature on marriage markets and household formation recognizes that marriage, labor supply, and investment decisions are interlinked. The analysis of these interlinkages is sometimes done with unitary households (upon marriage) (Du & Wei 2013 ; Guvenen & Rendall 2015 ), or with non-cooperative models of individual decision-making within households (Grossbard & Pereira 2015 ; Grossbard-Shechtman 1984 ).

Voigtländer and Voth ( 2013 ) argue that the emergence of the “European Marriage Pattern” is a direct consequence of the mid-fourteen century Black Death. They set up a two-sector agricultural economy consisting of physically demanding cereal farming, and less physically demanding pastoral production. The economy is populated by many male and female peasants and by a class of idle, rent-maximizing landlords. Female peasants are heterogeneous with respect to physical strength, but, on average, are assumed to have less brawn relative to male peasants and, thus, have a comparative advantage in the pastoral sector. Both sectors use land as a production input, although the pastoral sector is more land-intensive than cereal production. All land is owned by the landlords, who can rent it out for peasant cereal farming, or use it for large-scale livestock farming, for which they hire female workers. Crucially, women can only work and earn wages in the pastoral sector as long as they are unmarried. Footnote 23 Peasant women decide when to marry and, upon marriage, a peasant couple forms a new household, where husband and wife both work on cereal farming, and have children at a given time frequency. Thus, the only contraceptive method available is delaying marriage. Because women derive utility from consumption and children, they face a trade-off between earned income and marriage.

Initially, the economy rests in a Malthusian regime, where land-labor ratios are relatively low, making the land-intensive pastoral sector unattractive and depressing relative female wages. As a result, women marry early and fertility is high. The initial regime ends in 1348–1350, when the Black Death kills between one third and half of Europe’s population, exogenously generating land abundance and, therefore, raising the relative wages of female labor in pastoral production. Women postpone marriage to reap higher wages, and fertility decreases—moving the economy to a regime of late marriages and low fertility.

In addition to late marital ages and reduced fertility, another important feature of the “European Marriage Pattern” was individual consent for marriage. Edlund and Lagerlöf ( 2006 ) study how rules of consent for marriage influence long-run economic development. In their model, marriages can be formed according to two types of consent rules: individual consent or parental consent. Under individual consent, young people are free to marry whomever they wish, while, under parental consent, their parents are in charge of arranging the marriage. Depending on the prevailing rule, the recipient of the bride-price differs. Under individual consent, a woman receives the bride-price from her husband, whereas, under parental consent, her father receives the bride-price from the father of the groom. Footnote 24 In both situations, the father of the groom owns the labor income of his son and, therefore, pays the bride-price, either directly, under parental consent, or indirectly, under individual consent. Under individual consent, the father needs to transfer resources to his son to nudge him into marrying. Thus, individual consent implies a transfer of resources from the old to the young and from men to women, relative to the rule of parental consent. Redistributing resources from the old to the young boosts long-run economic growth. Because the young have a longer timespan to extract income from their children’s labor, they invest relatively more in the human capital of the next generation. In addition, under individual consent, the reallocation of resources from men to women can have additional positive effects on growth, by increasing women’s bargaining power (see section 4 ), although this channel is not explicitly modeled in Edlund and Lagerlöf ( 2006 ).

Tertilt ( 2005 ) explores the effects of polygyny on long-run development through its impact on savings and fertility. In her model, parental consent applies to women, while individual consent applies to men. There is a competitive marriage market where fathers sell their daughters and men buy their wives. As each man is allowed (and wants) to marry several wives, a positive bride-price emerges in equilibrium. Footnote 25 Upon marriage, the reproductive rights of the bride are transferred from her father to her husband, who makes all fertility decisions on his own and, in turn, owns the reproductive rights of his daughters. From a father’s perspective, daughters are investments goods; they can be sold in the marriage market, at any time. This feature generates additional demand for daughters, which increases overall fertility, and reduces the incentives to save, which decreases the stock of physical capital. Under monogamy, in contrast, the equilibrium bride-price is negative (i.e., a dowry). The reason is that maintaining unmarried daughters is costly for their fathers, so they are better-off paying a (small enough) dowry to their future husbands. In this setting, the economic returns to daughters are lower and, consequently, so is the demand for children. Fertility decreases and savings increase. Thus, moving from polygny to monogamy lowers population growth and raises the capital stock in the long run, which translates into higher output per capita in the steady state.

Instead of enforcing monogamy in a traditionally polygynous setting, an alternative policy is to transfer marriage consent from fathers to daughters. Tertilt ( 2006 ) shows that when individual consent is extended to daughters, such that fathers do not receive the bride-price anymore, the consequences are qualitatively similar to a ban on polygyny. If fathers stop receiving the bride-price, they save more physical capital. In the long run, per capita output is higher when consent is transferred to daughters.

Grossbard-Shechtman ( 1984 ) develops the first non-cooperative model where (monogamous) marriage, home production, and labor supply decisions are interdependent. Footnote 26 Spouses are modeled as separate agents deciding over production and consumption. Marriage becomes an implicit contract for ‘work-in-household’ (WiHo), defined as “an activity that benefits another household member [typically a spouse] who could potentially compensate the individual for these efforts” (Grossbard 2015 , p. 21). Footnote 27 In particular, each spouse decides how much labor to supply to market work and WiHo, and how much labor to demand from the other spouse for WiHo. Through this lens, spousal decisions over the intra-marriage distribution of consumption and WiHo are akin to well-known principal-agent problems faced between firms and workers. In the marriage market equilibrium, a spouse benefiting from WiHo (the principal) must compensate the spouse producing it (the agent) via intra-household transfers (of goods or leisure). Footnote 28 Grossbard-Shechtman ( 1984 ) and Grossbard ( 2015 ) show that, under these conditions, the ratio of men to women (i.e., the sex ratio) in the marriage market is inversely related to female labor supply to the market. The reason is that, as the pool of potential wives shrinks, prospective husbands have to increase compensation for female WiHo. From the potential wife’s point of view, as the equilibrium price for her WiHo increases, market work becomes less attractive. Conversely, when sex ratios are lower, female labor supply outside the home increases. Although the model does not explicit derive growth implications, the relative increase in female labor supply is expected to be beneficial for economic growth, as argued by many of the theories reviewed so far.

In an extension of this framework, Grossbard & Pereira ( 2015 ) analyze how sex ratios affect gendered savings over the marital life-cycle. Assuming that women supply a disproportionate amount of labor for WiHo (due, for example, to traditional gender norms), the authors show that men and women will have very distinct saving trajectories. A higher sex ratio increases savings by single men, who anticipate higher compensation transfers for their wives’ WiHo, whereas it decreases savings by single women, who anticipate receiving those transfers upon marriage. But the pattern flips after marriage: precautionary savings raise among married women, because the possibility of marriage dissolution entails a loss of income from WiHo. The opposite effect happens for married men: marriage dissolution would imply less expenditures in the future. The higher the sex ratio, the higher will be the equilibrium compensation paid by husbands for their wives’ WiHo. Therefore, the sex ratio will positively affect savings among single men and married women, but negatively affect savings among single women and married men. The net effect on the aggregate savings rate and on economic growth will depend on the relative size of these demographic groups.

In a related article, Du & Wei ( 2013 ) propose a model where higher sex ratios worsen marriage markets prospects for young men and their families, who react by increasing savings. Women in turn reduce savings. However, because sex ratios shift the composition of the population in favor of men (high saving type) relative to women (low saving type) and men save additionally to compensate for women’s dis-saving, aggregate savings increase unambiguously with sex ratios.

In Guvenen & Rendall ( 2015 ), female education is, in part, demanded as insurance against divorce risk. The reason is that divorce laws often protect spouses’ future labor market earnings (i.e., returns to human capital), but force them to share their physical assets. Because, in the model, women are more likely to gain custody of their children after divorce, they face higher costs from divorce relative to their husbands. Therefore, the higher the risk of divorce, the more women invest in human capital, as insurance against a future vulnerable economic position. Guvenen & Rendall ( 2015 ) shows that, over time, divorce risk has increased (for example, consensual divorce became replaced by unilateral divorce in most US states in the 1970s). In the aggregate, higher divorce risk boosted female education and female labor supply.

In summary, the rules regulating marriage and household formation carry relevant theoretical consequences for economic development. While the few studies on this topic have focused on age at marriage, consent rules and polygyny, and the interaction between sex ratios, marriage, and labor supply, other features of the marriage market remain largely unexplored (Borella, De Nardi and Yang 2018 ). Growth theorists would benefit from further incorporating theories of household formation in gendered macro models. Footnote 29

6 Conclusion

In this article, we surveyed micro-founded theories linking gender inequality to economic development. This literature offers many plausible mechanisms through which inequality between men and women affects the aggregate economy (see Table 1 ). Yet, we believe the body of theories could be expanded in several directions. We discuss them below and highlight lessons for policy.

The first direction for future research concerns control over fertility. In models where fertility is endogenous, households are always able to achieve their preferred number of children (see Strulik 2019 , for an exception). The implicit assumption is that there is a free and infallible method of fertility control available for all households—a view rejected by most demographers. The gap between desired fertility and achieved fertility can be endogeneized at three levels. First, at the societal level, the diffusion of particular contraceptive methods may be influenced by cultural and religious norms. Second, at the household level, fertility control may be object of non-cooperative bargaining between the spouses, in particular, for contraceptive methods that only women perfectly observe (Ashraf, Field and Lee 2014 ; Doepke & Kindermann 2019 ). More generally, the role of asymmetric information within the household is not yet explored (Walther 2017 ). Third, if parents have preferences over the gender composition of their offspring, fertility is better modeled as a sequential and uncertain process, where household size is likely endogenous to the sex of the last born child (Hazan & Zoabi 2015 ).

A second direction worth exploring concerns gender inequality in a historical perspective. In models with multiple equilibria, an economy’s path is often determined by its initial level of gender equality. Therefore, it would be useful to develop theories explaining why initial conditions varied across societies. In particular, there is a large literature on economic and demographic history documenting how systems of marriage and household formation differed substantially across preindustrial societies (e.g., De Moor & Van Zanden 2010 ; Hajnal 1965 , 1982 ; Hartman 2004 ; Ruggles 2009 ). In our view, more theoretical work is needed to explain both the origins and the consequences of these historical systems.

A third avenue for future research concerns the role of technological change. In several models, technological change is the exogenous force that ultimately erodes gender gaps in education or labor supply (e.g., Bloom et al. 2015 ; Doepke & Tertilt 2009 ; Galor & Weil 1996 ). For that to happen, technological progress is assumed to be skill-biased, thus raising the returns to education—or, in other words, favoring brain over brawn. As such, new technologies make male advantage in physical strength ever more irrelevant, while making female time spent on childrearing and housework ever more expensive. Moreover, recent technological progress increased the efficiency of domestic activities, thereby relaxing women’s time constraints (e.g., Cavalcanti & Tavares 2008 ; Greenwood, Seshadri and Yorukoglu 2005 ). These mechanisms are plausible, but other aspects of technological change need not be equally favorable for women. In many countries, for example, the booming science, technology, and engineering sectors tend to be particularly male-intensive. And Tejani & Milberg ( 2016 ) provide evidence for developing countries that as manufacturing industries become more capital intensive, their female employment share decreases.

Even if current technological progress is assumed to weaken gender gaps, historically, technology may have played exactly the opposite role. If technology today is more complementary to brain, in the past it could have been more complementary to brawn. An example is the plow that, relative to alternative technologies for field preparation (e.g., hoe, digging stick), requires upper body strength, on which men have a comparative advantage over women (Alesina, Giuliano and Nunn 2013 ; Boserup 1970 ). Another, even more striking example, is the invention of agriculture itself—the Neolithic Revolution. The transition from a hunter-gatherer lifestyle to sedentary agriculture involved a relative loss of status for women (Dyble et al. 2015 ; Hansen, Jensen and Skovsgaard 2015 ). One explanation is that property rights on land were captured by men, who had an advantage on physical strength and, consequently, on physical violence. Thus, in the long view of human history, technological change appears to have shifted from being male-biased towards being female-biased. Endogeneizing technological progress and its interaction with gender inequality is a promising avenue for future research.

Fourth, open economy issues are still almost entirely absent. An exception is Rees & Riezman ( 2012 ), who model the effect of globalization on economic growth. Whether global capital flows generate jobs primarily in female or male intensive sectors matters for long-run growth. If globalization creates job opportunities for women, their bargaining power increases and households trade off child quantity by child quality. Fertility falls, human capital accumulates, and long-run per capita output is high. If, on the other hand, globalization creates jobs for men, their intra-household power increases; fertility increases, human capital decreases, and steady-state income per capita is low. The literature would benefit from engaging with open economy demand-driven models of the feminist tradition, such as Blecker & Seguino ( 2002 ), Seguino ( 2010 ). Other fruitful avenues for future research on open economy macro concern gender analysis of global value chains (Barrientos 2019 ), gendered patterns of international migration (Cortes 2015 ; Cortes & Tessada 2011 ), and the diffusion of gender norms through globalization (Beine, Docquier and Schiff 2013 ; Klasen 2020 ; Tuccio & Wahba 2018 ).

A final point concerns the role of men in this literature. In most theoretical models, gender inequality is not the result of an active male project that seeks the domination of women. Instead, inequality emerges as a rational best response to some underlying gender gap in endowments or constraints. Then, as the underlying gap becomes less relevant—for example, due to skill-biased technological change—, men passively relinquish their power (see Doepke & Tertilt 2009 , for an exception). There is never a male backlash against the short-term power loss that necessarily comes with female empowerment. In reality, it is more likely that men actively oppose losing power and resources towards women (Folbre 2020 ; Kabeer 2016 ; Klasen 2020 ). This possibility has not yet been explored in formal models, even though it could threaten the typical virtuous cycle between gender equality and growth. If men are forward-looking, and the short-run losses outweigh the dynamic gains from higher growth, they might ensure that women never get empowered to begin with. Power asymmetries tend to be sticky, because “any group that is able to claim a disproportionate share of the gains from cooperation can develop social institutions to fortify their position” (Folbre 2020 , p. 199). For example, Eswaran & Malhotra ( 2011 ) set up a household decision model where men use domestic violence against their wives as a tool to enhance male bargaining power. Thus, future theories should recognize more often that men have a vested interest on the process of female empowerment.

More generally, policymakers should pay attention to the possibility of a male backlash as an unintended consequence of female empowerment policies (Erten & Keskin 2018 ; Eswaran & Malhotra 2011 ). Likewise, whereas most theories reviewed here link lower fertility to higher economic growth, the relationship is non-monotonic. Fertility levels below the replacement rate will eventually generate aggregate social costs in the form of smaller future workforces, rapidly ageing societies, and increased pressure on welfare systems, to name a few.

Many theories presented in this survey make another important practical point: public policies should recognize that gender gaps in separate dimensions complement and reinforce one another and, therefore, have to be dealt with simultaneously. A naïve policy targeting a single gap in isolation is unlikely to have substantial growth effects in the short run. Typically, inequalities in separate dimensions are not independent from each other (Agénor 2017 ; Bandiera & Does 2013 ; Duflo 2012 ; Kabeer 2016 ). For example, if credit-constrained women face weak property rights, are unable to access certain markets, and have mobility and time constraints, then the marginal return to capital may nevertheless be larger for men. Similarly, the return to male education may well be above the female return if demand for female labor is low or concentrated in sectors with low productivity. In sum, “the fact that women face multiple constraints means that relaxing just one may not improve outcomes” (Duflo 2012 , p. 1076).

Promising policy directions that would benefit from further macroeconomic research are the role of public investments in physical infrastructure and care provision (Agénor 2017 ; Braunstein, Bouhia and Seguino 2020 ), gender-based taxation (Guner, Kaygusuz and Ventura 2012 ; Meier & Rainer 2015 ), and linkages between gender equality and pro-environmental agendas (Matsumoto 2014 ).

See Echevarria & Moe ( 2000 ) for a similar complaint that “theories of economic growth and development have consistently neglected to include gender as a variable” (p. 77).

A non-exhaustive list includes Bandiera & Does ( 2013 ), Braunstein ( 2013 ), Cuberes & Teignier ( 2014 ), Duflo ( 2012 ), Kabeer ( 2016 ), Kabeer & Natali ( 2013 ), Klasen ( 2018 ), Seguino ( 2013 , 2020 ), Sinha et al. ( 2007 ), Stotsky ( 2006 ), World Bank ( 2001 , 2011 ).

For an in-depth history of “new home economics” see Grossbard-Shechtman ( 2001 ) and Grossbard ( 2010 , 2011 ).

For recent empirical reviews see Duflo ( 2012 ) and Doss ( 2013 ).

Although the unitary approach has being rejected on theoretical (e.g., Echevarria & Moe 2000 ; Folbre 1986 ; Knowles 2013 ; Sen 1989 ) and empirical grounds (e.g., Doss 2013 ; Duflo 2003 ; Lundberg et al. 1997 ), these early models are foundational to the subsequent literature. As it turns out, some of the key mechanisms survive in non-unitary theories of the household.

For nice conceptual perspectives on conflict and cooperation in households see Sen ( 1989 ), Grossbard ( 2011 ), and Folbre ( 2020 ).

The relationship depicted in Fig. 1 is robust to using other composite measures of gender equality (e.g., UNDP’s Gender Inequality Index or OECD’s Social Institutions and Gender Index (SIGI) (see Branisa, Klasen and Ziegler 2013 )), and other years besides 2000. In Fig. 2 , the linear prediction explains 56 percent of the cross-country variation in per capita income.

See Seguino ( 2013 , 2020 ) for a review of this literature.

The model allows for sorting on ability (“some people are better teachers”) or sorting on occupation-specific preferences (“others derive more utility from working as a teacher”) (Hsieh et al. 2019 , p. 1441). Here, we restrict our presentation to the case where sorting occurs primarily on ability. The authors find little empirical support for sorting on preferences.

Because the home sector is treated as any other occupation, the model can capture, in a reduced-form fashion, social norms on women’s labor force participation. For example, a social norm on traditional gender roles can be represented as a utility premium obtained by all women working on the home sector.

Note, however, that discrimination against women raises productivity in the non-agricultural sector. The reason is that the few women who end up working outside agriculture are positively selected on talent. Lee ( 2020 ) shows that this countervailing effect is modest and dominated by the loss of productivity in agriculture.

This is not the classic Beckerian quantity-quality trade-off because parents cannot invest in the quality of their children. Instead, the mechanism is built by assumption in the household’s utility function. When women’s wages increase relative to male wages, the substitution effect dominates the income effect.

The hypothesis that female labor force participation and economic development have a U-shaped relationship—known as the feminization-U hypothesis—goes back to Boserup ( 1970 ). See also Goldin ( 1995 ). Recently, Gaddis & Klasen ( 2014 ) find only limited empirical support for the feminization-U.

The model does not consider fertility decisions. Parents derive utility from their children’s human capital (social status utility). When household income increases, parents want to “consume” more social status by investing in their children’s education—this is the positive income effect.

Bloom et al. ( 2015 ) build their main model with unitary households, but show that the key conclusions are robust to a collective representation of the household.

This assumption does not necessarily mean that boys are more talented than girls. It can be also interpreted as a reduced-form way of capturing labor market discrimination against women.

Many empirical studies are in line with this assumption, which is rooted in evolutionary psychology. See Strulik ( 2019 ) for references. There are several other evolutionary arguments for men wanting more children (including with different women). See, among others, Mulder & Rauch ( 2009 ), Penn & Smith ( 2007 ), von Rueden & Jaeggi ( 2016 ). However, for a different view, see Fine ( 2017 ).

