Breaking the Glass Ceiling: Female Speaker Representation at the American Orthopaedic Foot & Ankle Society Annual Meetings Over Time.

Background: Female representation among residents and practicing surgeons in orthopaedics remains disproportionately low at 19.3% and 7.4%, respectively. This study investigates female representation in speaker roles at American Orthopaedic Foot & Ankle Society (AOFAS) meetings over time. Methods: The annual AOFAS meeting programs for 2012 to 2024 were reviewed by 3 independent raters. Each speaker, moderator, and panelist was classified based on gender and role; data were cross-checked using Fleiss multirater κ validation. Sessions discussing surgical or biomedical topics were categorized as "technical," and all other sessions were categorized as "nontechnical." Yearly odds ratios (ORs) and CIs evaluating gender vs session status, as well as gender vs speaker role, are provided. Results: A total of 2396 speaking sessions were analyzed; 11.5% of sessions were led by female speakers. Over time, female speaker representation ranged from 5.61% in 2014 to 18.75% in 2022. Female speakers led only 10.8% of the 2088 technical sessions. On average, female speakers were significantly more likely than males to assume nontechnical speaking roles across all years combined (OR 1.5111, 95% CI 1.0792-2.1158, Conclusion: Female speaker involvement was representative of AOFAS female membership and the national population of female orthopaedic surgeons. Additionally, our study revealed an increasing trend in female speakers, panelists, and moderators from 2012 to 2024. However, there is a need for a shift in the distribution of speaker roles to prevent professional marginalization. Continued efforts to support female representation as role models at national conferences increases visibility and may help to address the lack of women within orthopaedics. Level of Evidence: Level III, retrospective cross-sectional study.