Representation of women at American Psychiatric Association annual meetings over 10 years (between 2009 and 2019)

Objective Sex disparity is a major societal issue. The aim of this paper was to describe changes in the representation of women among speakers of the American Psychiatric Association (APA) annual meeting over 10 years, between 2009 and 2019 and to compare them to changes in the proportion of women among American psychiatrists. Methods Data were collected from the programs of the APA annual meetings of 2009 and 2019, and from the Association of American Medical Colleges. Descriptive and comparative statistical analyses were performed. Results There were 1,138 distinct speakers at the 2009 conference and 1,784 at the 2019 conference. The number of distinct female speakers increased from 413 (36.3%) to 813 (45.6%). The proportion of female speakers at the meetings was almost equivalent to the proportion of women in the American psychiatrists’ workforce. The number of female chairs increased from 158 (39.6%) to 322 (46.4%). There were 38 female speakers in child and adolescent psychiatry in 2009 (51.4% of 74 speakers) and 74 in 2019 (51.0% of 155 speakers). Conclusions The representation of women at the APA annual meetings increased between 2009 and 2019. At the same time, the growth in the percentage of women in the American psychiatrists’ workforce was slower. The APA appears to promote female representation during its annual meetings.


Statistical method and interpretation
As the authors responded to reviewer #2, the population of this study is "the speakers at the 2009 and 2019 APA annual meetings," and the data of this study are not sample data, but population data: "We collected the data for all the speakers of the 2009 and 2019 APA annual meetings." Here, the parameters of interest are the percentages of women of all the speakers in the meetings, which can be found by simply calculating the percentage using the population data the authors have. In other words, the parameters of interest are known, so it is inappropriate to perform any statistical estimation (i.e. ztest, Chi2 analysis, p-value, etc.), which is the process to use sample estimates to approximate the value of unknown population parameters. See similar previous papers (e.g. Gerull et al. 2020, Sleeman et al. 2019, and May and Dimand 2019 which simply report the number/percentage of women without any tests and perform statistical tests only when they need to estimate some unknown parameters.
In the result section, the authors repetitively report estimates, p-values, and statistical significance of the estimates. For the reasons I mentioned above, however, I am neither persuaded that these statistical analyses in this study are well performed, nor that the interpretation and discussion of the results are presented in an appropriate/intelligible fashion.

Logistic regression
The authors mechanically report the result of the logistic regression without any interpretation. I cannot find any consideration as to why the explanatory variables are chosen or what the estimates mean. The authors added this analysis responding to a previous reviewer who suggested to use a hierarchical regression technique, but the logistic regression was not performed as such.
This paper would be more substantial if the authors went beyond the current research question: whether the percentage of women in the APA meetings increased between 2009 and 2019. The question would be easily answered by simply calculating the percentage of women in the data without any statistical inferences. A possible question which can be further studied with the data is which factor explains the increase in the women's representation (this is the question where statistical estimation is really needed). Although the authors suggest some possible explanations in the discussion section, they are weakly supported by the data. For example, an interesting question left for future research is "the impact of the sex of the chair on the choice of speaker at the APA annual meetings," as suggested by the authors in "Strengths and limitations." If the data provide the information on chairs of each APA meeting session, the authors would be able to regress the percentage of women in a session on the gender of the chair of the session controlling for other explanatory variables.

Consistency with the national demographic data
The authors could provide more empirical analyses, especially in terms of the limitations of this paper mentioned in the subsection "Strengths and limitations." For example, one of the limits is that the speakers of the APA meetings are not necessarily U.S. researchers; they also consist of researchers from other countries. The authors could reduce this concern by collecting data on the speakers' institutions (as the authors collected the gender of the speakers) to determine whether the speakers working within or without the U.S.

Referring to figures
Although a previous reviewer suggested to "ensure that you refer to Figure 1-2 in your text," such figures have not been explicitly referred to by the text. The authors could mention figures 1-3 somewhere in the subsections "Roles," "Topics," or "Sessions" of the Results section.