They do not model fertility decisions. So there is no quantity-quality trade-off.

In their empirical application, Heath & Tan ( 2020 ) study the Hindu Succession Act, which, through improved female inheritance rights, increased the lifetime unearned income of Indian women. Other policies consistent with the model are, for example, unconditional cash transfers to women.

De la Croix & Vander Donckt ( 2010 ) show this with numerical simulations, because the interior regime becomes analytically intractable.

We focus on gender-related policies in our presentation, but the article simulates additional public policies.

Agénor and Agénor ( 2014 ) develop a similar model, but with unitary households, and Agénor and Canuto ( 2015 ) have a similar model of collective households for Brazil, where adult women can also invest time in human capital formation. Since public infrastructure substitutes for women’s time in home production, more (or better) infrastructure can free up time for female human capital accumulation and, thus, endogenously increase wives’ bargaining power.

Voigtländer and Voth ( 2013 ) justify this assumption arguing that, in England, employment contracts for farm servants working in animal husbandry were conditional on celibacy. However, see Edwards & Ogilvie ( 2018 ) for a critique of this assumption.

The bride-price under individual consent need not be paid explicitly as a lump-sum transfer. It could, instead, be paid to the bride implicitly in the form of higher lifetime consumption.

In Tertilt ( 2005 ), all men are similar (except in age). Widespread polygyny is possible because older men marry younger women and population growth is high. This setup reflects stylized facts for Sub-Saharan Africa. It differs from models that assume male heterogeneity in endowments, where polygyny emerges because a rich male elite owns several wives, while poor men remain single (e.g., Gould, Moav and Simhon 2008 ; Lagerlöf 2005 , 2010 ).

See Grossbard ( 2015 ) for more details and extensions of this model and Grossbard ( 2018 ) for a non-technical overview of the related literature. For an earlier application, see Grossbard ( 1976 ).

The concept of WiHo is closely related but not equivalent to the ‘black-box’ term home production used by much of the literature. It also relates to feminist perspectives on care and social reproduction labor (c.f. Folbre 1994 ).

In the general setup, the model need not lead to a corner solution where only one spouse specializes in WiHo.

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Acknowledgements

We thank the Editor, Shoshana Grossbard, and three anonymous reviewers for helpful comments. We gratefully acknowledge funding from the Growth and Economic Opportunities for Women (GrOW) initiative, a multi-funder partnership between the UK’s Department for International Development, the Hewlett Foundation and the International Development Research Centre. All views expressed here and remaining errors are our own. Manuel dedicates this article to Stephan Klasen, in loving memory.

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Santos Silva, M., Klasen, S. Gender inequality as a barrier to economic growth: a review of the theoretical literature. Rev Econ Household 19 , 581–614 (2021). https://doi.org/10.1007/s11150-020-09535-6

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Twenty years of gender equality research: A scoping review based on a new semantic indicator

Paola belingheri.

1 Dipartimento di Ingegneria dell’Energia, dei Sistemi, del Territorio e delle Costruzioni, Università degli Studi di Pisa, Largo L. Lazzarino, Pisa, Italy

Filippo Chiarello

Andrea fronzetti colladon.

2 Department of Engineering, University of Perugia, Perugia, Italy

3 Department of Management, Kozminski University, Warsaw, Poland

Paola Rovelli

4 Faculty of Economics and Management, Centre for Family Business Management, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy

Associated Data

All relevant data are within the manuscript and its supporting information files. The only exception is the text of the abstracts (over 15,000) that we have downloaded from Scopus. These abstracts can be retrieved from Scopus, but we do not have permission to redistribute them.

Gender equality is a major problem that places women at a disadvantage thereby stymieing economic growth and societal advancement. In the last two decades, extensive research has been conducted on gender related issues, studying both their antecedents and consequences. However, existing literature reviews fail to provide a comprehensive and clear picture of what has been studied so far, which could guide scholars in their future research. Our paper offers a scoping review of a large portion of the research that has been published over the last 22 years, on gender equality and related issues, with a specific focus on business and economics studies. Combining innovative methods drawn from both network analysis and text mining, we provide a synthesis of 15,465 scientific articles. We identify 27 main research topics, we measure their relevance from a semantic point of view and the relationships among them, highlighting the importance of each topic in the overall gender discourse. We find that prominent research topics mostly relate to women in the workforce–e.g., concerning compensation, role, education, decision-making and career progression. However, some of them are losing momentum, and some other research trends–for example related to female entrepreneurship, leadership and participation in the board of directors–are on the rise. Besides introducing a novel methodology to review broad literature streams, our paper offers a map of the main gender-research trends and presents the most popular and the emerging themes, as well as their intersections, outlining important avenues for future research.

Introduction

The persistent gender inequalities that currently exist across the developed and developing world are receiving increasing attention from economists, policymakers, and the general public [e.g., 1 – 3 ]. Economic studies have indicated that women’s education and entry into the workforce contributes to social and economic well-being [e.g., 4 , 5 ], while their exclusion from the labor market and from managerial positions has an impact on overall labor productivity and income per capita [ 6 , 7 ]. The United Nations selected gender equality, with an emphasis on female education, as part of the Millennium Development Goals [ 8 ], and gender equality at-large as one of the 17 Sustainable Development Goals (SDGs) to be achieved by 2030 [ 9 ]. These latter objectives involve not only developing nations, but rather all countries, to achieve economic, social and environmental well-being.

As is the case with many SDGs, gender equality is still far from being achieved and persists across education, access to opportunities, or presence in decision-making positions [ 7 , 10 , 11 ]. As we enter the last decade for the SDGs’ implementation, and while we are battling a global health pandemic, effective and efficient action becomes paramount to reach this ambitious goal.

Scholars have dedicated a massive effort towards understanding gender equality, its determinants, its consequences for women and society, and the appropriate actions and policies to advance women’s equality. Many topics have been covered, ranging from women’s education and human capital [ 12 , 13 ] and their role in society [e.g., 14 , 15 ], to their appointment in firms’ top ranked positions [e.g., 16 , 17 ] and performance implications [e.g., 18 , 19 ]. Despite some attempts, extant literature reviews provide a narrow view on these issues, restricted to specific topics–e.g., female students’ presence in STEM fields [ 20 ], educational gender inequality [ 5 ], the gender pay gap [ 21 ], the glass ceiling effect [ 22 ], leadership [ 23 ], entrepreneurship [ 24 ], women’s presence on the board of directors [ 25 , 26 ], diversity management [ 27 ], gender stereotypes in advertisement [ 28 ], or specific professions [ 29 ]. A comprehensive view on gender-related research, taking stock of key findings and under-studied topics is thus lacking.

Extant literature has also highlighted that gender issues, and their economic and social ramifications, are complex topics that involve a large number of possible antecedents and outcomes [ 7 ]. Indeed, gender equality actions are most effective when implemented in unison with other SDGs (e.g., with SDG 8, see [ 30 ]) in a synergetic perspective [ 10 ]. Many bodies of literature (e.g., business, economics, development studies, sociology and psychology) approach the problem of achieving gender equality from different perspectives–often addressing specific and narrow aspects. This sometimes leads to a lack of clarity about how different issues, circumstances, and solutions may be related in precipitating or mitigating gender inequality or its effects. As the number of papers grows at an increasing pace, this issue is exacerbated and there is a need to step back and survey the body of gender equality literature as a whole. There is also a need to examine synergies between different topics and approaches, as well as gaps in our understanding of how different problems and solutions work together. Considering the important topic of women’s economic and social empowerment, this paper aims to fill this gap by answering the following research question: what are the most relevant findings in the literature on gender equality and how do they relate to each other ?

To do so, we conduct a scoping review [ 31 ], providing a synthesis of 15,465 articles dealing with gender equity related issues published in the last twenty-two years, covering both the periods of the MDGs and the SDGs (i.e., 2000 to mid 2021) in all the journals indexed in the Academic Journal Guide’s 2018 ranking of business and economics journals. Given the huge amount of research conducted on the topic, we adopt an innovative methodology, which relies on social network analysis and text mining. These techniques are increasingly adopted when surveying large bodies of text. Recently, they were applied to perform analysis of online gender communication differences [ 32 ] and gender behaviors in online technology communities [ 33 ], to identify and classify sexual harassment instances in academia [ 34 ], and to evaluate the gender inclusivity of disaster management policies [ 35 ].

Applied to the title, abstracts and keywords of the articles in our sample, this methodology allows us to identify a set of 27 recurrent topics within which we automatically classify the papers. Introducing additional novelty, by means of the Semantic Brand Score (SBS) indicator [ 36 ] and the SBS BI app [ 37 ], we assess the importance of each topic in the overall gender equality discourse and its relationships with the other topics, as well as trends over time, with a more accurate description than that offered by traditional literature reviews relying solely on the number of papers presented in each topic.

This methodology, applied to gender equality research spanning the past twenty-two years, enables two key contributions. First, we extract the main message that each document is conveying and how this is connected to other themes in literature, providing a rich picture of the topics that are at the center of the discourse, as well as of the emerging topics. Second, by examining the semantic relationship between topics and how tightly their discourses are linked, we can identify the key relationships and connections between different topics. This semi-automatic methodology is also highly reproducible with minimum effort.

This literature review is organized as follows. In the next section, we present how we selected relevant papers and how we analyzed them through text mining and social network analysis. We then illustrate the importance of 27 selected research topics, measured by means of the SBS indicator. In the results section, we present an overview of the literature based on the SBS results–followed by an in-depth narrative analysis of the top 10 topics (i.e., those with the highest SBS) and their connections. Subsequently, we highlight a series of under-studied connections between the topics where there is potential for future research. Through this analysis, we build a map of the main gender-research trends in the last twenty-two years–presenting the most popular themes. We conclude by highlighting key areas on which research should focused in the future.

Our aim is to map a broad topic, gender equality research, that has been approached through a host of different angles and through different disciplines. Scoping reviews are the most appropriate as they provide the freedom to map different themes and identify literature gaps, thereby guiding the recommendation of new research agendas [ 38 ].

Several practical approaches have been proposed to identify and assess the underlying topics of a specific field using big data [ 39 – 41 ], but many of them fail without proper paper retrieval and text preprocessing. This is specifically true for a research field such as the gender-related one, which comprises the work of scholars from different backgrounds. In this section, we illustrate a novel approach for the analysis of scientific (gender-related) papers that relies on methods and tools of social network analysis and text mining. Our procedure has four main steps: (1) data collection, (2) text preprocessing, (3) keywords extraction and classification, and (4) evaluation of semantic importance and image.

Data collection

In this study, we analyze 22 years of literature on gender-related research. Following established practice for scoping reviews [ 42 ], our data collection consisted of two main steps, which we summarize here below.

Firstly, we retrieved from the Scopus database all the articles written in English that contained the term “gender” in their title, abstract or keywords and were published in a journal listed in the Academic Journal Guide 2018 ranking of the Chartered Association of Business Schools (CABS) ( https://charteredabs.org/wp-content/uploads/2018/03/AJG2018-Methodology.pdf ), considering the time period from Jan 2000 to May 2021. We used this information considering that abstracts, titles and keywords represent the most informative part of a paper, while using the full-text would increase the signal-to-noise ratio for information extraction. Indeed, these textual elements already demonstrated to be reliable sources of information for the task of domain lexicon extraction [ 43 , 44 ]. We chose Scopus as source of literature because of its popularity, its update rate, and because it offers an API to ease the querying process. Indeed, while it does not allow to retrieve the full text of scientific articles, the Scopus API offers access to titles, abstracts, citation information and metadata for all its indexed scholarly journals. Moreover, we decided to focus on the journals listed in the AJG 2018 ranking because we were interested in reviewing business and economics related gender studies only. The AJG is indeed widely used by universities and business schools as a reference point for journal and research rigor and quality. This first step, executed in June 2021, returned more than 55,000 papers.

In the second step–because a look at the papers showed very sparse results, many of which were not in line with the topic of this literature review (e.g., papers dealing with health care or medical issues, where the word gender indicates the gender of the patients)–we applied further inclusion criteria to make the sample more focused on the topic of this literature review (i.e., women’s gender equality issues). Specifically, we only retained those papers mentioning, in their title and/or abstract, both gender-related keywords (e.g., daughter, female, mother) and keywords referring to bias and equality issues (e.g., equality, bias, diversity, inclusion). After text pre-processing (see next section), keywords were first identified from a frequency-weighted list of words found in the titles, abstracts and keywords in the initial list of papers, extracted through text mining (following the same approach as [ 43 ]). They were selected by two of the co-authors independently, following respectively a bottom up and a top-down approach. The bottom-up approach consisted of examining the words found in the frequency-weighted list and classifying those related to gender and equality. The top-down approach consisted in searching in the word list for notable gender and equality-related words. Table 1 reports the sets of keywords we considered, together with some examples of words that were used to search for their presence in the dataset (a full list is provided in the S1 Text ). At end of this second step, we obtained a final sample of 15,465 relevant papers.

Text processing and keyword extraction

Text preprocessing aims at structuring text into a form that can be analyzed by statistical models. In the present section, we describe the preprocessing steps we applied to paper titles and abstracts, which, as explained below, partially follow a standard text preprocessing pipeline [ 45 ]. These activities have been performed using the R package udpipe [ 46 ].

The first step is n-gram extraction (i.e., a sequence of words from a given text sample) to identify which n-grams are important in the analysis, since domain-specific lexicons are often composed by bi-grams and tri-grams [ 47 ]. Multi-word extraction is usually implemented with statistics and linguistic rules, thus using the statistical properties of n-grams or machine learning approaches [ 48 ]. However, for the present paper, we used Scopus metadata in order to have a more effective and efficient n-grams collection approach [ 49 ]. We used the keywords of each paper in order to tag n-grams with their associated keywords automatically. Using this greedy approach, it was possible to collect all the keywords listed by the authors of the papers. From this list, we extracted only keywords composed by two, three and four words, we removed all the acronyms and rare keywords (i.e., appearing in less than 1% of papers), and we clustered keywords showing a high orthographic similarity–measured using a Levenshtein distance [ 50 ] lower than 2, considering these groups of keywords as representing same concepts, but expressed with different spelling. After tagging the n-grams in the abstracts, we followed a common data preparation pipeline that consists of the following steps: (i) tokenization, that splits the text into tokens (i.e., single words and previously tagged multi-words); (ii) removal of stop-words (i.e. those words that add little meaning to the text, usually being very common and short functional words–such as “and”, “or”, or “of”); (iii) parts-of-speech tagging, that is providing information concerning the morphological role of a word and its morphosyntactic context (e.g., if the token is a determiner, the next token is a noun or an adjective with very high confidence, [ 51 ]); and (iv) lemmatization, which consists in substituting each word with its dictionary form (or lemma). The output of the latter step allows grouping together the inflected forms of a word. For example, the verbs “am”, “are”, and “is” have the shared lemma “be”, or the nouns “cat” and “cats” both share the lemma “cat”. We preferred lemmatization over stemming [ 52 ] in order to obtain more interpretable results.

In addition, we identified a further set of keywords (with respect to those listed in the “keywords” field) by applying a series of automatic words unification and removal steps, as suggested in past research [ 53 , 54 ]. We removed: sparse terms (i.e., occurring in less than 0.1% of all documents), common terms (i.e., occurring in more than 10% of all documents) and retained only nouns and adjectives. It is relevant to notice that no document was lost due to these steps. We then used the TF-IDF function [ 55 ] to produce a new list of keywords. We additionally tested other approaches for the identification and clustering of keywords–such as TextRank [ 56 ] or Latent Dirichlet Allocation [ 57 ]–without obtaining more informative results.

Classification of research topics

To guide the literature analysis, two experts met regularly to examine the sample of collected papers and to identify the main topics and trends in gender research. Initially, they conducted brainstorming sessions on the topics they expected to find, due to their knowledge of the literature. This led to an initial list of topics. Subsequently, the experts worked independently, also supported by the keywords in paper titles and abstracts extracted with the procedure described above.

Considering all this information, each expert identified and clustered relevant keywords into topics. At the end of the process, the two assignments were compared and exhibited a 92% agreement. Another meeting was held to discuss discordant cases and reach a consensus. This resulted in a list of 27 topics, briefly introduced in Table 2 and subsequently detailed in the following sections.

Evaluation of semantic importance

Working on the lemmatized corpus of the 15,465 papers included in our sample, we proceeded with the evaluation of semantic importance trends for each topic and with the analysis of their connections and prevalent textual associations. To this aim, we used the Semantic Brand Score indicator [ 36 ], calculated through the SBS BI webapp [ 37 ] that also produced a brand image report for each topic. For this study we relied on the computing resources of the ENEA/CRESCO infrastructure [ 58 ].

The Semantic Brand Score (SBS) is a measure of semantic importance that combines methods of social network analysis and text mining. It is usually applied for the analysis of (big) textual data to evaluate the importance of one or more brands, names, words, or sets of keywords [ 36 ]. Indeed, the concept of “brand” is intended in a flexible way and goes beyond products or commercial brands. In this study, we evaluate the SBS time-trends of the keywords defining the research topics discussed in the previous section. Semantic importance comprises the three dimensions of topic prevalence, diversity and connectivity. Prevalence measures how frequently a research topic is used in the discourse. The more a topic is mentioned by scientific articles, the more the research community will be aware of it, with possible increase of future studies; this construct is partly related to that of brand awareness [ 59 ]. This effect is even stronger, considering that we are analyzing the title, abstract and keywords of the papers, i.e. the parts that have the highest visibility. A very important characteristic of the SBS is that it considers the relationships among words in a text. Topic importance is not just a matter of how frequently a topic is mentioned, but also of the associations a topic has in the text. Specifically, texts are transformed into networks of co-occurring words, and relationships are studied through social network analysis [ 60 ]. This step is necessary to calculate the other two dimensions of our semantic importance indicator. Accordingly, a social network of words is generated for each time period considered in the analysis–i.e., a graph made of n nodes (words) and E edges weighted by co-occurrence frequency, with W being the set of edge weights. The keywords representing each topic were clustered into single nodes.

The construct of diversity relates to that of brand image [ 59 ], in the sense that it considers the richness and distinctiveness of textual (topic) associations. Considering the above-mentioned networks, we calculated diversity using the distinctiveness centrality metric–as in the formula presented by Fronzetti Colladon and Naldi [ 61 ].

Lastly, connectivity was measured as the weighted betweenness centrality [ 62 , 63 ] of each research topic node. We used the formula presented by Wasserman and Faust [ 60 ]. The dimension of connectivity represents the “brokerage power” of each research topic–i.e., how much it can serve as a bridge to connect other terms (and ultimately topics) in the discourse [ 36 ].

The SBS is the final composite indicator obtained by summing the standardized scores of prevalence, diversity and connectivity. Standardization was carried out considering all the words in the corpus, for each specific timeframe.

This methodology, applied to a large and heterogeneous body of text, enables to automatically identify two important sets of information that add value to the literature review. Firstly, the relevance of each topic in literature is measured through a composite indicator of semantic importance, rather than simply looking at word frequencies. This provides a much richer picture of the topics that are at the center of the discourse, as well as of the topics that are emerging in the literature. Secondly, it enables to examine the extent of the semantic relationship between topics, looking at how tightly their discourses are linked. In a field such as gender equality, where many topics are closely linked to each other and present overlaps in issues and solutions, this methodology offers a novel perspective with respect to traditional literature reviews. In addition, it ensures reproducibility over time and the possibility to semi-automatically update the analysis, as new papers become available.

