Gender increasingly is recognized as a determining factor in the ability to achieve success in the workplace. This is observed not only with compensation, but with professional advancement and leadership opportunities. Longstanding evidence exists detailing the considerable differences in pay between men and women. While it might seem as though women have made great advances in overcoming these disparities with rising visibility of “glass ceiling breakers” such as Sheryl Sandberg, Oprah Winfrey, and others, the truth is that little has changed for most women. 

Pay inequities continue to exist across the spectrum. In almost every occupation and profession, women are paid less than their male counterparts, even those that are predominantly female (DOL, 2015). Likewise, women continue to lack equal representation in leadership roles, and do not have equal opportunities for professional advancement (Center for American Progress, 2014a). 

FIGURE 1. Equality on the left; equity on the right (The Inclusion Solution website, 2017).

Despite increased awareness and targeted efforts towards workplace equality, issues related to stereotypes, bias, and assigned or perceived gender roles persist. To eliminate the inequalities, we must reform the prevalent culture that quietly (and not so quietly) subverts efforts toward meaningful change. Beyond the pay gap, additional long overlooked issues surrounding gender equity and equality only recently have gained widespread attention in American society. 

Equity Versus Equality

How do equity and equality differ, and how does this impact women in the workplace? Equity is providing everyone with the resources they need to be successful, while equality is treating everyone the same. It might seem as though treating everyone equally is a simple and effective solution. However, this approach does not take into account individual differences, needs, or the context in which the disparities exist. 

FIGURE 1 (The Inclusion Solution, 2017) illustrates equality on the left: everyone trying to see over the fence gets the same box; clearly this doesn’t work well for two of the spectators. The image on the right illustrates equity by considering the specific needs of the individual spectators and address those needs with different resources. Achieving equity is dependent on the willingness to address differing needs to realize the best possible outcomes for each worker. 

Gender equality then, isn’t about making women into men or vice versa, it’s about recognizing that equal access to opportunities and resources for success must be provided. Effective solutions toward equality is predicated on recognizing what resources are needed to achieve equity. This article will explore challenges and opportunities in audiology in the area of leadership and professional advancement. The goal of this article is to start a much-needed dialogue on challenges and opportunities in developing women into leaders in our profession and in society as a whole. 

The Leadership Gap: Some Statistics

FIGURE 2. Percentage of the population aged 25 to 29 with a bachelor’s or higher degree, by sex (1967 to 2015).

Women make up nearly 51 percent of the general population in the United States and have outpaced men in terms of degree attainment for nearly two decades (FIGURE 2, DOL, 2016). Attainment of leadership roles, however, has not followed the same trend. For example, despite accounting for 78 percent of the health-care sector’s workforce, women represent only 15 percent of executive officers and only 12 percent hold board seats in the health-care arena. (FIGURE 3, Center for American Progress, 2014b).

Health care, however, is just one aspect of the professional disparity that exists in our country. This disparity also is seen in governance. In 1916, Jeannette Rankin of Montana was the first woman elected to the House of Representatives. Elected at a time when women did not have the right to vote, her achievement particularly was groundbreaking. More than 100 years later, however, the U.S. political system continues to be dominated by male representation. 

Women hold only 20 percent of the membership in the U.S. Congress and only 20 percent to 25 percent elected office nationwide (Center for American Women and Politics, 2018). At this rate, the Institute of Women’s Policy Research suggests that it will take another 100 years for women to reach parity in politics (Institute for Women’s Policy Research, 2015).  

As key stakeholders, our political leaders are the ones who hold the greatest power to effect change. This lack of progress of equal female representation where public policy is developed, and laws and regulations are enacted undoubtedly has cultivated the widespread inequities that persist across all sectors of society today.  

The Leadership Gap: What About Audiology?

Let’s take a deeper look at the profession of audiology. How do we measure up in terms of leadership distribution? In FIGURE 4, we see that the current 2017–2018 Academy Board of Directors is 58 percent female. The most recently elected classes of 2019 and 2020 are only 33 percent female. While men represent less than 20 percent of audiologists, they account for 40 percent of the upcoming 2018–2019 nominations for the Board of Directors. 

