Editorial: raising awareness about gender bias and disparity in clinical neuropsychology and a call to action

According to the most recent practice survey of clinical neuropsychologists (Sweet, Benson, Nelson, & Moberg, 2015), women in our field comprise approximately 56% of professionals and 77% of postdoctoral trainees. Despite the fact that women now make up the majority of practicing and incoming neuropsychologists, our profession, like the rest of society, is not free from gender bias and disparity. Because the first step toward effecting a change of any kind is awareness, it is hoped that this special issue will increase the field’s understanding of where we stand, thereby facilitating eventual shifts toward a more equitable distribution and utilization of resources, leadership roles, and intellectual capital.

Setting the stage for this special issue is the article by Sweet, Lee, Guidotti Breting, and Benson (2018) who tackle an important gender disparity – the gender pay gap. Sweet and colleagues utilize recurrent neuropsychology professional practice surveys spanning 2005–2015 to investigate gender differences in salary, as well as work status, work setting, professional identity, career satisfaction, and retirement expectations. These authors provide a helpful review of literature across a range of disciplines to put findings into context and to highlight factors that may contribute to gender differences when present. Results showed a sizeable pay gap within neuropsychology in favor of men – $48,600 in 2015 – that has remained stable over the past 10 years. Women neuropsychologists, perhaps not surprisingly, report lower income, job, and work-life balance satisfaction than men. Sweet and colleagues examine factors that could account for lower satisfaction among women and ultimately conclude that relationships are complex and not fully explained by the variables available in the current study. They point out that the future of neuropsychology ‘will rest squarely on the shoulders of women’ who will comprise the majority of the workforce. However, decisions about the future of our field, including implementation of policies that could reduce the gender pay gap and other gender disparities, will not be in the hands of women unless women ascend into leadership positions and their voices are heard.

This important gender disparity – fewer women in leadership positions – is the subject of the next few articles in this special issue. Sachs and colleagues (2018) start the discussion by reviewing historical underpinnings of women and leadership within neuropsychology and examine the current status of gender composition in a variety of elected and appointed leadership roles, including membership on editorial boards, leadership positions in professional organizations, and Fellow status attainment. Their findings reveal that gender disparities persist within neuropsychology leadership despite concerted efforts by professional organizations to address the issue. Sachs et al. touch on factors that contribute to continued gender disparities in leadership roles, such as achieving work–life integration, obtaining career confidence, and accessing mentors/sponsors. They advocate for institutions and organizations to take a systematic, multifaceted approach to confronting and eventually removing these disparities.

Dr. Cynthia Kubu’s contribution to this special issue catches one’s attention immediately by the title – Who does she think she is? Women, Leadership and the ‘B’(ias) Word. Kubu takes a deeper dive into reasons for gender differences in leadership by examining the broader academic literature. She reviews literature on gender roles, organizational expectations, and leadership models. One noteworthy finding was that although men and women are rated equally effective as leaders when considering all contexts, ratings of effectiveness are moderated by factors such as type of organization, hierarchy of leadership, and gender of the rater. Kubu also highlights studies revealing subtle gender bias in areas as diverse as hiring and renewal of National Institutes of Health R01 grants, and she touches on the intersection between gender and race/ethnicity. She closes by providing literature-based recommendations for becoming an effective leader, such as finding a sense of purpose, understanding the culture and values of the organization, and knowing how these align with one’s strengths and values.

Continuing with the theme of effective leadership, Silver, Benitez, Armstrong, and Tussey (2018) reached out for advice to women neuropsychologists who had been successful in obtaining leadership positions. Twenty-one of the field’s prominent women leaders freely shared their wisdom about how to obtain leadership roles, what leadership styles work best, and how to earn respect as a leader. Some important themes that emerged include knowing your strengths and proactively and strategically volunteering them, finding your own leadership style by observing others, utilizing a collaborative approach, doing your homework, showing respect for others’ ideas, and letting your actions speak louder than your words. These authors also make the important point that sitting at the table is only the first step – speaking up or ‘taking the microphone’ is equally important.

Although the articles by Kubu (2018) and Silver and colleagues (2018) address the gender gap of women in leadership positions, the recommendations provided can benefit both women and men as can the content of the next article of the special issue by Gooding, Block, Brown, and Sunderaraman (2018). Gooding and colleagues review the benefits of leadership and professional service and outline the many opportunities available within neuropsychology. They encourage both trainees and early career professionals to engage in professional service to facilitate development of leadership skills, and offer guidance for doing so successfully. They then point out several strategies that can be used by mentors, individuals serving in leadership roles, and professional organizations to promote involvement of trainees and early career professionals in professional service to the benefit all parties.

A recurring topic throughout the special issue is the importance of mentorship and sponsorship for career advancement, which is the subject of the next article. Hilsabeck (2018) explores differences between mentoring and sponsoring by interviewing 20 neuropsychologists with experience in these roles. Characteristics desired and valued in protégés, expectations of protégés, and reasons for and benefits of mentoring and sponsoring were examined, and findings can inform individuals seeking mentorship/sponsorship as well as future and current mentors/sponsors. There was significant overlap in mentoring and sponsoring, and these concepts are best viewed as part of a continuum. Results also revealed a gap in training in mentorship/sponsorship, and it is recommended that formal training in mentoring/sponsoring be addressed in the near future.

The final article of the special issue also addresses an important topic that came up repeatedly – that is, the challenge of work–life integration. Feigon and colleagues (2018) introduce this topic by first defining the concepts of work and life and then walking the reader through the evolution of the literature, which started as work–life conflict, evolved to work–life balance, and then finally emerged as work–life integration, acknowledging that work and life are constantly shifting and rarely in balance. These authors review the literature on work–life integration across different career stages, work settings, and gender and racial/ethnic diversity, and offer preliminary recommendations that will be beneficial to all neuropsychologists.

It is my sincere hope that the articles in this special issue will generate open dialog about gender bias and disparities within neuropsychology and inspire further research and policies to address them. Doing so will help ensure that the field of clinical neuropsychology maximizes its intellectual capital, which is critical in order to address the complex neurobehavioral issues faced by our patients and their families. The combined efforts of both men and women will be necessary to affect change.

A final note is warranted to express my sincere thanks to the contributors of this special issue for bringing these topics to the forefront of neuropsychology and pointing the way forward. My thanks also goes to the many colleagues, both women and men, with whom I have engaged in discussions about gender bias and disparity and who undoubtedly have shaped my thoughts and inspired my path in this direction. Finally, a word of thanks goes to Yana Suchy, Editor-in-Chief of The Clinical Neuropsychologist, for suggesting a special issue on this topic and for modeling effective leadership in all ways possible.

Disclosure statement

There are no financial or legal conflicts of interest related to this manuscript.

Robin C. Hilsabeck
Independent Private Practice, Austin, TX, USA
Department of Psychology, University of Texas at Austin, Austin, TX, USA
Central Nervous System (CNS) Business Unit, INC Research/inVentiv Health, Austin, TX, USA
[email protected]