Overview of main topics

In terms of descriptive textual statistics, our corpus is made of 15,465 text documents, consisting of a total of 2,685,893 lemmatized tokens (words) and 32,279 types. As a result, the type-token ratio is 1.2%. The number of hapaxes is 12,141, with a hapax-token ratio of 37.61%.

Fig 1 shows the list of 27 topics by decreasing SBS. The most researched topic is compensation , exceeding all others in prevalence, diversity, and connectivity. This means it is not only mentioned more often than other topics, but it is also connected to a greater number of other topics and is central to the discourse on gender equality. The next four topics are, in order of SBS, role , education , decision-making , and career progression . These topics, except for education , all concern women in the workforce. Between these first five topics and the following ones there is a clear drop in SBS scores. In particular, the topics that follow have a lower connectivity than the first five. They are hiring , performance , behavior , organization , and human capital . Again, except for behavior and human capital , the other three topics are purely related to women in the workforce. After another drop-off, the following topics deal prevalently with women in society. This trend highlights that research on gender in business journals has so far mainly paid attention to the conditions that women experience in business contexts, while also devoting some attention to women in society.

Fig 2 shows the SBS time series of the top 10 topics. While there has been a general increase in the number of Scopus-indexed publications in the last decade, we notice that some SBS trends remain steady, or even decrease. In particular, we observe that the main topic of the last twenty-two years, compensation , is losing momentum. Since 2016, it has been surpassed by decision-making , education and role , which may indicate that literature is increasingly attempting to identify root causes of compensation inequalities. Moreover, in the last two years, the topics of hiring , performance , and organization are experiencing the largest importance increase.

Fig 3 shows the SBS time trends of the remaining 17 topics (i.e., those not in the top 10). As we can see from the graph, there are some that maintain a steady trend–such as reputation , management , networks and governance , which also seem to have little importance. More relevant topics with average stationary trends (except for the last two years) are culture , family , and parenting . The feminine topic is among the most important here, and one of those that exhibit the larger variations over time (similarly to leadership ). On the other hand, the are some topics that, even if not among the most important, show increasing SBS trends; therefore, they could be considered as emerging topics and could become popular in the near future. These are entrepreneurship , leadership , board of directors , and sustainability . These emerging topics are also interesting to anticipate future trends in gender equality research that are conducive to overall equality in society.

In addition to the SBS score of the different topics, the network of terms they are associated to enables to gauge the extent to which their images (textual associations) overlap or differ ( Fig 4 ).

There is a central cluster of topics with high similarity, which are all connected with women in the workforce. The cluster includes topics such as organization , decision-making , performance , hiring , human capital , education and compensation . In addition, the topic of well-being is found within this cluster, suggesting that women’s equality in the workforce is associated to well-being considerations. The emerging topics of entrepreneurship and leadership are also closely connected with each other, possibly implying that leadership is a much-researched quality in female entrepreneurship. Topics that are relatively more distant include personality , politics , feminine , empowerment , management , board of directors , reputation , governance , parenting , masculine and network .

The following sections describe the top 10 topics and their main associations in literature (see Table 3 ), while providing a brief overview of the emerging topics.

Compensation

The topic of compensation is related to the topics of role , hiring , education and career progression , however, also sees a very high association with the words gap and inequality . Indeed, a well-known debate in degrowth economics centers around whether and how to adequately compensate women for their childbearing, childrearing, caregiver and household work [e.g., 30 ].

Even in paid work, women continue being offered lower compensations than their male counterparts who have the same job or cover the same role [ 64 – 67 ]. This severe inequality has been widely studied by scholars over the last twenty-two years. Dealing with this topic, some specific roles have been addressed. Specifically, research highlighted differences in compensation between female and male CEOs [e.g., 68 ], top executives [e.g., 69 ], and boards’ directors [e.g., 70 ]. Scholars investigated the determinants of these gaps, such as the gender composition of the board [e.g., 71 – 73 ] or women’s individual characteristics [e.g., 71 , 74 ].

Among these individual characteristics, education plays a relevant role [ 75 ]. Education is indeed presented as the solution for women, not only to achieve top executive roles, but also to reduce wage inequality [e.g., 76 , 77 ]. Past research has highlighted education influences on gender wage gaps, specifically referring to gender differences in skills [e.g., 78 ], college majors [e.g., 79 ], and college selectivity [e.g., 80 ].

Finally, the wage gap issue is strictly interrelated with hiring –e.g., looking at whether being a mother affects hiring and compensation [e.g., 65 , 81 ] or relating compensation to unemployment [e.g., 82 ]–and career progression –for instance looking at meritocracy [ 83 , 84 ] or the characteristics of the boss for whom women work [e.g., 85 ].

The roles covered by women have been deeply investigated. Scholars have focused on the role of women in their families and the society as a whole [e.g., 14 , 15 ], and, more widely, in business contexts [e.g., 18 , 81 ]. Indeed, despite still lagging behind their male counterparts [e.g., 86 , 87 ], in the last decade there has been an increase in top ranked positions achieved by women [e.g., 88 , 89 ]. Following this phenomenon, scholars have posed greater attention towards the presence of women in the board of directors [e.g., 16 , 18 , 90 , 91 ], given the increasing pressure to appoint female directors that firms, especially listed ones, have experienced. Other scholars have focused on the presence of women covering the role of CEO [e.g., 17 , 92 ] or being part of the top management team [e.g., 93 ]. Irrespectively of the level of analysis, all these studies tried to uncover the antecedents of women’s presence among top managers [e.g., 92 , 94 ] and the consequences of having a them involved in the firm’s decision-making –e.g., on performance [e.g., 19 , 95 , 96 ], risk [e.g., 97 , 98 ], and corporate social responsibility [e.g., 99 , 100 ].

Besides studying the difficulties and discriminations faced by women in getting a job [ 81 , 101 ], and, more specifically in the hiring , appointment, or career progression to these apical roles [e.g., 70 , 83 ], the majority of research of women’s roles dealt with compensation issues. Specifically, scholars highlight the pay-gap that still exists between women and men, both in general [e.g., 64 , 65 ], as well as referring to boards’ directors [e.g., 70 , 102 ], CEOs and executives [e.g., 69 , 103 , 104 ].

Finally, other scholars focused on the behavior of women when dealing with business. In this sense, particular attention has been paid to leadership and entrepreneurial behaviors. The former quite overlaps with dealing with the roles mentioned above, but also includes aspects such as leaders being stereotyped as masculine [e.g., 105 ], the need for greater exposure to female leaders to reduce biases [e.g., 106 ], or female leaders acting as queen bees [e.g., 107 ]. Regarding entrepreneurship , scholars mainly investigated women’s entrepreneurial entry [e.g., 108 , 109 ], differences between female and male entrepreneurs in the evaluations and funding received from investors [e.g., 110 , 111 ], and their performance gap [e.g., 112 , 113 ].

Education has long been recognized as key to social advancement and economic stability [ 114 ], for job progression and also a barrier to gender equality, especially in STEM-related fields. Research on education and gender equality is mostly linked with the topics of compensation , human capital , career progression , hiring , parenting and decision-making .

Education contributes to a higher human capital [ 115 ] and constitutes an investment on the part of women towards their future. In this context, literature points to the gender gap in educational attainment, and the consequences for women from a social, economic, personal and professional standpoint. Women are found to have less access to formal education and information, especially in emerging countries, which in turn may cause them to lose social and economic opportunities [e.g., 12 , 116 – 119 ]. Education in local and rural communities is also paramount to communicate the benefits of female empowerment , contributing to overall societal well-being [e.g., 120 ].

Once women access education, the image they have of the world and their place in society (i.e., habitus) affects their education performance [ 13 ] and is passed on to their children. These situations reinforce gender stereotypes, which become self-fulfilling prophecies that may negatively affect female students’ performance by lowering their confidence and heightening their anxiety [ 121 , 122 ]. Besides formal education, also the information that women are exposed to on a daily basis contributes to their human capital . Digital inequalities, for instance, stems from men spending more time online and acquiring higher digital skills than women [ 123 ].

Education is also a factor that should boost employability of candidates and thus hiring , career progression and compensation , however the relationship between these factors is not straightforward [ 115 ]. First, educational choices ( decision-making ) are influenced by variables such as self-efficacy and the presence of barriers, irrespectively of the career opportunities they offer, especially in STEM [ 124 ]. This brings additional difficulties to women’s enrollment and persistence in scientific and technical fields of study due to stereotypes and biases [ 125 , 126 ]. Moreover, access to education does not automatically translate into job opportunities for women and minority groups [ 127 , 128 ] or into female access to managerial positions [ 129 ].

Finally, parenting is reported as an antecedent of education [e.g., 130 ], with much of the literature focusing on the role of parents’ education on the opportunities afforded to children to enroll in education [ 131 – 134 ] and the role of parenting in their offspring’s perception of study fields and attitudes towards learning [ 135 – 138 ]. Parental education is also a predictor of the other related topics, namely human capital and compensation [ 139 ].

Decision-making

This literature mainly points to the fact that women are thought to make decisions differently than men. Women have indeed different priorities, such as they care more about people’s well-being, working with people or helping others, rather than maximizing their personal (or their firm’s) gain [ 140 ]. In other words, women typically present more communal than agentic behaviors, which are instead more frequent among men [ 141 ]. These different attitude, behavior and preferences in turn affect the decisions they make [e.g., 142 ] and the decision-making of the firm in which they work [e.g., 143 ].

At the individual level, gender affects, for instance, career aspirations [e.g., 144 ] and choices [e.g., 142 , 145 ], or the decision of creating a venture [e.g., 108 , 109 , 146 ]. Moreover, in everyday life, women and men make different decisions regarding partners [e.g., 147 ], childcare [e.g., 148 ], education [e.g., 149 ], attention to the environment [e.g., 150 ] and politics [e.g., 151 ].

At the firm level, scholars highlighted, for example, how the presence of women in the board affects corporate decisions [e.g., 152 , 153 ], that female CEOs are more conservative in accounting decisions [e.g., 154 ], or that female CFOs tend to make more conservative decisions regarding the firm’s financial reporting [e.g., 155 ]. Nevertheless, firm level research also investigated decisions that, influenced by gender bias, affect women, such as those pertaining hiring [e.g., 156 , 157 ], compensation [e.g., 73 , 158 ], or the empowerment of women once appointed [ 159 ].

Career progression

Once women have entered the workforce, the key aspect to achieve gender equality becomes career progression , including efforts toward overcoming the glass ceiling. Indeed, according to the SBS analysis, career progression is highly related to words such as work, social issues and equality. The topic with which it has the highest semantic overlap is role , followed by decision-making , hiring , education , compensation , leadership , human capital , and family .

Career progression implies an advancement in the hierarchical ladder of the firm, assigning managerial roles to women. Coherently, much of the literature has focused on identifying rationales for a greater female participation in the top management team and board of directors [e.g., 95 ] as well as the best criteria to ensure that the decision-makers promote the most valuable employees irrespectively of their individual characteristics, such as gender [e.g., 84 ]. The link between career progression , role and compensation is often provided in practice by performance appraisal exercises, frequently rooted in a culture of meritocracy that guides bonuses, salary increases and promotions. However, performance appraisals can actually mask gender-biased decisions where women are held to higher standards than their male colleagues [e.g., 83 , 84 , 95 , 160 , 161 ]. Women often have less opportunities to gain leadership experience and are less visible than their male colleagues, which constitute barriers to career advancement [e.g., 162 ]. Therefore, transparency and accountability, together with procedures that discourage discretionary choices, are paramount to achieve a fair career progression [e.g., 84 ], together with the relaxation of strict job boundaries in favor of cross-functional and self-directed tasks [e.g., 163 ].

In addition, a series of stereotypes about the type of leadership characteristics that are required for top management positions, which fit better with typical male and agentic attributes, are another key barrier to career advancement for women [e.g., 92 , 160 ].

Hiring is the entrance gateway for women into the workforce. Therefore, it is related to other workforce topics such as compensation , role , career progression , decision-making , human capital , performance , organization and education .

A first stream of literature focuses on the process leading up to candidates’ job applications, demonstrating that bias exists before positions are even opened, and it is perpetuated both by men and women through networking and gatekeeping practices [e.g., 164 , 165 ].

The hiring process itself is also subject to biases [ 166 ], for example gender-congruity bias that leads to men being preferred candidates in male-dominated sectors [e.g., 167 ], women being hired in positions with higher risk of failure [e.g., 168 ] and limited transparency and accountability afforded by written processes and procedures [e.g., 164 ] that all contribute to ascriptive inequality. In addition, providing incentives for evaluators to hire women may actually work to this end; however, this is not the case when supporting female candidates endangers higher-ranking male ones [ 169 ].

Another interesting perspective, instead, looks at top management teams’ composition and the effects on hiring practices, indicating that firms with more women in top management are less likely to lay off staff [e.g., 152 ].

Performance

Several scholars posed their attention towards women’s performance, its consequences [e.g., 170 , 171 ] and the implications of having women in decision-making positions [e.g., 18 , 19 ].

At the individual level, research focused on differences in educational and academic performance between women and men, especially referring to the gender gap in STEM fields [e.g., 171 ]. The presence of stereotype threats–that is the expectation that the members of a social group (e.g., women) “must deal with the possibility of being judged or treated stereotypically, or of doing something that would confirm the stereotype” [ 172 ]–affects women’s interested in STEM [e.g., 173 ], as well as their cognitive ability tests, penalizing them [e.g., 174 ]. A stronger gender identification enhances this gap [e.g., 175 ], whereas mentoring and role models can be used as solutions to this problem [e.g., 121 ]. Despite the negative effect of stereotype threats on girls’ performance [ 176 ], female and male students perform equally in mathematics and related subjects [e.g., 177 ]. Moreover, while individuals’ performance at school and university generally affects their achievements and the field in which they end up working, evidence reveals that performance in math or other scientific subjects does not explain why fewer women enter STEM working fields; rather this gap depends on other aspects, such as culture, past working experiences, or self-efficacy [e.g., 170 ]. Finally, scholars have highlighted the penalization that women face for their positive performance, for instance when they succeed in traditionally male areas [e.g., 178 ]. This penalization is explained by the violation of gender-stereotypic prescriptions [e.g., 179 , 180 ], that is having women well performing in agentic areas, which are typical associated to men. Performance penalization can thus be overcome by clearly conveying communal characteristics and behaviors [ 178 ].

Evidence has been provided on how the involvement of women in boards of directors and decision-making positions affects firms’ performance. Nevertheless, results are mixed, with some studies showing positive effects on financial [ 19 , 181 , 182 ] and corporate social performance [ 99 , 182 , 183 ]. Other studies maintain a negative association [e.g., 18 ], and other again mixed [e.g., 184 ] or non-significant association [e.g., 185 ]. Also with respect to the presence of a female CEO, mixed results emerged so far, with some researches demonstrating a positive effect on firm’s performance [e.g., 96 , 186 ], while other obtaining only a limited evidence of this relationship [e.g., 103 ] or a negative one [e.g., 187 ].

Finally, some studies have investigated whether and how women’s performance affects their hiring [e.g., 101 ] and career progression [e.g., 83 , 160 ]. For instance, academic performance leads to different returns in hiring for women and men. Specifically, high-achieving men are called back significantly more often than high-achieving women, which are penalized when they have a major in mathematics; this result depends on employers’ gendered standards for applicants [e.g., 101 ]. Once appointed, performance ratings are more strongly related to promotions for women than men, and promoted women typically show higher past performance ratings than those of promoted men. This suggesting that women are subject to stricter standards for promotion [e.g., 160 ].

Behavioral aspects related to gender follow two main streams of literature. The first examines female personality and behavior in the workplace, and their alignment with cultural expectations or stereotypes [e.g., 188 ] as well as their impacts on equality. There is a common bias that depicts women as less agentic than males. Certain characteristics, such as those more congruent with male behaviors–e.g., self-promotion [e.g., 189 ], negotiation skills [e.g., 190 ] and general agentic behavior [e.g., 191 ]–, are less accepted in women. However, characteristics such as individualism in women have been found to promote greater gender equality in society [ 192 ]. In addition, behaviors such as display of emotions [e.g., 193 ], which are stereotypically female, work against women’s acceptance in the workplace, requiring women to carefully moderate their behavior to avoid exclusion. A counter-intuitive result is that women and minorities, which are more marginalized in the workplace, tend to be better problem-solvers in innovation competitions due to their different knowledge bases [ 194 ].

The other side of the coin is examined in a parallel literature stream on behavior towards women in the workplace. As a result of biases, prejudices and stereotypes, women may experience adverse behavior from their colleagues, such as incivility and harassment, which undermine their well-being [e.g., 195 , 196 ]. Biases that go beyond gender, such as for overweight people, are also more strongly applied to women [ 197 ].

Organization

The role of women and gender bias in organizations has been studied from different perspectives, which mirror those presented in detail in the following sections. Specifically, most research highlighted the stereotypical view of leaders [e.g., 105 ] and the roles played by women within firms, for instance referring to presence in the board of directors [e.g., 18 , 90 , 91 ], appointment as CEOs [e.g., 16 ], or top executives [e.g., 93 ].

Scholars have investigated antecedents and consequences of the presence of women in these apical roles. On the one side they looked at hiring and career progression [e.g., 83 , 92 , 160 , 168 , 198 ], finding women typically disadvantaged with respect to their male counterparts. On the other side, they studied women’s leadership styles and influence on the firm’s decision-making [e.g., 152 , 154 , 155 , 199 ], with implications for performance [e.g., 18 , 19 , 96 ].

Human capital

Human capital is a transverse topic that touches upon many different aspects of female gender equality. As such, it has the most associations with other topics, starting with education as mentioned above, with career-related topics such as role , decision-making , hiring , career progression , performance , compensation , leadership and organization . Another topic with which there is a close connection is behavior . In general, human capital is approached both from the education standpoint but also from the perspective of social capital.

The behavioral aspect in human capital comprises research related to gender differences for example in cultural and religious beliefs that influence women’s attitudes and perceptions towards STEM subjects [ 142 , 200 – 202 ], towards employment [ 203 ] or towards environmental issues [ 150 , 204 ]. These cultural differences also emerge in the context of globalization which may accelerate gender equality in the workforce [ 205 , 206 ]. Gender differences also appear in behaviors such as motivation [ 207 ], and in negotiation [ 190 ], and have repercussions on women’s decision-making related to their careers. The so-called gender equality paradox sees women in countries with lower gender equality more likely to pursue studies and careers in STEM fields, whereas the gap in STEM enrollment widens as countries achieve greater equality in society [ 171 ].

Career progression is modeled by literature as a choice-process where personal preferences, culture and decision-making affect the chosen path and the outcomes. Some literature highlights how women tend to self-select into different professions than men, often due to stereotypes rather than actual ability to perform in these professions [ 142 , 144 ]. These stereotypes also affect the perceptions of female performance or the amount of human capital required to equal male performance [ 110 , 193 , 208 ], particularly for mothers [ 81 ]. It is therefore often assumed that women are better suited to less visible and less leadership -oriented roles [ 209 ]. Women also express differing preferences towards work-family balance, which affect whether and how they pursue human capital gains [ 210 ], and ultimately their career progression and salary .

On the other hand, men are often unaware of gendered processes and behaviors that they carry forward in their interactions and decision-making [ 211 , 212 ]. Therefore, initiatives aimed at increasing managers’ human capital –by raising awareness of gender disparities in their organizations and engaging them in diversity promotion–are essential steps to counter gender bias and segregation [ 213 ].

