In May 2018 at the Cannes Film Festival, 82 women directors and actresses came together to draw attention to gender inequity in the film industry. 1 They pointed out that during the festival's 71 years, only 82 films directed by women had premiered in competition for the top prize, compared with 1645 films directed by men. The top prize had only once been awarded to a female director. A similar gender inequity has been described in publishing. VIDA, an organization that collects data on parity

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... n the literary field, analyzed the major publishers of book reviews and found far more published reviews of books by men than by women. 2 To determine whether this was because of publishing bias, an analyst at the New Republic reviewed the catalogs of 13 publishing houses and found that in 11 of the publishing houses, 30% or fewer of their books were written by women. 3 This phenomenon appears to be unrelated to writing skill. When they are in high school, girls are generally better writers than boys. From 2006 to 2015, when the Scholastic Aptitude Test included a graded 25-minute essay, girls scored more than 10 points higher than boys on the writing test each year. 4 Women outperform men in college and graduate school as well. In their article "Assessment of Women Physicians Among Authors of Perspective-Type Articles Published in High-Impact Pediatric Journals," 5 Silver et al found that women physician authors were underrepresented in all 4 pediatric journals studied during a recent 5-year period (2013-2017) compared with the proportion of women practicing pediatrics. Why might this be? Three possible reasons come to mind. First, the writing of a perspective-type article is more likely to happen outside of the physician's normal workday. Women have fewer hours outside of their paid workday in which to undertake writing activities because they are doing more unpaid work than men. On an annual basis, the Organisation for Economic Co-operation and Development summarizes the amount of time that people aged 15 to 64 years spend on unpaid work (defined as work that produces goods or services but is unremunerated, such as caring for children or elders, cooking, or cleaning). The most recent survey data, collected in 2017, show that on average women in the United States reported doing more than 4 hours per day of unpaid work and men reported doing 2.5 hours per day of unpaid work. 6 Women physicians are generally time starved because society still assumes women will perform most of this unpaid work; it comes with an opportunity cost. A second possible factor is that all 4 high-impact pediatric journals studied had male editors in chief. Male physicians may be more likely to invite and favorably review perspective-type articles from other male colleagues (the "old boys club" effect). A third possible contributor might be the gender composition of the editorial boards of the 4 selected journals. The editorial boards are, with one exception, composed of more men than women; in 2018 only Academic Pediatrics has more women than men on its editorial board (16 of 27 [59%]); JAMA Pediatrics has 6 women of 15 board members (40%), The Journal of Pediatrics has 10 women of 31 board members (32%), and Pediatrics has 11 women of 26 board members (42%). This is not to say that male editorial board members consciously reach out to offer writing opportunities to others of their gender, but the power structure of American society ensures that subconscious gender bias is ubiquitous. It will not be easy to overcome this subconscious bias. Men continue to hold most of the power in pediatrics. When men evaluate the research that confirms gender bias in science, technology, +