With women accounting for about 81 percent of the profession (DataUSA, 2014), it seems implausible that women would not hold the majority of leadership roles. It is important to explore the contributing factors that lead to these inequities. Is it that women are not voting for women? Is it that women are not getting nominated or are less likely to self-nominate? Is it that women are less inclined to take on leadership roles? How do we ensure equal gender representation? To vote for women, they must be on the ballot. So, what prevents the engagement, the ability to step-up? 

Leadership Obstacles, Challenges, and Opportunities

FIGURE 3. Percentages of women in each role.

Tara Sophia Mohr, an expert on women’s leadership, found that women are less likely to apply for leadership roles due to the fear of failure. Women are less likely to rely on self-advocacy skills, relationships, or experience beyond the stated qualifications to make up for the lack of skills required (Harvard Business Review, 2014). While misperceptions about the hiring process as opposed to the actual job can be a factor, gender bias plays a much larger role. For example, women do likely need to be more qualified since they are more likely to be hired or promoted based on their records. 

On the contrary, men are more likely to advance due to their “potential.” In addition, young girls are socialized to “follow the rules” and subsequently are more successful in school relative to boys, but that rule-following skill becomes so ingrained, it’s hard to break the habit in the workplace. Credentials were essential and required of women early in the 20th century when starting to break into male-dominated positions. Without an “old boys” network to rely on, they had to play by the rules and over-credential themselves to be competitive. That mindset resulted in women overestimating formal training at the cost of using self-advocacy skills to promote themselves and continues today.

Heilman and Chen (2005) reported on two experimental studies where they postulated that men performing altruistic citizenship activities in the workplace would enhance their favorability rating, and women who chose not to do such activities would harm their favorability. An example of an altruistic citizenship activity in the study was staying late at work to help a colleague. 

Participants in the study were asked to rate the performance of a male or female employee who stayed late or chose to not stay late. If a man stayed late, he was deemed more favorable by a small amount as compared to the woman. However, if the man and the woman both chose not to stay late, the woman paid a much higher cost in terms of reduced favorability ratings. Isn’t it possible that the woman would not be in the position to make such a choice even if she wanted to stay late to help a colleague? Their analysis of 183 studies from 15 different countries indicated women’s increased chances of burnout due to emotional exhaustion when trying to maintain a healthy work/life balance. 

Women routinely take on the undervalued activities such as child pick-up and drop-off, child sick days, home cleaning/maintenance, planning parties, etc., causing them to miss important career opportunities or to not be taken seriously. In addition, although the majority (69 percent) of children in the United States live in a two-parent household, single mothers make up the second-most common family unit. Since 1960, the percentage of children living with only a mother nearly tripled from 8 percent to 23 percent, while those living with only a father increased from 1 percent to 4 percent (U.S. Census Bureau, 2016).

A survey of female and male surgeons in academic medicine (Dyrbye et al, 2011) found that more than 90 percent of male surgeons were married and 50 percent were married to someone who did not work outside the home. Conversely, women surgeons were more likely to be single. Also compelling was that only 60 percent of women in academic medicine have children while more than 90 percent of men have children. What contributes to this disparity? Is it that women who do not seek to have children are more likely to pursue demanding careers or is it that women are choosing not to have families due to challenges balancing family and strong academic careers? The inequity in spousal support for critical maintenance of family (children who are sick, pick-ups and drop-offs, etc.,) undoubtedly contributes to burnout. 

How does the imbalanced distribution of home responsibilities affect professional advancement? In the same survey (Dyrbye et al, 2011), the majority of women faculty were at the assistant professor rank (48 percent) while the majority of male faculty were at the full professor rank (42 percent). Yet, there were no differences in median hours worked per week between males and females. This clearly challenges the misconception that having a family contributes to working less. It suggests that women physicians work just as many hours, yet they do not achieve academic advancement at the same rate as their male colleagues. 