Emerging topics: Leadership and entrepreneurship

Among the emerging topics, the most pervasive one is women reaching leadership positions in the workforce and in society. This is still a rare occurrence for two main types of factors, on the one hand, bias and discrimination make it harder for women to access leadership positions [e.g., 214 – 216 ], on the other hand, the competitive nature and high pressure associated with leadership positions, coupled with the lack of women currently represented, reduce women’s desire to achieve them [e.g., 209 , 217 ]. Women are more effective leaders when they have access to education, resources and a diverse environment with representation [e.g., 218 , 219 ].

One sector where there is potential for women to carve out a leadership role is entrepreneurship . Although at the start of the millennium the discourse on entrepreneurship was found to be “discriminatory, gender-biased, ethnocentrically determined and ideologically controlled” [ 220 ], an increasing body of literature is studying how to stimulate female entrepreneurship as an alternative pathway to wealth, leadership and empowerment [e.g., 221 ]. Many barriers exist for women to access entrepreneurship, including the institutional and legal environment, social and cultural factors, access to knowledge and resources, and individual behavior [e.g., 222 , 223 ]. Education has been found to raise women’s entrepreneurial intentions [e.g., 224 ], although this effect is smaller than for men [e.g., 109 ]. In addition, increasing self-efficacy and risk-taking behavior constitute important success factors [e.g., 225 ].

Finally, the topic of sustainability is worth mentioning, as it is the primary objective of the SDGs and is closely associated with societal well-being. As society grapples with the effects of climate change and increasing depletion of natural resources, a narrative has emerged on women and their greater link to the environment [ 226 ]. Studies in developed countries have found some support for women leaders’ attention to sustainability issues in firms [e.g., 227 – 229 ], and smaller resource consumption by women [ 230 ]. At the same time, women will likely be more affected by the consequences of climate change [e.g., 230 ] but often lack the decision-making power to influence local decision-making on resource management and environmental policies [e.g., 231 ].

Research gaps and conclusions

Research on gender equality has advanced rapidly in the past decades, with a steady increase in publications, both in mainstream topics related to women in education and the workforce, and in emerging topics. Through a novel approach combining methods of text mining and social network analysis, we examined a comprehensive body of literature comprising 15,465 papers published between 2000 and mid 2021 on topics related to gender equality. We identified a set of 27 topics addressed by the literature and examined their connections.

At the highest level of abstraction, it is worth noting that papers abound on the identification of issues related to gender inequalities and imbalances in the workforce and in society. Literature has thoroughly examined the (unconscious) biases, barriers, stereotypes, and discriminatory behaviors that women are facing as a result of their gender. Instead, there are much fewer papers that discuss or demonstrate effective solutions to overcome gender bias [e.g., 121 , 143 , 145 , 163 , 194 , 213 , 232 ]. This is partly due to the relative ease in studying the status quo, as opposed to studying changes in the status quo. However, we observed a shift in the more recent years towards solution seeking in this domain, which we strongly encourage future researchers to focus on. In the future, we may focus on collecting and mapping pro-active contributions to gender studies, using additional Natural Language Processing techniques, able to measure the sentiment of scientific papers [ 43 ].

All of the mainstream topics identified in our literature review are closely related, and there is a wealth of insights looking at the intersection between issues such as education and career progression or human capital and role . However, emerging topics are worthy of being furtherly explored. It would be interesting to see more work on the topic of female entrepreneurship , exploring aspects such as education , personality , governance , management and leadership . For instance, how can education support female entrepreneurship? How can self-efficacy and risk-taking behaviors be taught or enhanced? What are the differences in managerial and governance styles of female entrepreneurs? Which personality traits are associated with successful entrepreneurs? Which traits are preferred by venture capitalists and funding bodies?

The emerging topic of sustainability also deserves further attention, as our society struggles with climate change and its consequences. It would be interesting to see more research on the intersection between sustainability and entrepreneurship , looking at how female entrepreneurs are tackling sustainability issues, examining both their business models and their company governance . In addition, scholars are suggested to dig deeper into the relationship between family values and behaviors.

Moreover, it would be relevant to understand how women’s networks (social capital), or the composition and structure of social networks involving both women and men, enable them to increase their remuneration and reach top corporate positions, participate in key decision-making bodies, and have a voice in communities. Furthermore, the achievement of gender equality might significantly change firm networks and ecosystems, with important implications for their performance and survival.

Similarly, research at the nexus of (corporate) governance , career progression , compensation and female empowerment could yield useful insights–for example discussing how enterprises, institutions and countries are managed and the impact for women and other minorities. Are there specific governance structures that favor diversity and inclusion?

Lastly, we foresee an emerging stream of research pertaining how the spread of the COVID-19 pandemic challenged women, especially in the workforce, by making gender biases more evident.

For our analysis, we considered a set of 15,465 articles downloaded from the Scopus database (which is the largest abstract and citation database of peer-reviewed literature). As we were interested in reviewing business and economics related gender studies, we only considered those papers published in journals listed in the Academic Journal Guide (AJG) 2018 ranking of the Chartered Association of Business Schools (CABS). All the journals listed in this ranking are also indexed by Scopus. Therefore, looking at a single database (i.e., Scopus) should not be considered a limitation of our study. However, future research could consider different databases and inclusion criteria.

With our literature review, we offer researchers a comprehensive map of major gender-related research trends over the past twenty-two years. This can serve as a lens to look to the future, contributing to the achievement of SDG5. Researchers may use our study as a starting point to identify key themes addressed in the literature. In addition, our methodological approach–based on the use of the Semantic Brand Score and its webapp–could support scholars interested in reviewing other areas of research.

Supporting information

Acknowledgments.

The computing resources and the related technical support used for this work have been provided by CRESCO/ENEAGRID High Performance Computing infrastructure and its staff. CRESCO/ENEAGRID High Performance Computing infrastructure is funded by ENEA, the Italian National Agency for New Technologies, Energy and Sustainable Economic Development and by Italian and European research programmes (see http://www.cresco.enea.it/english for information).

Funding Statement

P.B and F.C.: Grant of the Department of Energy, Systems, Territory and Construction of the University of Pisa (DESTEC) for the project “Measuring Gender Bias with Semantic Analysis: The Development of an Assessment Tool and its Application in the European Space Industry. P.B., F.C., A.F.C., P.R.: Grant of the Italian Association of Management Engineering (AiIG), “Misure di sostegno ai soci giovani AiIG” 2020, for the project “Gender Equality Through Data Intelligence (GEDI)”. F.C.: EU project ASSETs+ Project (Alliance for Strategic Skills addressing Emerging Technologies in Defence) EAC/A03/2018 - Erasmus+ programme, Sector Skills Alliances, Lot 3: Sector Skills Alliance for implementing a new strategic approach (Blueprint) to sectoral cooperation on skills G.A. NUMBER: 612678-EPP-1-2019-1-IT-EPPKA2-SSA-B.

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A qualitative study on gender inequality and gender-based violence in Nepal

• Pranab Dahal 1 ,
• Sunil Kumar Joshi 2 &
• Katarina Swahnberg 1  

BMC Public Health volume  22 , Article number:  2005 ( 2022 ) Cite this article

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Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and violence in Nepal. The study aims to explore participants' understanding and experience to identify the status of inequality for women and how violence emerges as one of its consequences. Furthermore, it explores the causes of sex trafficking as an example of an outcome of inequality and violence.

The study formulated separate male and female groups using a purposive sampling method. The study used a multistage focus group discussion, where the same groups met at different intervals. Six focus group discussions, three times each with male and female groups, were conducted in a year. Thirty-six individuals, including sixteen males and twenty females, were involved in the discussions. The study used constructivist grounded theory for the data analysis.

The study participants identify that a power play between men and women reinforce inequality and increases the likelihood of violence for women. The findings suggest that the subjugation of women occurs due to practices based on gender differences, constricted life opportunities, and internalization of constructed differences among women. The study identifies that interpersonal and socio-cultural violence can result due to established differences between men and women. Sex trafficking, as an example of the outcome of inequality and violence, occurs due to the disadvantageous position of women compounded by poverty and illiteracy. The study has developed a concept of power-play which is identified as a cause and consequence of women's subordination and violence. This power play is found operative at various levels with social approval for men to use violence and maintain/produce inequality.

The theoretical concept of power play shows that there are inequitable power relations between men and women. The male-centric socio-cultural norms and practices have endowed men with privilege, power, and an opportunity to exploit women. This lowers the status of women and the power-play help to produce and sustain inequality. The power-play exposes women to violence and manifests itself as one of the worst expressions used by men.

Peer Review reports

Violence against women is identified as an attempt by men to maintain power and control over women [ 1 ] and is manifested as a form of structural inequality. This structural inequality is apparent with greater agency among men [ 2 ]. The differences between sexes are exhibited in the attainment of education and professional jobs, ownership of assets, the feminization of poverty, etc., and these differences increase the risk of violence towards women [ 3 ]. The global estimate identifies that thirty percent of women experience physical and/or sexual violence during their lifetime, illustrating the enormity of this problem [ 4 ]. From a feminist perspective, lending ideas of patriarchy [ 5 ] and gender performativity [ 6 ], the understanding of gender roles prescribed by male-dominated social structures and processes helps further explore the violence and abuse faced by women [ 7 ]. According to Heise [ 8 ], men who adhere to traditional, rigid, and misogynistic views on gender norms, attitudes, and behaviors are more likely to use violence towards women. The individual and collective attitudes of men toward different established gender norms, and their reproduction explain men’s use of violence toward women [ 9 ]. It is known that gender norms influence violence, but at the same time violence also directs and dictates gender performance with fear, sanction, and corrective measures for enacting respective prescribed gender functions [ 10 ].

It is difficult for women subjected to violence to enjoy legitimate rights, as most of the infringement of their rights and violence takes place inside a private sphere of the home [ 11 , 12 ]. Violence against women is the major cause of death and disability for women [ 13 ] and globally a major public health concern [ 14 ]. Establishing gender equality is fundamental for fostering justice and attaining sustainable development [ 15 ]; moreover, violence against women has to be acknowledged as a fundamental abuse of human rights [ 16 ]. A report on global violence has identified that violence against women exists at all levels of the family, community, and state. The report recommended the development of frameworks for respecting, protecting, and fulfilling women’s rights [ 17 ]. Fifteen years later, a review of the same identifies that violence continues with impunity, reaffirming violence as a major obstacle to the attainment of justice [ 18 ].

The inclusion of the gender lens to violence against women has provided more contextual evidence to explore these processes of violence. This requires the identification of unequal power relationships and an inquiry into the differences-producing various gender stereotypes [ 19 ]. This analysis of violence requires an understanding of behaviors that promote women’s subordination and factors that favor men to sustain these malpractices [ 8 ]. A closer look at the male-centric structural arrangements embedded in the social, political, and economic organization of life reveals that these structures provide lesser access and lower accountability toward women, promote systemic subordination, and create hierarchies, resulting in the increase of violence against women [ 20 ]. This unequal gender power relationship reinforced and manifested by social approval of men’s authority over women is found operative at multiple levels and helps to produce diversities of inequalities and violence [ 21 , 22 ].

The inequalities faced by women in Nepal majorly stem from socio-cultural, economic, and religious factors and influencers that define traditional roles and responsibilities between men and women [ 23 ]. The inequalities are more evident and pronounced in settings exhibiting prominent patriarchal norms restricting advantages and opportunities for the majority of women [ 24 ]. Women in Nepal are restricted inside their homes, have lesser access to life opportunities, and have limited or no involvement in decision-making on important issues directly affecting their lives [ 25 , 26 ]. Figures indicative of women’s inequalities in Nepal suggest that one-third of women have no education, fifty-two percent of women are involved in non-paid jobs, and women are less likely than men to own a home or land [ 27 ]. The men in Nepalese society are positioned higher and are expected to be the breadwinner and protectors of their families. Most of these men intend to earn respect and obedience from women and are socially expected to discipline women to achieve it [ 28 ]. Many societies across the world including Nepal, recognizes violence as a private affair requiring discussion only within a family. This has led to a serious underreporting of violence committed toward women in Nepal [ 29 ]. The national gender data in Nepal is scarce, the available Nepal Demographic Health Survey 2016 identifies that since the age of fifteen, twenty-two percent of women and seven percent of women experience physical and sexual violence, respectively in the past twelve months [ 27 ].

The contributing factors for violence against women in Nepal include the lower social status of women, illiteracy, economic dependency, patriarchal society, sex trafficking, alcohol-related abuse, dowry-related violence, infidelity, extramarital affairs of husband, unemployment, and denial of sex with husband [ 30 , 31 , 32 ]. Nepalese women have been repressing violence with silence due to the fear of breaking relationships, receiving less love and affection from family, fear of social norms by going against men, lack of faith in the justice system, and the threat of increased violence [ 33 ]. Women and girls in Nepal are sex trafficked to various countries. Sex trafficking in Nepal is prevalent due to persistent gender inequality, violence, stigma, and discriminatory socio-cultural structures; however, the actual extent of sex trafficking is still undetermined [ 17 , 34 , 35 ].

The recent trends in Nepal with the increasing number of out-migration of men for employment have provided women with temporary autonomy, and a shift in the gender roles. Earlier research has identified that migration of male spouses has provided a resistance to the power dynamics for women on the other hand it has limited their mobility, required them to share decision-making with household structures, face continued social vigilance on the money received from remittance, and get central attention with their personal sexual lives [ 36 , 37 ].

Morang district lies in the eastern region of Nepal. A district profile report based on a census survey [ 38 ] identifies that the place is inhabited by a close to a million population, out of which ethnic groups ( close to forty percent) live in the district with a majority (seventy-eight percent) of its population living in the rural areas. Tharu an ethnic group is one of the dominant population in the study area and all study participants for this study were from same Tharu population. A close to thirty-six percent of women in the district are illiterate and the average age of marriage is eighteen years. The report identifies that only twenty-three percent of women engage in economic activities apart from agricultural work and less than fourteen percent of women head the household. Almost eighty percent of the population in the district practice Hinduism.

This study is a part of a large intervention project and it was focused to establish a qualitative baseline of the gender status in the study area. This study aimed to explore participants’ experiences and understanding of gender inequality, violence against women, and information on sex trafficking in the Morang district of eastern Nepal. The selection of sex trafficking topic was motivated to assess the respondents’ general understanding of one of the consequences of inequality and violence faced by women. The study focused to explore factors that help to produce and sustain the practice of gender inequality and violence against women in the local community.

Participants

This study was part of a larger control-comparison project that used Forum Theatre interventions to promote gender equality, reduce violence against women, and increase awareness of sex trafficking [ 39 , 40 ]. The participants for the focus group discussion included the intervention population from one of the randomly sampled intervention sites. A multistage focus group discussion [ 41 ] was used involving the same participants discussing various emerging topics at different periods. The participants were recruited voluntarily during an earlier quantitative data collection for the project. The study used a purposive sampling method for the selection of participants. The local field staff at the study site facilitated the recruitment of the participants. The study formulated separate male and female groups. A total of six focus groups, three each with male and female groups were conducted over twelve months. Two inclusion criteria were set for participation. First, the participants had to be part of the population of the larger study. Secondly, they had to witness and/or participate in the Forum Theatre interventions conducted in between the study. The set inclusion criteria served a dual purpose of understanding the causes of inequality and violence and further helped to develop and determine the efficacy of participatory Forum Theater intervention for awareness-raising among the study intervention groups [ 39 ].

A total of thirty-six participants consisting of sixteen males and twenty females joined the discussions. The first discussion consisted of eight participants each from groups while the second and the third discussion missed two female and four male participants respectively. The majority of the participants were 20–29 years old. Tharu, an ethnic community of Nepal, is a dominant population in the study area, and all the participants belonged to the same Tharu community. Only one female participant was unmarried, and a single married male participated in the discussions. All participants were literate, with four males completing a bachelor's level of education. Seven female participants had education below the high school level. The nuclear family with parents and their children was the major family type identified in both male and female groups. Table 1 provides the detail of the participants.

The focus group discussions were conducted in January 2017, April–May 2017, and January 2018. The discussions were conducted in a place recommended by the participants. An isolated place in an open setting at the premise of a local temple was used for conducting all discussions. The participants were briefed about the objectives of the discussion and written consent was obtained for their participation. Verbal consent was taken for the audio recording of the discussions. Each participant was assigned a unique numerical code before the discussions to ensure anonymity during recording, note-taking, and analysis. The discussions averaged ninety minutes during each session. The discussions were conducted with the same participants and no new participants were added during the follow-ups. A single male and female participant were missing in the second follow up and two male participants missed the final follow-up. The reason for missing participants was due to their unavailability as they were out of the village due to personal reasons.

The discussions were conducted in the Nepali language. The first author moderated all six discussions, a support field staff member took the notes, and the last author observed the discussions. The audio recordings were translated into English, and the transcriptions were checked with the recordings to verify accuracy. The field and the discussion notes were used during various stages of data analysis. The notes provided information on the discussion setting, as well as the verbal and nonverbal expressions of the participants. The notes helped to assess the impressions, emphasis, and feelings of the participants during the discussions.

The discussions used pre-formulated discussion guides with open-ended questions on inequalities, gender practices, violence, and sex trafficking. The guiding questions were based on the theoretical premise of discrimination, patriarchy, oppression, hegemony, and participation of women. Three separate discussion guides were developed for each of discussions. The guides were developed by the first and last authors. Probing was done on several occasions during the discussion to gain more clarity on the issue. Cross-checking among the participants and between the groups was done to triangulate received information. Any topic deemed appropriate for discussions and/or any unclear issues identified during the initial data analysis came up subsequently in the discussion guide during the follow-ups.

Data analysis

This study used the constructivist grounded theory method. This method adheres to a constructivist philosophical approach wherein both researchers and participants mutually co-construct the meaning of a phenomenon [ 42 ]. This interaction is important since it helps to impart the meaning of shared experiences [ 42 ]. The constructivist grounded theory made it possible to (re) discover gender issues, important for both the researcher and the study participants. This method allowed the study to progress with responsiveness to emerging issues with an in-depth exploration of the identified issues. This clarity was achieved through repeated interactive discussions, analysis of explanations, and sharing of emergent findings with the study participants.

The audio recordings were translated and transcribed into English. Six transcripts from discussions were initially analyzed using a line-by-line coding process. The coding process helped with the fragmentation of data through interactive comparisons. Fifty-two initial codes such as gender differences, restricting women, alcohol-related violence, underreporting of sexual violence, coping, etc. were identified. The later stage of focused coding helped to achieve categorized data, providing logical sense to the developed initial codes. Three focused codes, namely, the subjugation of women, violence, and chasing dreams were formulated during the analysis. The abductive reasoning from the codes, memos, and discussion notes helped to develop the theoretical concept. The development of conceptual abstraction involved an iterative comparison of the data, codes, categories, memos, and discussion notes.

The constant communication between the authors during the stages of data analysis such as the formulation of codes, explanations of concepts, and categories helped to refine the analysis. The shared experiences of the participants and the description of the data collection and analysis included substantial details, enabling comparisons for future research and application to other similar contexts. The reliability of the study is warranted by the theoretical saturation [ 42 ] achieved by this study. This is supported by prolonged engagement with the study participants with communication on the emerging findings, and triangulation.

