Since 1999, women have made up more than 50% of entrants to medical schools in Canada. 1 Despite this gender parity among younger physicians, the literature reveals that women secure academic promotions, receive large grants, and publish papers at persistently lower rates than their male counterparts. 2,3 These inequities have far reaching consequences for patient care, education, research, and workplace culture within organizations. 4,5 Peer reviewed publications (including first authorships and invited submissions), peer reviewing, and journal editorial positions all are metrics assessed during academic recruitment and are used to show career progression in university promotion and tenure considerations as well as other job advancement activities. Publications ''count''both literally and figuratively. In this edition of the Journal, Flexman et al. present a cross-sectional, retrospective analysis of authors' gender in articles published in the Canadian Journal of Anesthesia (CJA). 6 Flexman et al. analyzed the gender of the first and last authors of both original articles and editorials published in the CJA from 1954 to 2017 (sampling one year of each ten-year epoch). The authors sought evidence to assess whether gender balance exists within the CJA by comparing women with men in terms of first authorship proportions on original research publications and editorials. They further explored if this proportion is representative of the proportion of female anesthesiologists in Canada. Of the 639 included articles, the majority (518/639; 81%) of first authors were male. The proportion of women listed as first author of original research reports increased over time, from a nadir of two of 43 (5%) in 1960 to 16 of 60 (27%) in 2017. Original research articles received more citations and were more likely than editorials to have a woman as first author. From 2000 onward, the overall increase in the proportion of female first authors trailed the overall increase in proportion of women anesthesiologists in Canada. Flexman et al. thus concluded that female first authors are underrepresented both relative to male first authors and to the changing demographics of anesthesiologists in Canada. 6 As the authors note, the CJA is not alone. Using 2011 data, Galley and Colvin reported that of 188 original research papers published in the British Journal of Anaesthesia, 57 (30.3%) of first authors were women. 7 Similarly, Miller et al., found that of the 2,600 articles published in Anesthesiology and Anesthesia and Analgesia during four one-year epochs (2002, 2007, 2012, and 2017) the overall the contribution of female first authors was 24.8% (646/2,600). 8 Underrepresentation of women in academia and medicine is ubiquitous across nations, fields, and specialties. Indeed, this underrepresentation of women in the CJA mirrors findings in the larger medical community and should come as no surprise. Numerous high impact peer reviewed medical journals have been shown to suffer from a similar gender bias in their publications. A review of ...