Plenty of moustaches but not enough women: cross sectional study of medical leaders
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6311 (Published 16 December 2015) Cite this as: BMJ 2015;351:h6311
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As research fellow trained in epidemiology, I applaud the authors for their carefully-designed study. I disagree with the previous commenters about the authors' lack of consideration of female department heads as potentially having moustaches; the authors clearly state that "We evaluated each leader for the presence of facial hair regardless of sex." The authors also recognize the potential influence of both age and cohort effects by era of facial hair popularity, although it is true that the "Movember" effect could have been at play as well.
Although this study was perhaps satirical, it does present interesting possibilities for the evaluation of similar indices through digital footprints. Perhaps we will next see a study comparing Facebook posts about department leaders' automobile purchases, or geolocated tweets about international travel and how these may differ by age, race/ethnicity, sex/gender and disability status. The authors are to be commended for initiating a new research paradigm: Web Heuristics for Observing Online Properties using Satirical Insights and Examination (WHOOPSIE). We can only hope that other authors follow suit.
Competing interests: No competing interests
This study has a fatal flaw in that the two groups being examined are not mutually exclusive. Furthermore, and from anecdotal experience (1), the development of a moustache, and indeed a beard, may be related to being to busy in the pursuit of knowledge to have the time to shave.
Whilst the stated conclusion may be laudable, it may not be made as a result of this imperfect study.
(1) Benett IJ personal communication.
Competing interests: I have a moustache
This year's National Medical Director's Clinical Fellows had an immediate resonance with the themes presented in this wonderful paper. A firm appreciation of facial hair accompanied unanimous discontent with the gender inequality that has been demonstrated to persist in medical leadership roles.
After debate around taxonomy and categorisation was quashed with referral to the moustache overview in Figure 2 of the methods section, what was apparent was the need to determine how we would fare when scrutinised by the same test.
After much concentrated effort (displayed in the figure attached) the calculations revealed a rather welcome moustache index of 2.17 where women outnumber the moustachioed by more than twice. Debate continues to surround the interpretation of this number and its applicability as a metric around equality but what is clear is that all the Keogh Fellows are strongly committed to gender equality in medical leadership, and some of us recognise the value of a good moustache.
Competing interests: Male with moustache
The authors raise an interesting observation on the paucity of women in NIH medical institutes, that moustachioed individuals significantly outnumber women as leaders of medical departments in the US.
However, the data is compromised by two confounding variables ignored from analysis - one significant, one less so. The rise of 'Movember', exploiting male upper lip hursuitism for charity purposes and endured by women for up to 30 days each year, is an annual male competition excluded from your data. This is significant as the 'Movember' movement continues to grow (1). Timing of the 'MI' score could skew the data.
Secondly, in this age of equality, the authors excluded women from the 'Moustache index' rating score. Female upper lip hair is an aesthetic issue, and variation in removal methods influence visual scoring ability (2). However, given the paucity of women in senior roles the scoring of both sexes in terms of upper lip hair growth would not have altered the findings significantly.
1. Wassersug, Richard, John Oliffe, and Christina Han. "On manhood and Movember… or why the moustache works." Global health promotion (2014): 1757975914536913. http://ped.sagepub.com/content/early/2014/07/14/1757975914536913.abstract
2 .Javorsky E, Perkins AC, Hillebrand G, Miyamoto K, Boer Kimball A. Race, Rather than Skin Pigmentation, Predicts Facial Hair Growth in Women. The Journal of Clinical and Aesthetic Dermatology. 2014;7(5):24-26.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025516/
Competing interests: No competing interests
Re: Plenty of moustaches but not enough women: cross sectional study of medical leaders
In regards to your article, "Plenty of moustaches but not enough women: cross sectional study of medical leaders,"
I believe Frank Zappa, in his famous song, "Catholic Girls," mentioned women with tiny little mustaches. I wonder if the authors in this critical study controlled for that occurrence?
Thank you!
Jeff L Laskin DMD MS MD
Former Associate Professor
Colleges of Dentistry and Medicine
University of Florida
Gainesville, Florida
Competing interests: No competing interests