Reflexivity has a greater significance for the constructivist approach. The first and the second author of Nepalese origin were aware of the socio-cultural norms, stereotypes, values, and stigmas associated with gender in the local context. This helped the study to ascertain the depth of inquiry within the acceptable local normative limits. The non-Nepalese author, familiar with the study participants and Nepalese contexts, witnessed the discussions as an observer. The prior knowledge of the authors helped to critically assess different schemas, perspectives, and explanations shared by the participants. The universality of gender inequality and violence against women and its re-examination in the local context helped the authors to build upon existing knowledge by providing contextual explanations. The diversities among the authors and research participants established a basis for co-creating the perceived and observed realities.

The section below describes the participants’ perceptions and understanding of inequality and violence. The section contains subheadings that were derived as themes in the data analysis. The first theme subjugation of women; discusses how norms, beliefs, and practices produce inferior status and positions for women. The second theme domestic and gender violence; provides a narrative of interpersonal and socio-cultural violence present in the study area. The theme of chasing dreams; discusses the process of sex trafficking as an outcome of violence. The theoretically abstracted concept of power-play identifies the cause for the generation of power imbalance producing inequality and the use of violence by men.

Subjugation of women

The subjugation of women reflected practices and beliefs imparting positional differences for women and their social situation compared to men. The participants shared a common understanding that belief systems adhering to male supremacy have positioned women in a lower status. They provided examples of social practices of male supremacy such as males being considered as the carrier of a family name, legacy, and heritage, while women were referred to as someone else’s property. The socialization of the idea that girls will be married off to a husband and relocate themselves to their homes was identified as the major reason for instilling and perpetuating early gender differences. The participants mentioned that discriminatory practices and seclusion have situated women at the bottom rung of the gender hierarchy, establishing them as socially incompetent individuals or groups. Moreover, they inferred that selective preferences provided preparatory grounds for inequalities, and they remain attached to women throughout their lives. The participants provided examples of unequal access to education and life opportunities as a practice of selective preferences occurring in the community. They mentioned that socialization with these discriminatory beliefs and their practice helped to develop specialized gender roles from an early age. The participants provided an example of how gender intersected with mobility and resource generation in the community, it was clear from the discussions that this has restricted women inside homes but provided freedom and opportunities for men. A female participant expressed,

A woman from a poor family is more than willing to work and support her family. But she is not allowed by the men in the family to work outside of the home.

The participants informed that differences between the sexes were visible for women from a young age. Sharing practical examples from the community, the participants from both groups stated that girls received education mostly in low-cost government and community schools, while boys were enrolled in expensive private schools. They raised concerns that this selective investment for education, cited as the ‘building block of life’ by the participants, installed lesser capacity, and negotiating abilities in girls. A female participant stated,

There are differences in educational opportunities for boys and girls in our community. Family provides more support for a boy’s education by enrolling him in private schools, while a girl mostly gets her education in a community school together with engagement in household work.

The discussions revealed that women required several male anchors for their survival during their various stages of life. The participants provided examples of the shift of anchors for women which traversed from a father to a husband during marriage and later to the male child during her old age. They believed that this tradition of transferring women’s identity established men as a higher social category and stripped women of their individuality and identity. A male participant added,

Women have to remain dependent on men throughout their lives, first with their fathers and later with their husbands. They remain completely dependent as they are not economically active. This makes men believe that they have higher authority.

The female participants provided an example of marriage to illustrate how someone else’s decision-making had been affecting women’s lives. A participant explained that women were held responsible for household activities after marriage and any support for career progression or education was restricted despite her desire for its continuation. It was inferred that women had to drop their hopes and aspirations as the husband and his family made decisions for them. The female participants agreed that this continuous exposure to the ideas of male supremacy makes them start to believe and internalize the idea that women have lesser cognitive abilities and intelligence compared to men. A female participant stated,

Men and women certainly have different mental abilities. Men think and act differently often in a smart way compared to women.

The participants from both groups expressed that youth in the community were developing flexible attitudes and beliefs towards gender roles and responsibilities. They agreed that both young men and women were observed altering their roles and responsibilities shifting from traditional gender ideologies. The participants expressed that instilling these fluidity and flexible approaches in the older generation was impossible as they strictly followed traditional beliefs and practices. Few of the female participants admitted that at times young women also fail to accommodate the situation and reap benefits from available opportunities. The discussions revealed that a few of the women in the community received opportunities for independence and economic empowerment. These women had received entrepreneurial training and various skill development activities for sustaining livelihoods with practical skill-based training in tailoring, beautician, and doll-making. The female participants expressed that opportunities for independence and growth slipped away from them due to a lack of family support, financial constraints, and self-passivity. They explained that starting a business required approval from a family which was difficult to obtain. Moreover, if women made a self-decision to start up on their own, they lacked the initial capital and had to rely on men for obtaining resources. The participants further explained that the denial of men to support women were majorly due to the fear that norms of staying indoors for women will be breached and economic independence may enable women to have a similar financial footing as men. The participants stated that self-passivity in women emerged due to their engagement in household multiple roles, dependency upon males, and lack of decision-making power and abilities. A female participant summed it up by stating,

Some of us women in the community have received entrepreneurial skills training, but we have not been able to use our skills for our growth and development. Once the training finishes, we get back to our household chores and taking care of the children.

The female participants admitted that acceptance of belief systems requiring women to be docile, unseen, and unheard were the reasons for this self-passivity. The female participants resonated that the external controlling and unfavorable environment influenced by practices of discriminatory norms and beliefs developed self-passivity for women. A female participant expressed the cause and consequence of self-passivity as,

Women have inhibitions to speaking their minds; something stops us from making our position clear, making us lose all the time.

The discussions identified that gender norms were deeply engraved in various social interactions and daily life, and any deviance received strict criticism. The participants shared common examples of sanctions for women based on rigid norms like restrictive movements for women, social gossiping when women communicated with outsider men, prohibition for opinion giving in public, and lesser involvement during key decision-making at home. The participants shared that norms dictating gender roles were in place for both men and women with social sanctions and approval for their performance. A male discussion participant who occasionally got involved with cooking which was a so-called “women’s job” faced outright disapproval from his female relatives and neighbors. The male participant stated,

If I cook or get engaged in any household jobs, it is mostly females from the home and neighborhood who make fun of me and remind me that I am a man and that I should not be doing a woman’s job.

The foreign migration of youth looking for job opportunities has affected the Tharu community. It was known that a large number of men were absent from the community. The participants stated that women in such households with absent men had gained authority and control over resources, moreover, these women have been taking some of the men’s roles. The participants disclosed that these women had greater access and control over resources and were involved in the key decision-making positioning them in a relatively higher position compared to other women. It was known that this higher position for women came with a price, they were under higher social vigilance and at higher risk of abuse and violence due to the absence of ‘protective men’. It was known that women's foreign employment was associated with myths and sexist remarks. The participants shared that women had to face strict social criticisms and that their plans for livelihood and independence were related to an issue of sexual immorality and chastity. The participants from both groups strictly opposed the norms that associated women with sexual immorality but lamented that it continues. A male participant provided an insight into the social remarks received by women if she dares to go for foreign employment,

If a woman wants to go for a foreign job, she is considered to be of loose character. The idea that she is corrupt and will get involved in bad work will be her first impression of anyone.

Although the participant did not explicitly describe what bad work referred to as but it was inferred that he was relating it to sex work.

Domestic and gender violence

The participants identified violence as control, coercion, and use of force against someone will occurring due to unequal status. They primarily identified men as the perpetrators and women as the victims of violence. They explained that two types of violence were observed in the community. The first type occurred in an interpersonal relationship identified as physical, emotional, and sexual violence. The second type, as explained by the participants had its roots in socio-cultural belief systems. They provided examples of dowry exchange and witchcraft accusations for the latter type. The participants identified women as primary victims and listed both men and women as the perpetrators of both types of violence. They reported that physical violence against women by men under the influence of alcohol was the most commonly occurring violence in the community. The participants from both groups confirmed that wife-beating, verbal abuse, and quarrel frequently occurred in the community. It was known from discussions that alcohol consumption among men was widespread, and its cultural acceptance was also increasing episodes of violence. One of the female participants clarified further,

The most common violence occurring in our society is wife-beating by a husband under the influence of alcohol. We see it every day.

The participants reported the occurrence of sexual violence in the community but also pointed out that people refrained from discussing it considering it a taboo and private affair. The participants had hesitation to discuss freely on sexual violence. During the discussions, participants from both groups informed only of rape and attempted rape of women by men as sexual violence present in the community. Despite repeated probing, on several occasions, none of the participants from either group brought up issues and discussions about any other forms of sexual violence. Participants from both groups confirmed that stories about incidents of rape or attempted rape emerged only after cases were registered with the local police. The participants presumed that incidents of rape and attempted rape were not known to the wider community. A female participant stated,

Sexual violence does occur in our community, but people mostly do not report or disclose it, but they tend to keep it amongst themselves and their families.

The participants explained the identity of the rape perpetrator and victim. They identified the perpetrator as a rich, influential, and relatively powerful man from the community. The victim was portrayed as a poor and isolated woman which lesser social ties. It was known from the discussions that most of the rape cases in the community were settled with financial negotiations and monetary compensations for the victim rather than finding legal remedies. It can be inferred that the victimization of women intersects with gender, wealth, social stature, and affluence. The participants feared that this practice of settlement of rape with money could make rape a commodity available for the powerful, rich, and affluent men to exploit and victimize women. A male participant clarifies,

Recently, a man in his sixties raped a young girl near our village. The victim's family was ready to settle with monetary compensation offered by the rapist, but the involvement of the community stopped it and the rapist was handed over to the police.

The participants shared available coping mechanisms against violence practiced in the community by women. It was learned that the victim of household violence mostly used community consultation and police reporting to evade further violence. They divulged that community consultation and police reporting resulted in decisions in favor of victim women, directing abusive husbands to show decency and stop committing violence. The fear of legal repercussions such as spending time in police custody and getting charged under domestic violence cases was understood as the reasons for husbands to stop abuse and violence. The discussions revealed that women who file a formal complaint about their husband’s violent behavior could face an increased risk of violence. The participants disclosed that sharing such incidents publicly brought shame to some of the men and increased their anger, and often backlashed with increased violence. The participants in both groups stated that not all women in the community reported violence. They identified that women tend to be quiet despite facing continuous violence due to the fear of encountering more violence and to keeping their families together. A female participant clarifies,

Lodging public complaints against the abusive husband can sometimes escalate the violence. The husband’s anger for being humiliated in public must be faced by the woman inside the closed doors of the house with more violence and the men’s threat of abandoning the relationship.

The participants stated that socio-cultural violence against women in dowry-related cases was widespread and increasing. The dowry exchange was explained as a traditional practice with the family of the bride paying cash and kind to the groom's family. The participants clarified that the practice of dowry in the earlier days must have been an emergency fund for the newly wedded bride in a newer setting. According to the participants, the system of dowry has now developed and evolved as a practice of forced involuntary transfer of goods and cash demanded by the groom’s family. The discussions disclosed that the demands for dowry were increasing with time and failing to provide as promised immediately resulted in violence for the newly wedded bride. The participants described that dowry-related violence starts with taunts and progresses to withholding of food, verbal abuse, and finally, physical violence. They added that perpetrators of such violence were both men and women from the groom’s family. They stated that due to poverty not all bride families in the community were able to supply all demanded dowry which has exposed a large number of women to face dowry-related abuse and violence. The discussions also informed of a newer trend among girls by demanding goods during their wedding. It was shared that this new emerging trend had increased a two-fold financial burden on the bride’s family with heavy marriage debts. The male participants when questioned about the dowry demands cunningly shifted the responsibilities towards family and stated that it was not the groom but their families who were making such dowry demands. The discussions verified that dowry practice was so engraved in the community that it was impossible to even imagine a marriage without any dowry. A male participant reflected,

If I marry without any dowry, my family, neighbors, and all whom I know would consider that I am insane.

The participants also discussed and identified harmful traditional practices present in the community. The participants informed a common practice of accusing women of as witches existed in the community. It was mentioned that women faced witchcraft allegations in different situations. They provided examples of witchcraft allegations in common situations such as when someone’s cow stops producing milk when a child has a sore eye, when someone is bedridden due to sickness for days, or when a woman undergoes a miscarriage, etc. The participants stated that women accused of witch were always elderly/single women living in seclusion, poverty, and with fewer social ties. They also shared that the witch doctors, who ascertain whether a woman is a witch or not, were surprisingly mostly always men and hold higher status, respect, and social recognition. The consequences of being labeled as a witch, as explained by the participants, haunted victim women with torture, name-calling, social boycott, and extremes of physical violence. The participants informed that inhumane practices such as forceful feeding of human excreta prevailed during the witch cleansing sessions. A female participant explaining the witchcraft situation stated,

Witchcraft accusation is very real in our community; I know someone who has tortured his mother, citing reasons for his wife being childless. The old woman was called names, beaten, and later thrown out of the home.

The participants felt that men’s use of violence and its legitimization primarily existed due to gender hierarchy and internalization of the belief that violence was the best method to resolve any conflict. They inferred that men’s use of violence was further reinforced by women's acceptance and belief that violence had occurred due to their faults and carelessness. The female participants shared examples of common household situations that could result in an episode of violence such as women cooking distasteful food, failing to provide timely care to children and the elderly due to workload, and forgetting to clean rooms. These incidents make women believe that violence majorly occurred due to their mistakes. Furthermore, the participants believed that this self-blaming of the victim resulted due to constant exposure to violence and a non-negotiable social positioning of women for raising questions. The participants stated that beliefs instilled by religion increased the likelihood of victimization for women. They explained that religious practices and ideologies required women to refer to their husbands as godly figures, and a religious belief that anything said or done against husbands was a disgrace bringing sin upon her and family positioned women in an inferior position. A male participant added,

We belong to a culture where females worship their husbands as a god, and this might be an important reason for men to feel powerful as a god to exploit and abuse women.

The discussions put forward the idea that the existence of discriminatory beliefs, reinforcement of such beliefs, and a blind following of such practices produced differences and violence. The male participants acknowledged that the idea of male supremacy not only produced violence but also established a belief system that considered violence as an indispensable way to treat deviated women. One male participant stated this idea of male supremacy and privilege as,

The language of the feet is essential when words fail.

The participants also discussed violence committed toward men by women. The male participants burst into laughter when they stated that some men were beaten by their wives when they were drunk. The male participants admitted that intoxication reduced their strength and they got beaten. The female participants, on the other hand, assumed that women hit intoxicated men due to frustration and helplessness. They further clarified that the act of husband beating was a situational reaction towards men who had spent all of their daily earnings on alcohol. They stated that women with the responsibility to cook and feed family find themselves in an utterly helpless situation by the irresponsible drinking behavior of men. The male participants shared incidences of violence against men due to foreign migration. It was revealed in the discussions that some of the migrating men’s wives had run away with remitted money, abandoning marriage, and breaking up the family. The male participants identified this as a form of victimization of men, furthermore, the spreading of rumors and gossip caused emotional instability in those men. The female participants confirmed that some returning men failed to find their homes, property, money, and/or their wives. The discussion participants in both groups identified that this practice was on the rise in the community. It became apparent from the discussions that this increasing trend of women running away with the money and breaking away from family was a personal issue requiring social remedies.

Chasing dreams

The participants referred to sex trafficking as the exploitation of women, arising from poverty, illiteracy, and deceit. Explaining the causes of trafficking, the participants stated that women living in poverty, having dreams of prosperity and abundance were tricked by the traffickers making them victims of sex trafficking. The participants mentioned that women who had dreams larger than life and yearned for a comfortable and luxurious life in a short time were at a greater risk for sex trafficking. The participants from both groups resonated that the traffickers had been manipulating the dreams of poor women and deceiving them into trafficking. A female participant elaborated,

Women in poverty can be fooled easily with dreams. She can be tricked by a trafficker by saying I will find you employment with good pay abroad, and she gets into the trap easily.

A male participant further clarified,

Women readily fall into fraud and trickery shown by the traffickers who assure of luxurious life with foreign employment and this bait often leads to sex trafficking.

They identified that false hopes for foreign jobs were primarily used as an entry point by the traffickers to trap potential victims. Besides, they stated that some traffickers tricked women with false romantic relationships and marriages to win over their trust enabling traffickers to maneuver women as they wished.

It was identified that traffickers were not always strangers but known and familiar faces from the community, allowing the traffickers to gain the victim’s trust. The discussions divulged that traffickers strategically chose women who were less educated and poor. The participants explained that sex trafficking mostly occurred among women from a lower caste (the caste system is hierarchy-based in Hindu society which is determined by birth and unchangeable). They further explained that if one of these lower caste women went missing, it seldom raised any serious concerns in society, making these women easy targets for the traffickers. The discussions revealed that life for the survivors of sex trafficking was difficult. They identified that the survivor had to face strong stigmas and stereotypes which further increased their risk for re-victimization. The participants explained that the social acceptance of the trafficking survivors was minimal and finding a job for survival was very difficult. It was reported that social beliefs, norms, and practices were rigid for sex trafficking survivors and provided lesser opportunities for complete social integration. A female participant stated,

The story of a sex-trafficked woman does not end after her rescue. It is difficult for her to live in society, and this increases her chances of being a further victim.

The discussions in both groups highlighted that education and awareness were important for reducing sex trafficking. The participants felt that securing a livelihood for women was essential, but they identified it as a major challenge. The female participants recommended the use of education and awareness for reducing sex trafficking. They demanded effective legal actions and stringent enforcement of the law with maximum punishment for offending sex traffickers. They mentioned that the fear of law with maximum punishment for culprits could help decrease cases of trafficking.

The theoretical concept of power play

The discussions identified that gender inequality and violence against women occurred as men possessed and exercised greater authority. The participants explained that the authority emerging from male-centric beliefs was reinforced through established socio-cultural institutions. It was known that oppressive practices toward women in both public and private life have led to the domination and devaluation of women. The differences between men and women were known to be instilled by evoking discriminatory beliefs and due to internalization of them as fundamental truths by women which further helps to sustain these created differences.

The concept of power-play developed from the study has its roots in the belief systems and was found constantly used by men to maintain created differences. The power-play rise due to patriarchy, guiding discriminatory norms and unequal gender practices. These norms and practices in the canopy of patriarchy positions women inferior to men and impose control and restrictions. The power play possessed multi-dimensional effects on women such as creating further barriers, restricted life opportunities, the need for men-centered anchoring systems, and exclusion from the public arena. The power play gains its strength from the strict enforcement of stereotypical practices and committed adherence to gender performances. This leads to internalization of subordination as a natural occurrence by women. These further isolate women putting them into several non-negotiating positions. The power play at an individual level provides restrictive movement for women, barring them from quality education and other life opportunities, and is exhibited in alcohol-related assault and sexual violence. At the structural level, this power play limits women from economic opportunities, access to resources, and decision-making, and induces socio-cultural inequality exhibited in dowry and cases of witchcraft. The socio-cultural acceptance of power-play allows men to use violence as a misuse of power and use it as an effort to maintain authority. The use of power-play for committing violence was identified as the worst display of exercised power play.

