Advances and barriers in gender equity within Brazilian rheumatology: a two-year follow-up study

INTRODUCTION: Gender equity is increasingly recognized as essential to integrity and sustainability of the medical workforce, yet significant disparities remain. This study aims to evaluate longitudinal trends in gender equity within Brazilian rheumatology, focusing on career advancement, work-family interface, and workplace safety. METHODS: This comparative cross-sectional study analyzed two self-administered, web-based surveys conducted at different moments among members of the Brazilian Society of Rheumatology (SBR), to assess temporal changes. The surveys included Reuma Equity (2022, n = 459, 67.1% women) and the Brazilian subset of the global Coalition for Health and Gender Equity (CHANGE) (2024, n = 301, 74.4% women). Statistical analyses included Pearson's chi-square, Fisher's exact, and Mann-Whitney tests, with a significance level set at p ≤ 0.05. RESULTS: In both moments, female rheumatologists were younger [2022: OR 3.7, (95% CI 2.2-6.4, p = 0.001); 2024: OR 4.3, (95% CI 2.2-8.6, p < 0.001)], carried a greater burden of domestic labor [2022: OR 2.8, (95% CI 1.8-4.3, p < 0.001); 2024: OR 2.8, (95% CI 1.5-5.1, p < 0.001)], and men were more likely to occupy prominent positions at national congresses [2022: OR 2.3, (95% CI 1.5-3.4, p < 0.001); 2024: OR 2.1, (95%CI 1.3-3.6, p = 0.005)]. There was an increase in the probability of women being more likely to refuse career progression for family-related reasons [2022: OR 2.1, (95% CI 1.2-3.7, p = 0.038); 2024: OR 3.2, (95% CI 1.8-6.1, p < 0.001)], and a decrease in reported rates of sexual harassment [2022: OR 4.2, (95% CI 2.5-6.9, p < 0.001); 2024: OR 2.6, (95% CI 1.4-4.6, p = 0.002)]. Gender disparities in medical visit fees (lower fees: 69.2% women and 57.6% men, p = 0.043), and medical visit duration (longer appointments: 78.2% women and 69.5% men, p = 0.014) observed in 2022 disappeared by 2024 (p = 1.00, p = 0.318). CONCLUSION: Although representation in Brazilian rheumatology is increasing, women continue to shoulder disproportionate domestic responsibilities, decline career opportunities more often, and experience higher rates of harassment. Even so, improvements were observed in professional indicators and in the male' views, suggesting gradual progress toward gender equity.