Background: Gender inequality in medicine still remains an issue. Despite the growing proportion of female physicians in pulmonology, they appear underrepresented in interventional pulmonology careers and leading positions. To obtain further insights in the gender distribution in interventional pulmonology, a survey of female, male and gender diverse physicians was conducted worldwide in 2022.
Methods: The online survey was sent to physicians working in pulmonology departments internationally between July and December 2022. The questionnaire included questions on gender diversity in the pulmonology departments in hospitals and universities, proportions of male, female and gender diverse physicians performing bronchoscopy, career progression and social life.  
Results: Responses were analysed from 92 physicians (mean age 45±10 years) from 47 hospitals in 17 countries, of whom 52% were women, 0% were gender diverse. Overall, 79% of the respondents were pulmonologists and 83% perform bronchoscopy. Women were more likely to have another specialist qualification in addition to pulmonology (66% women vs. 48% men). While 60% of the male responders hold leading positions, it was only 23% for female respondents. Men were more likely to be involved in research compared to women (89% men vs. 77% women). Discrimination due to gender was reported from 5.3% of all men and 26.8% of all women.
Conclusion: Men and women are equally engaged in interventional pulmonology. Gender diverse physicians are highly underrepresented, probably due to the newer classification for the third sex. While women are more likely to hold a second specialty, men are more involved in research and more likely to hold leading positions.