Figure  1 describes the concept of power-play developed from the study. The power-play model is based on discussions and inferences made from data analysis. The model provides a description and explanation of how women are subjected to inequality and face violence. The concept of power play derives its strength from the subjugated status of women which are based on selective treatment, self-embodiment of inferiority, imposed restrictions and due to lesser life opportunities. The power play gain legitimacy through social approval of the status differences between men and women and through social systems and institutions majorly developed and favoring men. The status difference between men and women and its approval by developed social institutions and processes give rise to the concept of powerplay. It identifies that status differences allow men to gain and (mis)use power play not only to maintain differences but also enable men to use violence. The use of power-play exists at both interpersonal and cultural levels. Further, the model elaborates on influencers causing subjugation of women, display of power-play, and violence. The model identified that lodging public complaints and seeking legal remedies are the influencers that suppress violence against women. The influence of Forum Theater was perceived to have greater influence for victim, perpetrator, and bystanders. The influencers that aggravate violence are fear of further violence, the nature of the interpersonal relationship, alcohol-related abuse, and remaining silent especially on sexual violence. The cultural violence mentioned in the model refers to dowry and witchcraft-related violence and stands as systemic subordination. In the model, sex trafficking is depicted as one of the outcomes of inequality and violence faced by women majorly occurring due to deceit and fraud.

The theoretical concept of power-play developed in this study identifies that inequality produces violence and violence further reinforces inequality, creating a vicious circle. The power play situates hierarchy based on gender as the primary cause and identifies violence as an outcome of this power asymmetry. The authority to use power by men is received by social approval from embedded structures and institutions. The functioning of associated structures and norms is designed and run by men helping to perpetuate the dominance and subjugation of women. The study identifies that both interpersonal and socio-cultural violence emerges due to the positional differences and use of power. The study found that an element of control exists in interpersonal violence. The findings show that few victim women in the community took advantage of consultations and rely on the law to evade and /or cope during the occurrence of interpersonal violence. A large number of victims women however suffer silently as they are unable and unwilling to take a stand on violence due to their perceived positional differences and strict norms following. The study finds that violence originating from socio-cultural systems is widely accepted and no established means of control exists. The practice of heinous acts against a fellow human during witchcraft allegations and dowry exchanges is prohibited by the law of Nepal but is widespread. This situates that practices which are based on belief systems are more effective than prevailing national laws which try to stop them. Sex trafficking as a form of sexual violence use deceit and fraud against women. Poverty and illiteracy compel women to search for alternatives, and they become easy victims of sex trafficking when their dreams of a better life are manipulated by the traffickers. The false promise of a better life and highly paid job put women in a non-negotiating position with traffickers. The cherished dream of escaping the prevailing status-quo of oppression, subordination, violence, and poverty mesmerizes women to take risky decisions, falling into the risk and trap of sex trafficking.

The socio-cultural norms are the unwritten script of social operatives and functioning. These social norms function as codes of operation and are a major determinant for behavior and interactions between people [ 43 ]. The study has found that these norms were skewed, and most favored men, giving rise to status differences and producing inequalities for women. This is observed with lesser life opportunities, lower participation in decision-making, and a constant need to anchor women. This further helps men to maintain their hierarchical positional status and use violence. The subjugation of women does not occur in a linear process, it is influenced by the internalization of discrimination resulting in lower self-esteem, suppression, and domination of women based on norms and unequal practices. Earlier research has identified that norms and beliefs encourage men to control women, and direct them to use force to discipline women which increases the risk of violence occurrence [ 44 , 45 ]. An earlier study shows that traits of masculinity require men to become controlling, aggressive, and dominant over women to maintain status differences [ 46 ]. The study confirms that men upon receiving both normative and social approval for using violence against women can do so without hesitation.

Violence against women in Nepal mostly occurs inside the home and is only reported when it reaches higher levels of severity. The acceptance of violence as a private affair has restricted women from seeking support and discourages them from communicating their problems with outsiders [ 47 ] this increases more likelihood for men to use violence. The study finds issues related to sex and sexual violence is a taboo and are seldom reported. The study could only identify cases of sexual assault registered with the police and other cases known to the wider community as sexual violence. A community with known incidents of rape may have other cases of abuse, harassment, incest, forceful sexual contact, etc. Failure to report incidents of sexual violence infer that a large number of women could be suffering in silence. Earlier research identifies that increased stigmatization associated with sexual violence, and fear of seclusion cause reluctance in victims to report or seek support [ 48 ]. This silencing of victims provides men with greater sexual control over women [ 49 ] increasing more likelihood of use of violence. Gender-based inequality and violence intersect structures, institutions, and socio-cultural processes, making inequality and violence visible at all levels. The dowry-related violence and witchcraft allegation intersect interpersonal and structural violence. This cultural violence forces women to be a victim of lifelong abuse and trauma. The intersecting relationship between gender norms, social structures, and individual is so closely knitted that it produces varieties of inequality and violence at all levels [ 50 ]. Emotional violence in this study only emerged as a type of violence, during discussions in both groups. It did not emerge as a major concern for the participants except for dowry-related violence and violence against men. The intertwined nature of emotional violence and its occurrence with each abusive, exploitative, and violent situation may have influenced the participants understand it as a result, rather than as a specific type of violence.

The power play between sexes was found in synchronicity with the established norms and prevailing stereotypes, helping to perpetuate gender power imbalance. The gender system is influenced and governed by norms and the social arena becomes the site of its reproduction through the interaction and engagement of people. This interaction provides approval to the institutions and processes that are based on constructed differences between men and women [ 51 ]. The power, as identified by Fricker [ 52 ], controls a social group and operates and operates through the agent or established social structures. A man can actively use the vested power to either patronize and/or abuse women while passively women’s internalization of social settings and embedded norms can put them docile. The social controls as reported by Foucault [ 53 ] work with the embedded systems of internalization, discipline, and social monitoring and uses coercion rather than inflicting pain. The internalization of status differences among women as indicated by the study confirms this schema of social control. The dominance of men over women with patriarchal beliefs establishes the significance of male-centered kinship. This requires women to constantly anchor with men providing grounds for inequalities to perpetuate further. This idealizes men and reinforces the belief that women are non-existent without their presence. The requirement for male anchorage has an attachment to prevailing structural inequality. The family property and resources are mostly controlled by men and it usually transfers from father to son limiting inheritance to women [ 51 ]. These glorified idealizations of men's competence as described by Ridgeway [ 54 ] idealize men as individuals with abilities, status, power, and influences. The need for women to rely on men as anchors, fear of going against the norms and social sanctions explains the positional difference and show that men possess greater competencies. The internalization of men-centric superior beliefs by women occurs due to self-passivity and devalues women creating false impressions of their abilities. The gender roles and responsibilities were strict for both sexes but provided greater flexibility, privilege, and opportunity for men. Earlier studies in congruence with this study find that socio-cultural expectations limit women from deviation, and strictly adhere to their prescribed role and expectations [ 55 , 56 ] providing an upper hand to the men. The unequal social positioning of women, as defined by a few of the participants, can help define men's use of violence. As inferred by Kaufman [ 57 ], the disadvantageous position of women and support from the established structures enable men to use aggression and violence with considerable ease. The concept of power-play derived from this study also reflects that inequalities not only create hierarchies, putting women into a subordinating position but also legitimize norms of harmful masculinity and violence [ 57 , 58 , 59 , 60 ] creating a vicious cycle of inequality and violence. The concept of power-play developed by this study requires further exploration of gender relations, injustice, and patriarchy to identify multiple operatives of power with an outcome of inequality and violence.

Strengths and limitations of the study

The study followed the same participants over a period, which helped the study to achieve clarity on the topics through constant engagement. The data collection and the initial data analysis of the study were conducted by the same person, which reduced the risk of misrepresented findings. The study used follow-up discussions, which provided an opportunity to meet the participants again to resolve any ambiguities. The constant engagement with the participants helped to develop rapport and trust, which is essential to enable meaningful discussions. The study gathered rich data for developing the theory of power play in the Nepalese context. The study has attempted to explain the interplay of men’s use of power play, gender inequality, and violence against women, which, in itself, is a complex, but important issue. The study helped to develop a platform by identifying a level of awareness and needs for a Forum Theatre intervention study, a first of its kind in Nepal.

The major limitation of the study is that it was conducted with only one of the ethnic populations of Nepal; thus, the findings from this study cannot be generalized to a completely different setting. However, the transferability of the study is possible in a similar setting. The incidences of inequality and violence shared by the participants were self-reported, and no other means of verification were available to crosscheck those claims. The differences among the participants both in and between groups based on education and marital status might have influenced the study participants to understand, observe, and experience the phenomenon. The possibility of social desirability bias remains with the study, as a constant engagement with the study participants might have influenced them to answer differently. Furthermore, the discussions were conducted in groups, and participants might have had hesitation to bring up any opposing views. The study relied on collecting information on social norms and individual experiences and the perceptions of the study participants. It cannot be claimed that the study is devoid of any data rigidity as participants were free to choose what they wanted to share and express.

Study implications

The study explains gender practices, norms, violence against women, and sex trafficking in Nepal. The study helps to increase the understanding of how gender systems are operative in the daily lives of the Tharu community in the Morang district of Nepal. Future studies can explore the established linkages of interpersonal and socio-cultural violence. Like the complex link existing between gender inequality and violence against women, interpersonal violence and socio-cultural violence cannot be studied in isolation. The study provides an opportunity for future research on exploring how changing norms have been altering the position and victimization of women. The study finds that changing gender norms and responsibilities have, on the one hand, provided agency and empowerment for women, but on the other hand, they have also increased their risk of being a victim, an area that requires further exploration. The study has identified that constant engagement with the study participants through follow-up studies ensures the richness of data, which can be useful information for a future research study design. The study can be helpful for policy development, social activists, leaders, and researchers as it discusses prevalent gender oppressions and victimization, which need to be addressed. The findings from the study can be helpful for dialogue imitation and for designing intervention projects aimed at providing justice and equality to women.

The study identifies the presence of gender inequalities and violence against women in the study area. The positional differences based on norms, institutions, and practices have assigned greater privileges to men. The concept of power-play devised by the study ascertains the maintenance of gender hierarchy to produce inequality further and victimization of women. The subjugation of women based on the social-cultural process, embedded belief systems, and norms prevent women from life opportunities and dignified life. It situates men at the highest rung of the gender and social ladder providing a comparative advantage for men to use power. Violence emerges as men’s use of power play and as a strategy for the continued subjugation of women. Sex trafficking as a consequence of inequality and violence has its origins in illiteracy and poverty with women falling prey to the deceit of traffickers. It is important that dreams for progression provide motivation for women to develop further but at the same time, dreams should not be exchanged with trickery and fraud offered by the traffickers. Awareness and attitudinal changes are imperative to challenge unequal norms, and practices, and reduce the risks of sex trafficking. This can help to develop negotiations for power-sharing which helps to reduce inequality, violence, and preparedness in chasing dreams. Changes at both individual and societal levels are necessary to develop a collective action for establishing belief systems and practices providing women with an equal position and reducing the risk of violence.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to privacy but are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors are grateful to all the focus group discussion participants. The authors are indebted to Bhojraj Sharma, Deekshya Chaudhary, Subham Chaudhary, and Dev Kala Dhungana for their coordination and facilitation in reaching the discussion participants.

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PD, SKJ, and KS were involved in the study design. PD and KS developed the discussion guides. PD was responsible for the data collection and the data analysis. All authors read and approved the final manuscript.

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Dahal, P., Joshi, S.K. & Swahnberg, K. A qualitative study on gender inequality and gender-based violence in Nepal. BMC Public Health 22 , 2005 (2022). https://doi.org/10.1186/s12889-022-14389-x

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How to Save Humanity in 17 Goals: reduce inequality within and among countries (SDG 10)

Francisco Ferreira’s first exposure to inequality of opportunity was during his daily ride to school in São Paulo, Brazil, and seeing children his age selling chewing gum on the streets. Ferreira, a former World Bank economist who now researches inequality at the London School of Economics, speculates on the wasted human talent caused by such hardships, and how many more scientists, engineers, entrepreneurs and writers there would be if inequalities could be tackled at an early stage in children’s lives. “I think it deserves even more attention than it already gets,” he says, before going on to describe progress towards delivering Sustainable Development Goal 10: to reduce inequality in and among countries, and how best to measure it. Ferreira outlines how machine learning tools are helping to identify the most powerful predictors of societal divisions and how income is distributed.

How to Save Humanity in 17 Goals is a podcast series that profiles scientists whose work addresses one or more of the SDGs. Episodes 7–12 are produced in partnership with Nature Water , and introduced by Fabio Pulizzi, its chief editor.

doi: https://doi.org/10.1038/d41586-024-01534-2

Fabio Pulizzi: 00:09

Hello, this is How to Save Humanity in 17 Goals , a podcast brought to you by Nature Careers in partnership with Nature Water .

I’m Fabio Pulizzi, chief editor at Nature Water . This is a series where we meet the scientists working towards the Sustainable Development Goals agreed by the United Nations and world leaders in 2015.

Since then, in a huge global effort, thousands of researchers have been using those targets to tackle the biggest problems that the planet faces today.

In episode 10, we look at Sustainable Development Goal number 10: to reduce inequality in and among countries. And meet an academic works to improve opportunity to level the playing field.

Francisco Ferreira 01:03

So I’m Francisco Ferreira, and I’m the Amartya Sen Professor of Inequality Studies at the London School of Economics, where I also direct the International Inequalities Institute.

Sustainable development goal number 10 is about reducing inequalities, both within and among countries. And it’s got, you know, like all the Sustainable Development Goals, it’s got different targets and indicators and so on.

As to how aware I am of it when I’m conducting my research, you know, I’ve been studying inequality and working on inequality since before the Sustainable Development Goals. But obviously, when they came up, you know, they’re a huge sort of unifying force, a kind of a rallying cry for policymakers around the world.

And so that did become important to those of us working on it. And in fact, I was a little bit involved in the, in the design of some of the targets, because I was working at the World Bank at the time.

And this concept that target 10.1 has, which is about sustaining income growth for the bottom 40% of the population at a rate higher than the national average, is something that we came up with at the World Bank under the heading of “shared prosperity.”

Yeah, inequality can mean different things to different people. But I think there are two main definitions that I like to think about.

One, which is perhaps the primary definition, it’s just a measure of dispersion in a distribution of something among some group. So the distribution of income amongst people, or the distribution of years of schooling amongst countries, or the distribution of wealth amongst households.

So we just measure how far apart those incomes or wealth are from one another, or from the average. And that’s really what most inequality is. Now the secondary definition is that people say, individuals or countries that have other characteristics as well.

So if we’re thinking of individuals they have races or genders or ethnicities. And so we can take the same measures of inequality, but among groups, rather than between people. And whereas the between people is often called vertical inequality, the measures amongst groups are often called horizontal inequality.

And one is not better than the other. They’re just different. And they inform us about different things. But often when people think about inequality between men and women, for example That’s an example of horizontal inequality.

So as I was saying, inequality is, is about how things are distributed, right? So in a sense it’s important to understand the causes of that. Because nobody lives on the average, right? If you think of yourself, you're not exactly on the average, whoever you are listening to this, you’re not exactly on the average, or maybe close to the average, and maybe richer than the average and maybe poorer than the average.

So averages don’t matter on their own. When a country produces a certain amount of output or generates a certain amount of income, what really matters in the end is who gets to benefit from it, to what extent.

And there’s quite a lot of evidence, scientific evidence based on experiments, on experiments with people and experiments with monkeys. And there are surveys. There’s all kinds of different evidence that on the whole people prefer equality to inequality. Even monkeys get uncomfortable if they see an uneven distribution of food in their group.

And human beings tend to have a preference for fairness, if not exactly equality, at least for fairness. And so because of those preferences, and because also inequality can offset how an economy functions. You know, if a lot of people are very poor, they can’t get their children into good schools, or they can’t invest in their own learning or in owning their own business ideas, and the economy ends up being less vital and less vibrant than it might otherwise have been.

So both for intrinsic reasons that we care about fairness, and also instrumental reasons that, you know, more equality tends to be associated with better functioning outcomes for everyone, it’s important to understand where that inequality comes from, and whether we can or should do anything about it.

Francisco Ferreira 05:48

I was born in São Paulo, Brazil. São Paulo is the largest city in Brazil, the largest city in South America. And Brazil is a incredibly unequal country.

And I grew up in a middle class to upper middle class household in São Paulo, and I was exposed very early on to the huge gaps, right. So I would drive around or drive to school, for example, and, and see people my age selling chewing gum on the streets.

And it occurred to me that there was something odd about that. And I had a sense straightaway that it wasn’t only about how different we were then, but that our whole lives would be different.

So I guess I was interested from very early on in ideas of justice, and, and ideas of what determine the distribution of life chances and outcomes in Brazil. And from there I ended up going to the London School of Economics where I did my PhD, which was very fortunate because at the time, inequality wasn't a central question in economics, so much as it had been in the classical days.

But in the 1980s and early 90s. It wasn’t yet but. But at LSE it was. And we had some really important thinkers and professors who had been there like Amartya Sen or Tony Atkinson. So I learned a lot from these these guys. And it was hugely important. Then I spent a lot of my career at the World Bank where we in the research department worked a lot on the measurement of global poverty and global inequality.

And so I worked there for many years before eventually returning to my alma mater, to the LSE, now as a professor on this topic.

Inequality of opportunity is basically differences in in people's life chances for reasons that they don't control.

So for example, when the COVID pandemic hit the UK, and, you know, 17% of all workers in April 2020, lost their jobs, there was a almost five percentage point difference in terms of women having lost their jobs, five percentage points more than than men. You know, another example is in South Africa, in 2017, the average income for a white household was 5.6 times larger than an African household.

So these are examples of, these are examples of huge differences that are determined by factors that people don’t control themselves like race, or gender, or parental background, or where you come from.

So inequality of opportunity is about differences that we observe in society, which are not due to, say, “Ah this person worked harder than the other one, or was more responsible than the other one.” But really have to do with things we inherit, and cannot control race, ethnicity, family background, where we were born, our earliest experiences, and so.

There are a number of people out there who are really interested in an opportunity. But the reason I think it deserves more attention than it gets is that in a sense, I like to think of inequality a little bit like cholesterol, you know, there’s two kinds. And one is worse than the other.

You could think of inequality of effort or inequality that rewards responsibility in some senses, the good cholesterol. The really bad cholesterol, the really bad inequality is the one that we inherit, that we’re not responsible for.

And of course, it shapes also how much effort we put in and how much responsibility we have. I'm not suggesting and at least that they’re, they’re separable in that easy way.

Of course, we are shaped by the circumstances we inherit. So quite a lot of the inequality that we see really is inherited and is inequality of opportunity.

And it’s the bad cholesterol in two senses. It’s the bad cholesterol in the sense that it is the one that people find most objectionable. And again, without getting into the details, there are experiments out there. There’s a lot of work done by people in Norway, for example, in Bergen, at the Fair Institute, they’re looking at, you know, how do people in games, how do players in games with real money. What do they really object to, when are they prepared to pay to have a more equal outcome in their game?

And it’s typically when the inequality arises from something the players do not control, like, they will randomize, they were randomly given a lower wage rate and a game or something like that.

So there’s a lot of evidence that people object to that kind of inherited or, or or, you know, arbitrary inequality that we cannot control. It’s also the bad cholesterol in the instrumental sense, how inequality can harm the economy as a whole.

Because, you know, the example I like to think of this as a Brazilian is, if you think of all the kids growing up in the Brazilian slums, in the hills in Rio, or in various areas in São Paulo, or other cities, you know, how many engineers and scientists and great writers and so on, that could have been there, and some of them will make it, but many, many fewer than would otherwise make it. Just because of the quality of the schools they are confined to, and other hardships and having to get out of school early to help their parents, all sorts of other other things that happen to them. Crime, violence.

So there’s a lot of wasted human talent, a lot of human potential that goes to waste, because it is not given those opportunities that other that other people have. So inequality of opportunities is, you know, the bad cholesterol in both of the senses. And so I think it deserves even more attention than it already gets.