If the work weeks are similar, then it must be the extracurricular activities where discrepancies occur (i.e., needing to skip the after-hours meeting or get-together in order to care for the children). In addition, family care issues might take precedence over writing a case report for publication that leads to improving one’s curriculum vitae. Maybe women must choose a less rigorous committee on which to serve so that night-time conference calls are limited, providing more time for family matters. Recognizing the highly imbalanced distribution of home responsibilities among women and men is a step in the right direction to a more equitable work environment.

Change Is Possible: Small Successes Daily

Indeed, a fundamental barrier to achieving gender equality is the limited voice women have in decision making across all sectors of society—politics, economics, education, employment, etc. We need increased female leadership to influence these changes. Improved mentoring to elevate women into leadership roles would serve to grow awareness and allow for a platform to discuss and address issues that are specific to women, by women. With more balanced gender representation, this would help us to move toward more equitable solutions.

FIGURE 4. Percentage of women in leadership roles in the Academy.

Each of us is capable of affecting change in our own environment. Making the choice to take an active role in empowering the women around us is a small but important step in raising the female voice and encouraging women on the path to leadership. We cannot sit back and wait for others to create change for us. Make the decision today to recognize your own value. If you do not fully believe in the value that you bring to your organization, you cannot successfully advocate for yourself or your colleagues. For this to be effective, we must also support others in self-advocacy—seeking out opportunities to lift those around us. 

Working to raise the value of the group provides the necessary foundation to raise ourselves individually. There is a great truth to the concept of strength in numbers. Changing the culture only happens if each of us is actively engaging. The following section highlights just a few practical solutions you can implement in the short term to accelerate long-term change. 


Take a seat at the table. Unless there is a specific reason not to do so, always take a seat at the table. Ensure your ideas are heard and acknowledged by being an active participant in meetings. Never apologize when sharing your ideas, as it automatically undervalues your contribution. Make it a personal goal that at every meeting you either use your voice to champion yourself or a colleague.


Identify those who can mentor you and reach out to them. Asking for help and locating resources is critical for advancing. Don’t be afraid to send an email or pull them aside at a conference. Reaching out to other women who have attained a level of leadership that is your goal is imperative. Individuals at every level enjoy being sought out for advice and counsel. Developing a peer support group is also effective as it provides opportunities to amplify each other’s ideas and solutions. Engage these individuals to provide you with honest feedback. This is hard but critical for growth. 


One of the most important solutions for short- and long-term advancement is to start your career positioned for equality and success. Babcock and Laschever (2007) report that women are reticent to negotiate their salaries leaving as much as $2 million over their lifetime. Men are more than four times as likely as women to negotiate a first salary and women who consistently negotiate their salary increase their earnings at least $1 million   more during their careers than  women who do not. 

Prepare to talk about your value and how it benefits the workplace. Be specific about past accomplishments and how they contribute to the overall success of the team. Don’t undersell even though it might seem boastful and uncomfortable. 

We Are Just Getting Started

As the emerging professional works to further her or his career, biases surrounding leadership attributes and promotion are hurdles that must be faced not only in audiology but all professions and occupations. Even seasoned professionals must remain aware of how bias (including outdated gender roles) affects their advancement and the advancement of others and how that influences the workplace. 

For equality (parity, equivalence) to happen in the workplace in our lifetime, we will need to promote women by elevating and amplifying their accomplishments. We must nominate women for the tough jobs, get women’s names on the ballot, and be vigilant in calling out gender bias when we see it.  This requires the commitment of women and men. There is no question that having the courage and resources to do this is easier the more advanced we are in our career. 

The truth is that the ability to mentor, guide, promote, and elevate qualified women exists at all career stages.  As a profession, we can work to identify ways to reduce inequities, acknowledge our biases, and work toward change by creating more opportunities for women early in their careers. 

We have just scratched the surface. We need to discuss issues such as how to find a mentor or become a mentor, how to advocate for pay equity, how to negotiate effectively for compensation and leadership opportunities, and much more. Leadership is a learned behavior and it is earned through many small experiences that build on each other. The critical missing pieces to date, have been (1) limited access to opportunities and (2) true equity. For real, sustainable change we need both. Let’s keep the discussion going. 

People illustration.