Francisco Ferreira 11:58

Another reason, perhaps why people talk less about inequality of opportunity than, than I think we should, is because there isn’t yet full agreement on on how we should measure it, and on the idea of data that, that we need to observe it. You know, in a sense, inequality of opportunities quite close as a concept to the inverse of intergenerational mobility.

So there is a lot of work out there on on measuring the association between parents and children, say the incomes of fathers and sons or mothers and daughters.

And that association measured in different ways and elasticity, or a correlation, or a rank correlation, those measures are popular and are, are often widely available.

They’re very close to what inequality of opportunity seeks to measure because it is about the influence of inherited circumstances on life today. I find that by looking only at income, we’re ignoring some of the other factors that are important in shaping opportunities.

Parental income is hugely important. There is evidence, there are a few studies that suggest that in many countries race, or parental wealth, are important independently of income, in addition to income. Economists say even when you control for income, these other things are still important. And so you’d like if you’d like in some sense, to get a measure of the overall extent to which inequality that we observe today is inherited these past circumstances, you’d like to observe things beyond income and to go beyond the studies just mobility, which are very important and informative in their own right. But you'd like to go beyond that.

But then we get into this question of, in some sense, where do we stop? Does any dataset contain all of the information that we need? And how do we put that together? And there are some statistical issues, but they pose some challenges. And that’s some of the areas in which my group at LSE has been working.

Francisco Ferreira 14:26

In the end, we’ve come I think, to accept that these measures of the extent to which inequality that we observe is inherited, are never going to be perfect, because you’re never going to observe all of the data on circumstances.

So we need to think of them as flaws, as indications of at least how much of the inequality that we see today, is inherited. And now we have some different techniques and approaches to just select the circumstances that are most important.

And these use machine learning tools. These techniques are not magic, that they're just designed to look at a data set and extract the most powerful predictors, the most salient divisions in society in some sense.

These are machine learning techniques, I mean, in some very basic sense, they are artificial intelligence in the sense that they are supervised learning, you know, the computer is learning from, from the data that it’s, that it’s looking at. What it does is fundamentally, look at the way income, say is distributed and how it’s related, how it’s associated with different characteristics.

So when it looks at South Africa, for example, just looking at the sample, it finds, it’s very heavily associated with race.

So it’ll use race as a first splitting point. And then it it keeps going. And so then it will find that, you know, mother’s education is actually the thing that’s most associated in that area. Father’s education in their other area. Maybe occupation, maybe place of birth, and it keeps looking for the most salient variable that is inherited, that is beyond people’s control, that seems to predict income differences.

And it tells us then, how to partition the population in a way that is most predictive of income, most salient. And from that division, we can we can obtain thesei measures of inequality. And that’s what they're designed to do.

And when we apply those to, to this problem, we tend to find much larger numbers. In a recent paper we did for Latin America, we find an average about 50%. And some countries in the 60% range. And for South Africa, we find a number nearer 70%, suggesting that, you know, even with the imperfect, imperfect information that we have, in a country like Brazil, or Guatemala, about two thirds of the inequality that we observe, is fully inherited.

And that’s likely to be just a base. And in South Africa, the two thirds really are inherited. In richer countries, in Europe, in the United States, the numbers are a bit lower. In some of the more egalitarian European countries, they are in the 20 to 30% range. In the United States, they are under sort of 40% range.

And then so again, is just an indication of, at a minimum, how much of the inequality that we observe is deeply unfair.

The second one is really about whether there's a relationship between these kinds of inequality and the aggregate performance of the economy.

For example, economic growth. And there are a number of studies of that, some of which have found quite a substantial impact, actually. There’s a very nice study in the Journal of Development Economics by by two Spanish economista, Mateo and Rodrigues. who find that if they look across states in the US, and the US Census data for the states over a 30 year period, and they look at growth in in GDP per capita of each state.

And they find that if you look at the association between just aggregate overall inequality, income inequality, and, and growth in the States, they don’t find much.

But when they separate out between these two components, right, the bad cholesterol, inequality of opportunity, and the residual, some of which is an equality of effort, and some of which is just things we don’t observe, and in terms of circumstances. But anyway, when they split it between those two, they find it as something of a positive association between inequality of effort and growth, and a very negative association between inequality of opportunity and growth.

That is to say, those states, where more of the distribution seems to reflect inherited factors like race, like differences in family background, and so on, and so forth, grow more slowly than those states, which have less of that kind of inequality.

And this has been replicated in Brazil and a number of other countries And then there are other kinds of studies that don’t use this kind of cross country regression method.

But there have also found, for example, that the opening up of opportunity in the medical and legal professions in the United States, to women, and then to African Americans, over the course of the 20th century, contributed a great deal to growth in the output of those professions. That also has model-based simulations in it and so on.

But it’s a, you know, it’s an influential paper that also reflects this idea that that more opportunity means more talent can be used, and out of that comes more production and more efficiency.

There are at least two basic ways in which we can use that information on measurement that we have created. To reduce the rate, right, to help generate policies that will make a difference and improve the lives of those of the bottom.

One is simply targeting if you like, I mean, what is simply getting a map, a social map of society. So these, these trees, they generate, effectively a map of social groups. And we can see what their average income is and what their distribution is.

And we can see which groups, again determined purely by circumstances they inherited, which groups do systematically worse than others and persistently so.

And then presumably, if you wanted to target a program with early childhood development, or a program of improving teacher practices in certain schools, you might want to do it in the, in the areas where a majority of these people live first. And you may want to put most, most resources into those groups.

Because the other thing about inequality of opportunity is that we know that people who have the least advantage, you know, whose circumstances hold them back the most, in a sense, those are the people for whom it will be hardest to advance.

So in some sense, they should get not just equal treatment, but better treatment, because the intervention needs to compensate for the drag of the background, if you understand so.

So this is one way. And in fact, some of our funders and foundations that we work with are very interested exactly in that aspect of this kind of social map of societies in Latin America in particular, that we're working on. That’s one way, there’s another way, which is actually through, in some sense, through the political process, which is, we feel that by highlighting the extent to which inequality is unjust and reflects things that have nothing to do with people’s responsibilities that people cannot control, that people simply inherit, we may contribute to an understanding of just how unfair inequality is, and therefore enhance political support for redistribution more broadly.

And there are many places in the world. Nowadays, in Europe and the United States, there’s already a great deal of understanding of the costs of inequality, which was not necessarily true in the US 30 years ago. But it is more so now after the, you know, the 1% Movement and the global financial crisis and Tomhas Piketty’s work and so on. But in many places, you know, I remember talking to an African president once when I was at the World Bank.

And he wanted to reduce poverty, he wanted to understand what more he could do in policy terms to accelerate poverty reduction in his country. And, and when we talked about inequality, his eyes glazed out a little bit. And he said, “Well, you know, inequality is not something we can worry about in Africa, because, you know, we have so little. We have to, we have to work our way from the bottom up for everyone. Handouts won’t work.”

And then when you sort of get across to him, the idea that actually by giving more opportunities to some of these poorest people, their contribution to the economy, their own output, their own incomes, what they do for themselves, will improve. It’s not about handouts, it’s about chances to produce, chances to lift yourself up.

You know, he changed his whole outlook. And in fact, I don’t want to give too many details. But in fact, I’m told by my former World Bank colleagues that they were policy changes and programs created, in part as a result of his being convinced that that there was something and I’m reducing inequality that went beyond handouts and had efficiency consequences.

Francisco Ferreira 23:58

So the thing about sustainable goal number 10 is it doesn’t have a specific numerical target like goal one has, right. So goal one says, well, this this the pure UN version of goal one says completely eradicate extreme poverty by 2030.

The slightly more realistic World Bank version of that says, let’s reduce it to 3% or below. And that goal will almost certainly not be met by 2030, in part, because of COVID, which represented a regression and a slowdown in poverty reduction. But in part, actually, because of inequality, interestingly enough. Because in some sense, the poverty that remains is the poverty that is hardest to reach, is the poverty in the poorest countries in the poorest people of the poorest countries.

And it’s harder to reach those parts of the poverty map if you like. But I think if we look at inequality between countries and inequality within countries, it will be difficult to conclude that it has been very satisfactory match.

Because there are many countries where inequality has grown over the last years, there’s a sense sometimes that inequality has grown everywhere. And this is actually not true. There are many countries where inequality has fallen. Pretty much however you measure it, a number of those are actually in Latin America.

But there are also many, many countries where it has grown, no matter how you measure it. And so the inequality within countries, and this is true in the US, and it is true in a number of other countries that, you know, we won’t be able to say that we met that.

In terms of inequality. between countries, there was actually a long trend of convergence and inequality, between countries driven primarily by the growth of places like China and India, which for the last half century or so has been much faster than than in the West. COVID produced a little bit of a setback to that, particularly because of India.

But by 2030, the process may have resumed. The issue there looking forward is a different worry. And that worry is now that China is around the middle of the global distribution, and its growth in the future will no longer contribute to a reduction in inequality, but in fact, possibly to an increase in between country inequality, then these trends may change considerably but that’ll be likely after 2030.

Fabil Pulizzi: 26:53

Thanks for listening to this series How to Save Humanity in 17 Goals.

Join us again next time when we look at Sustainable Development Goal number 11: how to improve our cities. See you then.

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• Published: 30 May 2024

Differential attainment in assessment of postgraduate surgical trainees: a scoping review

• Rebecca L. Jones 1 , 2 ,
• Suwimol Prusmetikul 1 , 3 &
• Sarah Whitehorn 1  

BMC Medical Education volume  24 , Article number:  597 ( 2024 ) Cite this article

81 Accesses

Metrics details

Introduction

Solving disparities in assessments is crucial to a successful surgical training programme. The first step in levelling these inequalities is recognising in what contexts they occur, and what protected characteristics are potentially implicated.

This scoping review was based on Arksey & O’Malley’s guiding principles. OVID and Embase were used to identify articles, which were then screened by three reviewers.

From an initial 358 articles, 53 reported on the presence of differential attainment in postgraduate surgical assessments. The majority were quantitative studies (77.4%), using retrospective designs. 11.3% were qualitative. Differential attainment affects a varied range of protected characteristics. The characteristics most likely to be investigated were gender (85%), ethnicity (37%) and socioeconomic background (7.5%). Evidence of inequalities are present in many types of assessment, including: academic achievements, assessments of progression in training, workplace-based assessments, logs of surgical experience and tests of technical skills.

Attainment gaps have been demonstrated in many types of assessment, including supposedly “objective” written assessments and at revalidation. Further research is necessary to delineate the most effective methods to eliminate bias in higher surgical training. Surgical curriculum providers should be informed by the available literature on inequalities in surgical training, as well as other neighbouring specialties such as medicine or general practice, when designing assessments and considering how to mitigate for potential causes of differential attainment.

Peer Review reports

Diversity in the surgical workforce has been a hot topic for the last 10 years, increasing in traction following the BlackLivesMatter movement in 2016 [ 1 ]. In the UK this culminated in publication of the Kennedy report in 2021 [ 2 ]. Before this the focus was principally on gender imbalance in surgery, with the 2010 Surgical Workforce report only reporting gender percentages by speciality, with no comment on racial profile, sexuality distribution, disability occurrence, or socioeconomic background [ 3 ].

Gender is not the only protected characteristic deserving of equity in surgery; many groups find themselves at a disadvantage during postgraduate surgical examinations [ 4 ] and at revalidation [ 5 ]. This phenomenon is termed ‘differential attainment’ (DA), in which disparities in educational outcomes, progression rates, or achievements between groups with protected characteristics occur [ 4 ]. This may be due to the assessors’ subconscious bias, or a deficit in training and education before assessment.

One of the four pillars of medical ethics is “justice”, emphasising that healthcare should be provided in a fair, equitable, and ethical manner, benefiting all individuals and promoting the well-being of society as a whole. This applies not only to our patients but also to our colleagues; training should be provided in a fair, equitable, and ethical manner, benefiting all. By applying the principle of justice to surgical trainees, we can create an environment that is supportive, inclusive, and conducive to professional growth and well-being.

A diverse consultant body is crucial for providing high-quality healthcare to a diverse patient population. It has been shown that patients are happier when cared for by a doctor with the same ethnic background [ 6 ]. Takeshita et al. [ 6 ] proposed this is due to a greater likelihood of mutual understanding of cultural values, beliefs, and preferences and is therefore more likely to cultivate a trusting relationship, leading to accurate diagnosis, treatment adherence and improved patient understanding. As such, ensuring that all trainees are justly educated and assessed throughout their training may contribute to improving patient care by diversifying the consultant body.

Surgery is well known to have its own specific culture, language, and social rules which are unique even within the world of medicine [ 7 , 8 ]. Through training, graduates develop into surgeons, distinct from other physicians and practitioners [ 9 ]. As such, research conducted in other medical domains is not automatically applicable to surgery, and behavioural interventions focused on reducing or eliminating bias in training need to be tailored specifically to surgical settings.

Consequently, it’s important that the surgical community asks the questions:

Does DA exist in postgraduate surgical training, and to what extent?

Why does DA occur?

What groups or assessments are under-researched?

How can we apply this knowledge, or acquire new knowledge, to provide equity for trainees?

The following scoping review hopes to provide the surgical community with robust answers for future of surgical training.

Aims and research question

The aim of this scoping review is to understand the breadth of research about the presence of DA in postgraduate surgical education and to determine themes pertaining to causes of inequalities. A scoping review was chosen to provide a means to map the available literature, including published peer-reviewed primary research and grey literature.

Following the methodological framework set out by Arksey and O’Malley [ 10 ], our research was intended to characterise the literature addressing DA in HST, including Ophthalmology, Obstetrics & Gynaecology (O&G). We included literature from English-language speaking countries, including the UK and USA.

Search strategy

We used search terms tailored to our target population characteristics (e.g., gender, ethnicity), concept (i.e., DA) and context (i.e., assessment in postgraduate surgical education). Medline and Embase were searched with the assistance of a research librarian, with addition of synonyms. This was conducted in May 2023, and was exported to Microsoft Excel for further review. The reference lists of included articles were also searched to find any relevant data sources that had yet to be considered. In addition, to identify grey literature, a search was performed for the term “differential attainment” and “disparity” on the relevant stakeholders’ websites (See supplemental Table 1 for full listing). Stakeholders were included on the basis of their involvement in governance or training of surgical trainees.

Study selection

To start we excluded conference abstracts that were subsequently published as full papers to avoid duplications ( n  = 337). After an initial screen by title to exclude obviously irrelevant articles, articles were filtered to meet our inclusion and exclusion criteria (Table  1 ). The remaining articles ( n  = 47) were then reviewed in their entirety, with the addition of five reports found in grey literature. Following the screening process, 45 studies were recruited for scoping review (Fig.  1 ).

Charting the data

The extracted data included literature title, authors, year of publication, country of study, study design, population characteristic, case number, context, type of assessment, research question and main findings (Appendix 1). Extraction was performed initially by a single author and then subsequently by a second author to ensure thorough review. Group discussion was conducted in case of any disagreements. As charting occurred, papers were discovered within reference lists of included studies which were eligible for inclusion; these were assimilated into the data charting table and included in the data extraction ( n  = 8).

Collating, summarizing and reporting the results

The included studies were not formally assessed in their quality or risk of bias, consistent with a scoping review approach [ 10 ]. However, group discussion was conducted during charting to aid argumentation and identify themes and trends.

We conducted a descriptive numerical summary to describe the characteristics of included studies. Then thematic analysis was implemented to examine key details and organise the attainment quality and population characteristics based on their description. The coding of themes was an iterative process and involved discussion between authors, to identify and refine codes to group into themes.

We categorised the main themes as gender, ethnicity, country of graduation, individual and family background in education, socioeconomic background, age, and disability. The number of articles in each theme is demonstrated in Table  2 . Data was reviewed and organised into subtopics based on assessment types included: academic achievement (e.g., MRCS, FRCS), assessments for progression (e.g., ARCP), workplace-based assessment (e.g., EPA, feedback), surgical experience (e.g., case volume), and technical skills (e.g., visuo-spatial tasks).

PRISMA flow diagram

44 articles defined the number of included participants (89,399 participants in total; range of participants across individual studies 16–34,755). Two articles reported the number of included studies for their meta-analysis (18 and 63 included articles respectively). Two reports from grey literature did not define the number of participants they included in their analysis. The characteristics of the included articles are displayed in Table  2 .

Growth in published literature on differential attainment over the past 40 years

Academic achievement

In the American Board of Surgery Certifying Exam (ABSCE), Maker [ 11 ] found there to be no significant differences in terms of gender when comparing those who passed on their first attempt and those who did not in general surgery training, a finding supported by Ong et al. [ 12 ]. Pico et al. [ 13 ] reported that in Orthopaedic training, Orthopaedic In-Training Examination (OITE) and American Board of Orthopaedic Surgery (ABOS) Part 1 scores were similar between genders, but that female trainees took more attempts in order to pass. In the UK, two studies reported significantly lower Membership of the Royal College of Surgeons (MRCS) pass rates for female trainees compared to males [ 4 , 14 ]. However, Robinson et al. [ 15 ] presented no significant gender differences in MRCS success rates. A study assessing Fellowship of the Royal College of Surgeons (FRCS) examination results found no significant gender disparities in pass rates [ 16 ]. In MRCOG examination, no significant gender differences were found in Part 1 scores, but women had higher pass rates and scores in Part 2 [ 17 ].

Assessment for Progression

ARCP is the annual process of revalidation that UK doctors must perform to progress through training. A satisfactory progress outcome (“outcome 1”) allows trainees to advance through to the next training year, whereas non-satisfactory outcomes (“2–5”) suggest inadequate progress and recommends solutions, such as further time in training or being released from the training programme. Two studies reported that women received 60% more non-satisfactory outcomes than men [ 16 , 18 ]. In contrast, in O&G men had higher non-satisfactory ARCP outcomes without explicit reasons for this given [ 19 ].

Regarding Milestone evaluations based from the US Accreditation Council for Graduate Medical Education (ACGME), Anderson et al. [ 20 ] reported men had higher ratings of knowledge of diseases at postgraduate year 5 (PGY-5), while women had lower mean score achievements. This was similar to another study finding that men and women had similar competencies at PGY-1 to 3, and that it was only at PGY-5 that women were evaluated lower than men [ 21 ]. However, Kwasny et al. [ 22 ] found no difference in trainers’ ratings between genders, but women self-rated themselves lower. Salles et al. [ 23 ] demonstrated significant improvement in scoring in women following a value-affirmation intervention, while this intervention did not affect men.

Workplace-based Assessment

Galvin et al. [ 24 ] reported better evaluation scores from nurses for PGY-2 male trainees, while females received fewer positive and more negative comments. Gerull et al. [ 25 ] demonstrated men received compliments with superlatives or standout words, whereas women were more likely to receive compliments with mitigating phrases (e.g., excellent vs. quite competent).

Hayward et al. [ 26 ] investigated assessment of attributes of clinical performance (ethics, judgement, technical skills, knowledge and interpersonal skills) and found similar scoring between genders.

Several authors have studied autonomy given to trainees in theatre [ 27 , 28 , 29 , 30 , 31 ]. Two groups found no difference in level of granted autonomy between genders but that women rated lower perceived autonomy on self-evaluation [ 27 , 28 ]. Other studies found that assessors consistently gave female trainees lower autonomy ratings, but only in one paper was this replicated in lower performance scores [ 29 , 30 , 31 ].

Padilla et al. [ 32 ] reported no difference in entrustable professional activity assessment (EPA) levels between genders, yet women rated themselves much lower, which they regarded as evidence of imposter syndrome amongst female trainees. Cooney et al. [ 33 ] found that male trainers scored EPAs for women significantly lower than men, while female trainers rated both genders similarly. Conversely, Roshan et al. [ 34 ] found that male assessors were more positive in feedback comments to female trainees than male trainees, whereas they also found that comments from female assessors were comparable for each gender.

Surgical Experience

Gong et al. [ 35 ] found significantly fewer cataract operations were performed by women in ophthalmology residency programmes, which they suggested could be due to trainers being more likely to give cases to male trainees. Female trainees also participated in fewer robotic colorectal procedures, with less operative time on the robotic console afforded [ 36 ]. Similarly, a systematic review highlighted female trainees in various specialties performed fewer cases per week and potentially had limited access to training facilities [ 37 ]. Eruchalu et al. [ 38 ] found that female trainees performed fewer cases, that is, until gender parity was reached, after which case logs were equivalent.

Technical skills

Antonoff et al. [ 39 ] found higher scores for men in coronary anastomosis skills, with women receiving more “fail” assessments. Dill-Macky et al. [ 40 ] analysed laparoscopic skill assessment using blinded videos of trainees and unblinded assessments. While there was no difference in blinded scores between genders, when comparing blinded and unblinded scores individually, assessors were less likely to agree on the scores of women compared to men. However, another study about laparoscopic skills by Skjold-Ødegaard et al. [ 41 ] reported higher performance scores in female residents, particularly when rated by women. The lowest score was shown in male trainees rated by men. While some studies showed disparities in assessment, several studies reported no difference in technical skill assessments (arthroscopic, knot tying, and suturing skills) between genders [ 42 , 43 , 44 , 45 , 46 ].

Several studies investigated trainees’ abilities to complete isolated tasks associated with surgical skills. In laparoscopic tasks, men were initially more skilful in peg transfer and intracorporeal knot tying than women. Following training, the performance was not different between genders [ 47 ]. A study on microsurgical skills reported better initial visual-spatial and perceptual ability in men, while women had better fine motor psychomotor ability. However, these differences were not significant, and all trainees improved significantly after training [ 48 ]. A study by Milam et al. [ 49 ] revealed men performed better in mental rotation tasks and women outperformed in working memory. They hypothesised that female trainees would experience stereotype threat, fear of being reduced to a stereotype, which would impair their performance. They found no evidence of stereotype threat influencing female performance, disproving their hypothesis, a finding supported by Myers et al. [ 50 ].

Ethnicity and country of graduation

Most papers reported ethnicity and country of graduation concurrently, for example grouping trainees as White UK graduates (WUKG), Black and minority ethnicity UK graduates (BME UKG), and international medical graduates (IMG). Therefore, these areas will be addressed together in the following section.

When assessing the likelihood of passing American Board of Surgery (ABS) examinations on first attempt, Yeo et al. [ 51 ] found that White trainees were more likely than non-White. They found that the influence of ethnicity was more significant in the end-of-training certifying exam than in the start-of-training qualifying exam. This finding was corroborated in a study of both the OITE and ABOS certifying exam, suggesting widening inequalities during training [ 52 ].

Two UK-based studies reported significantly higher MRCS pass rates in White trainees compared to BMEs [ 4 , 14 ]. BMEs were less likely to pass MRCS Part A and B, though this was not true for Part A when variations in socioeconomic background were corrected for [ 14 ]. However, Robinson et al. [ 53 ] found no difference in MRCS pass rates based on ethnicity. Another study by Robinson et al. [ 15 ] demonstrated similar pass rates between WUKGs and BME UKGs, but IMGs had significantly lower pass rates than all UKGs. The FRCS pass rates of WUKGs, BME UKGs and IMGs were 76.9%, 52.9%, and 53.9%, respectively, though these percentages were not statistically significantly different [ 16 ].

There was no difference in MRCOG results based on ethnicity, but higher success rates were found in UKGs [ 19 ]. In FRCOphth, WUKGs had a pass rate of 70%, higher than other groups of trainees, with a pass rate of only 45% for White IMGs [ 52 ].

By gathering data from training programmes reporting little to no DA due to ethnicity, Roe et al. [ 54 ] were able to provide a list of factors they felt were protective against DA, such as having supportive supervisors and developing peer networks.

Assessment for progression

RCOphth [ 55 ] found higher rates of satisfactory ARCP outcomes for WUKGs compared to BME UKGs, followed by IMGs. RCOG [ 19 ] discovered higher rates of non-satisfactory ARCP outcomes from non-UK graduates, particularly amongst BMEs and those from the European Economic Area (EEA). Tiffin et al. [ 56 ] considered the difference in experience between UK graduates and UK nationals whose primary medical qualification was gained outside of the UK, and found that the latter were more likely to receive a non-satisfactory ARCP outcome, even when compared to non-UK nationals.

Woolf et al. [ 57 ] explored reasons behind DA by conducting interview studies with trainees. They investigated trainees’ perceptions of fairness in evaluation and found that trainees felt relationships developed with colleagues who gave feedback could affect ARCP results, and might be challenging for BME UKGs and IMGs who have less in common with their trainers.

Workplace-based assessment

Brooks et al. [ 58 ] surveyed the prevalence of microaggressions against Black orthopaedic surgeons during assessment and found 87% of participants experienced some level of racial discrimination during workplace-based performance feedback. Black women reported having more racially focused and devaluing statements from their seniors than men.

Surgical experience

Eruchalu et al. [ 38 ] found that white trainees performed more major surgical cases and more cases as a supervisor than did their BME counterparts.

Dill-Macky et al. [ 40 ] reported no significant difference in laparoscopic surgery assessments between ethnicities.

Individual and family background in education

Two studies [ 4 , 16 ] concentrated on educational background, considering factors such as parental occupation and attendance of a fee-paying school. MRCS part A pass rate was significantly higher for trainees for whom Medicine was their first Degree, those with university-educated parents, higher POLAR (Participation In Local Areas classification group) quintile, and those from fee-paying schools. Higher part B pass rate was associated with graduating from non-Graduate Entry Medicine programmes and parents with managerial or professional occupations [ 4 ]. Trainees with higher degrees were associated with an almost fivefold increase in FRCS success and seven times more scientific publications than their counterparts [ 16 ].

Socioeconomic background

Two studies used Index of Multiple Deprivation quintile, the official measure of relative deprivation in England based on geographical areas for grading socioeconomic level. The area was defined at the time of medical school application. Deprivation quintiles (DQ) were calculated, ranging from DQ1 (most deprived) to DQ5 (least deprived) [ 4 , 14 ].

Trainees with history of less deprivation were associated with higher MRCS part A pass rate. More success in part B was associated with history of no requirement for income support and less deprived areas [ 4 ]. Trainees from DQ1 and DQ2 had lower pass rates and higher number of attempts to pass [ 14 ]. A general trend of better outcomes in examination was found from O&G trainees in less deprived quintiles [ 19 ].

Trainees from DQ1 and DQ2 received significantly more non-satisfactory ARCP outcomes (24.4%) than DQ4 and DQ5 (14.2%) [ 14 ].

Trainees who graduated at age less than 29 years old were more likely to pass MRCS than their counterparts [ 4 ].

Authors [ 18 , 56 ] found that older trainees received more non-satisfactory ARCP outcomes. Likewise, there was higher percentage of non-satisfactory ARCP outcomes in O&G trainees aged over 45 compared with those aged 25–29 regardless of gender [ 19 ].

Trainees with disability had significantly lower pass rates in MRCS part A compared to candidates without disability. However, the difference was not significant for part B [ 59 ].

What have we learnt from the literature?

It is heartening to note the recent increase in interest in DA (27 studies in the last 4 years, compared to 26 in the preceding 40) (Fig.  2 ). The vast majority (77%) of studies are quantitative, based in the US or UK (89%), focus on gender (85%) and relate to clinical assessments (51%) rather than examination results. Therefore, the surgical community has invested primarily in researching the experience of women in the USA and UK.

Interestingly, a report by RCOG [ 19 ] showed that men were more likely to receive non-satisfactory ARCP outcomes than women, and a study by Rushd et al. [ 17 ] found that women were more likely to pass part 2 of MRCOG than men. This may be because within O&G men are the “out-group” (a social group or category characterised by marginalisation or exclusion by the dominant cultural group) as 75% of O&G trainees are female [ 60 ].

This contrasts with other specialities in which men are the in-group and women are seen to underperform. Outside of O&G, in comparison to men, women are less likely to pass MRCS [ 4 , 14 ], receive satisfactory ARCP outcome [ 16 , 18 ], or receive positive feedback [ 24 ], whilst not performing the same number of procedures as men [ 34 , 35 ]. This often leads to poor self-confidence in women [ 32 ], which can then worsen performance [ 21 ].

It proves difficult to comment on DA for many groups due to a lack of evidence. The current research suggests that being older, having a disability, graduate entry to medicine, low parental education, and living in a lower socioeconomic area at the time of entering medical school are all associated with lower MRCS pass rates. Being older and having a lower socioeconomic background are also associated with non-satisfactory ARCP outcomes, slowing progression through training.

These characteristics may provide a compounding negative effect – for example having a previous degree will automatically make a trainee older, and living in a lower socioeconomic area makes it more likely their parents will have a non-professional job and not hold a higher degree. When multiple protected characteristics interact to produce a compounded negative effect for a person, it is often referred to as “intersectional discrimination” or “intersectionality” [ 61 ]. This is a concept which remains underrepresented in the current literature.

The literature is not yet in agreement over the presence of DA due to ethnicity. There are many studies that report perceived discrimination, however the data for exam and clinical assessment outcomes is equivocal. This may be due to the fluctuating nature of in-groups and out-groups, and multiple intersecting characteristics. Despite this, the lived experience of BME surgeons should not be ignored and requires further investigation.

What are the gaps in the literature?

The overwhelming majority of literature exploring DA addresses issues of gender, ethnicity or country of medical qualification. Whilst bias related to these characteristics is crucial to recognise, studies into other protected characteristics are few and far between. The only paper on disability reported striking differences in attainment between disabled and non-disabled registrars [ 59 ]. There has also been increased awareness about neurodiversity amongst doctors and yet an exploration into the experience of neurodiverse surgeons and their progress through training has yet to be published [ 62 ].

The implications of being LGBTQ + in surgical training have not been recognised nor formally addressed in the literature. Promisingly, the experiences of LGBTQ + medical students have been recognised at an undergraduate level, so one can hope that this will be translated into postgraduate education [ 63 , 64 ]. While this is deeply entwined with experiences of gender discrimination, it is an important characteristic that the surgical community would benefit from addressing, along with disability. To a lesser extent, the effect of socioeconomic background and age have also been overlooked.

Characterising trainees for the purpose of research

Ethnicity is deeply personal, self-defined, and may change over time as personal identity evolves, and therefore arbitrarily grouping diverse ethnic backgrounds is unlikely to capture an accurate representation of experiences. There are levels of discrimination even within minority groups; colourism in India means dark-skinned Indians will experience more discrimination than light-skinned Indians, even from those within in their own ethnic group [ 65 ]. Therefore, although the studies included in the scoping review accepted self-definitions of ethnicity, this is likely not enough to fully capture the nuances of bias and discrimination present in society. For example, Ellis et al. [ 4 ] grouped participants as “White”, “Mixed”, “Asian”, “Black” and “Other”, however they could have also assigned a skin tone value such as the NIS Skin Colour Scale [ 66 ], thus providing more detail.

Ethnicity is more than genetic heritage; it is also cultural expression. The experience of an IMG in UK postgraduate training will differ from that of a UKG, an Indian UKG who grew up in India, and an Indian UKG who grew up in the UK. These are important distinctions which are noted in the literature (e.g. by Woolf et al., 2016 [ 57 ]) however some do not distinguish between ethnicity and graduate status [ 15 ] and none delve into an individual’s cultural expression (e.g., clothing choice) and how this affects the perception of their assessors.

Reasons for DA

Despite the recognition of inequalities in all specialties of surgery, there is a paucity of data explicitly addressing why DA occurs. Reasons behind the phenomenon must be explored to enable change and eliminate biases. Qualitative research is more attuned to capturing the complexities of DA through observation or interview-based studies. Currently most published data is quantitative, and relies on performance metrics to demonstrate the presence of DA while ignoring the causes. Promisingly, there are a gradually increasing number of qualitative, predominantly interview-based, studies (Fig.  2 ).

To create a map of DA in all its guises, an analysis of the themes reported to be contributory to its development is helpful. In our review of the literature, four themes have been identified:

Training culture

In higher surgical training, for there to be equality in outcomes, there needs to be equity in opportunities. Ellis et al. [ 4 ] recognised that variation in training experiences, such as accessibility of supportive peers and senior role models, can have implications on attainment. Trainees would benefit from targeted support at times of transition, such as induction or at examinations, and it may be that currently the needs of certain groups are being met before others, reinforcing differential attainment [ 4 ].

Experience of assessment

Most literature in DA relates to the presence (or lack of) an attainment gap in assessments, such as ARCP or MRCS. It is assumed that these assessments of trainee development are objective and free of bias, and indeed several authors have described a lack of bias in these high-stakes examinations (e.g., Ong et al., 2019 [ 12 ]; Robinson et al., 2019 [ 53 ]). However, in some populations, such as disabled trainees, there are differences in attainment [ 59 ]. This is demonstrated despite legislation requiring professional bodies to make reasonable adjustments to examinations for disabled candidates, such as additional time, text formatting amendments, or wheelchair-accessible venues [ 67 ]. Therefore it would be beneficial to investigate the implementation of these adjustments across higher surgical examinations and identify any deficits.

Social networks

Relationships between colleagues may influence DA in multiple ways. Several studies identified that a lack of a relatable and inspiring mentor may explain why female or BME doctors fail to excel in surgery [ 4 , 55 ]. Certain groups may receive preferential treatment due to their perceived familiarity to seniors [ 35 ]. Robinson et al. [ 15 ] recognised that peer-to-peer relationships were also implicated in professional development, and the lack thereof could lead to poor learning outcomes. Therefore, a non-discriminatory culture and inclusion of trainees within the social network of training is posited as beneficial.

Personal characteristics

Finally, personal factors directly related to protected characteristics have been suggested as a cause of DA. For example, IMGs may perform worse in examinations due to language barriers, and those from disadvantaged backgrounds may have less opportunity to attend expensive courses [ 14 , 16 ]. Although it is impossible to exclude these innate deficits from training, we may mitigate their influence by recognising their presence and providing solutions.

The causes of DA may also be grouped into three levels, as described by Regan de Bere et al. [ 68 ]: macro (the implications of high-level policy), meso (focusing on institutional or working environments) and micro (the influence of individual factors). This can intersect with the four themes identified above, as training culture can be enshrined at both an institutional and individual level, influencing decisions that relate to opportunities for trainees, or at a macro level, such as in the decisions made on nationwide recruitment processes. These three levels can be used to more deeply explore each of the four themes to enrich the discovery of causes of DA.

Discussions outside of surgery

Authors in General Practice (e.g., Unwin et al., 2019 [ 69 ]; Pattinson et al., 2019 [ 70 ]), postgraduate medical training (e.g., Andrews, Chartash, and Hay, 2021 [ 71 ]), and undergraduate medical education (e.g., Yeates et al., 2017 [ 72 ]; Woolf et al., 2013 [ 73 ]) have published more extensively in the aetiology of DA. A study by Hope et al. [ 74 ] evaluating the bias present in MRCP exams used differential item functioning to identify individual questions which demonstrated an attainment gap between male and female and Caucasian and non-Caucasian medical trainees. Conclusions drawn about MRCP Part 1 examinations may be generalisable to MRCS Part A or FRCOphth Part 1: they are all multiple-choice examinations testing applied basic science and usually taken within the first few years of postgraduate training. Therefore it is advisable that differential item functioning should also be applied to these examinations. However, it is possible that findings in some subspecialities may not be generalisable to others, as training environments can vary profoundly. The RCOphth [ 55 ] reported that in 2021, 53% of ophthalmic trainees identified as male, whereas in Orthopaedics 85% identified as male, suggesting different training environments [ 5 ]. It is useful to identify commonalities of DA between surgical specialties and in the wider scope of medical training.

Limitations of our paper

Firstly, whilst aiming to provide a review focussed on the experience of surgical trainees, four papers contained data about either non-surgical trainees or medical students. It is difficult to draw out the surgeons from this data and therefore it is possible that there are issues with generalisability. Furthermore, we did not consider the background of each paper’s authors, as their own lived experience of attainment gap could form the lens through which they commented on surgical education, colouring their interpretation. Despite intending to include as many protected characteristics as possible, inevitably there will be lived experiences missed. Lastly, the experience of surgical trainees outside of the English-speaking world were omitted. No studies were found that originated outside of Europe or North America and therefore the presence or characteristics of DA outside of this area cannot be assumed.

Experiences of inequality in surgical assessment are prevalent in all surgical subspecialities. In order to further investigate DA, researchers should ensure all protected characteristics are considered - and how these interact - to gain insight into intersectionality. Given the paucity of current evidence, particular focus should be given to the implications of disability, and specifically neurodiversity, in progress through training as they are yet to be explored in depth. In defining protected characteristics, future authors should be explicit and should avoid generalisation of cultural backgrounds to allow authentic appreciation of attainment gap. Few authors have considered the driving forces between bias in assessment and DA, and therefore qualitative studies should be prioritised to uncover causes for and protective factors against DA. Once these influences have been identified, educational designers can develop new assessment methods that ensure equity across surgical trainees.

Data availability

All data provided during this study are included in the supplementary information files.

Abbreviations

Accreditation Council for Graduate Medical Education

American Board of Orthopaedic Surgery

American Board of Surgery

American Board of Surgery Certifying Exam

Annual Review of Competence Progression

Black, Asian, and Minority Ethnicity

Council on Resident Education in Obstetrics and Gynecology

Differential Attainment

Deprivation Quintile

European Economic Area

Entrustable Professional Activities

Fellowship of The Royal College of Ophthalmologists

Fellow of the Royal College of Surgeons

General Medical Council

Higher Surgical Training

International Medical Graduate

In-Training Evaluation Report

Member of the Royal College of Obstetricians and Gynaecologists

Member of the Royal College of Physicians

Member of the Royal College of Surgeons

Obstetrics and Gynaecology

Orthopaedic In-Training Examination

Participation In Local Areas

Postgraduate Year

The Royal College of Ophthalmologists

The Royal College of Obstetricians and Gynaecologists

The Royal College of Surgeons of England

United Kingdom Graduate

White United Kingdom Graduate

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Rebecca L. Jones, Suwimol Prusmetikul & Sarah Whitehorn

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RJ, SP and SW conceived the study. RJ carried out the search. RJ, SP and SW reviewed and appraised articles. RJ, SP and SW extracted data and synthesized results from articles. RJ, SP and SW prepared the original draft of the manuscript. RJ and SP prepared Figs. 1 and 2. All authors reviewed and edited the manuscript and agreed to the final version.

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Jones, R.L., Prusmetikul, S. & Whitehorn, S. Differential attainment in assessment of postgraduate surgical trainees: a scoping review. BMC Med Educ 24 , 597 (2024). https://doi.org/10.1186/s12909-024-05580-2

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Received : 27 February 2024

Accepted : 20 May 2024

Published : 30 May 2024

DOI : https://doi.org/10.1186/s12909-024-05580-2

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