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Int. J. Environ. Res. Public Health2026, 23(1), 103;https://doi.org/10.3390/ijerph23010103 
(registering DOI)
by
  • Giulia Lausi

Reviewer 1: Anonymous Reviewer 2: Clarissa R. Steele

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for undertaking this review, however, I was not certain about the purpose of the review. 

Lots of people have worked in discrimination and gender why this review? Why now? We are all aware of these things, they have been researched for decades- what is new about this review? This really needs to stand out and be clear.

 

Surprised such a low number of papers were retrieved, more on the search terms and filtering would be useful to understand why this was the case as this is a very popular term in health and social research 

 

Author Response

I'd like to thank the reviewer for their comments on the manuscript and for raising important points regarding the purpose, novelty, and scope of the review. I will try to clarify these aspects.

C1: Lots of people have worked in discrimination and gender why this review? Why now? We are all aware of these things, they have been researched for decades- what is new about this review?

Response: This work was designed as an umbrella review, with the explicit aim of synthesizing and integrating evidence from systematic reviews and meta-analyses on gender discrimination and related psychological mechanisms. While it is true that gender discrimination has been extensively studied over several decades, the rapid expansion, fragmentation, and disciplinary diversification of this literature has resulted in a body of evidence that is difficult to navigate, compare, and conceptually integrate. The aim of this review does not consist in identifying new instances of discrimination, but in systematically consolidating higher-order evidence to clarify how discrimination manifests across different levels, and how these mechanisms are linked to mental, physical, and professional outcomes. To the best of my knowledge, this is the first umbrella review to provide an integrated psychological synthesis of gender discrimination evidence across health, occupational, and social domains, thereby offering a conceptual map that can guide future empirical, theoretical, and intervention-oriented research.

I revised the Introduction and Discussion to more explicitly answer to this comment, following also Reviewer 2 suggestions, everything is highlighted in yellow within the text.

C2: Surprised such a low number of papers were retrieved, more on the search terms and filtering would be useful to understand why this was the case as this is a very popular term in health and social research 

Response: The relatively low number of included studies reflects the stringent inclusion criteria inherent to umbrella reviews, which are restricted to systematic reviews and meta-analyses rather than primary studies. Moreover, only reviews that explicitly examined gender-based discrimination and/or gender stereotypes as central analytical constructs were included, excluding reviews focused primarily on other forms of discrimination (e.g., race, age, disability) unless gender discrimination was directly addressed: this criterion reduced the eligible pool of papers.

Finally, although research on gender discrimination is extensive, the need for a systematic synthesis emerged precisely from the attempt to examine gender discrimination through a multi-level perspective. Approaching gender discrimination from a multi-level perspective required integrating evidence across methods, populations, and disciplinary traditions. Given the wide range of research questions and disciplinary traditions addressing gender discrimination, such a synthesis is necessary to meaningfully compare convergences and divergences across findings, and to identify consistent patterns as well as critical gaps in the existing evidence.

I hope that these clarifications address the reviewer’s concerns and improve the manuscript’s clarity regarding its contribution and scope.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to read your manuscript, “Discrimination and Gender: An Umbrella Review of Psychological Evidence.” This review is helpful for those who are interested in gender prejudice and discrimination to track the latest research in the area.

I see your review as helpful for scholars who need information about the more recent research on gender prejudice and discrimination. However, the way that your paper is organized makes it difficult for readers to find the information they want quickly and easily.  I have divided my comments into major and minor points to improve your manuscript and make it more useful for readers.

Major:

  1. Thematic categories and dimensions are not well differentiated: The main concern I have with your paper is in the way you organized your analysis. It was difficult for me to follow your analysis because your thematic categories and dimensions were not well differentiated. This lack of differentiation is common in research on bias, prejudice, and discrimination because implicit and explicit biases manifest in individuals, groups, institutions, and cultures.  To address this concern, I would consider a different way of organizing your analysis.  A process model might be more helpful in organizing your codes.  Something like prejudice (beliefs, attitudes, cognitions) à discrimination (bias, differential behaviors and treatment of groups) à outcomes of discrimination (negative (and positive?) impacts of discrimination for different groups) à strategies individuals and groups use and interventions to avoid, reduce, or eliminate discrimination and its harmful effects on individuals and groups.  The way your codes are organized now are difficult to distinguish as attitudes, behaviors, and cognitions are mixed together at different levels of analysis (individual, interpersonal, organizational, institutional).  Particularly when you review outcomes of discrimination, you mix levels (institutional (e.g., legal and institutional frameworks), interpersonal (e.g., exclusion from work activities), and individual (e.g., lack of promotion), which is confusing. Additionally, you may want to consider separating out different gender effects in your analysis, such as women, men, trans-gender individuals, motherhood and parental status, intersectionality, etc.
  2. Your Results sections comprises many very long paragraphs. These paragraphs contain a number of sub-topics that should be highlighted as patterns you found across your reviews.
    • For your outcomes analyses, breaking up the really long paragraphs into sub-topics and using headers would make it easier for the reader to see the patterns across outcomes you coded in the reviews as well as find information more easily. The large blocks of text are difficult to read and contain many sub-topics.
    • Within your outcomes analyses, you may want to consider further subdividing outcomes. For example, you note that women have fewer opportunities than men at work, receive lower evaluation scores, are promoted at a slower rate than men, etc. Each of these are important outcomes to highlight and could be divided into different sub-topics (with headings) to make them more salient. You can then connect reviews across different professions, regions or areas of the world, etc. that show similar patterns in terms of gender discrimination and/or outcomes of discrimination.

  3. Define your terms at the beginning: It would be helpful to define discrimination for your reader from the beginning. You mention it in your introductory paragraph, but then you discuss gender bias in the next paragraph without linking the two concepts together. Gender bias (prejudice), the psychological mechanisms you describe, can lead to gender discrimination, treating an individual differently because of their gender, and much of the research in this study focuses on gender discrimination rather than gender bias directly.
    • I would also note that the basic psychological mechanisms related to gender stereotyping often function below the level of consciousness but that they also often operate automatically. This automaticity underlies much of the gender discrimination that your review focuses on.
    • It may be worth adding on page 2 in your Introduction that gender discrimination can be overt or subtle. One of the difficulties today is that a lot of gender discrimination is subtle, which makes it difficult to detect. This subtlety can exacerbate the negative effects of gender discrimination because it can go unrecognized and unaddressed, allowing gender discrimination to perpetuate.
    • At the bottom of page 2 in your Introduction, another benefit of psychological research on gender discrimination is that systemic change has also occurred. For example, the Violence Against Women Act (VAWA) provided funding, resources, training, and legal reform to address domestic violence, lowering domestic violence rates in the U.S. over the last three decades.

  4. Who Benefits from Discrimination? Did you find research that showed the benefits of discrimination for particular individuals or groups? You mentioned the golden escalator for male nurses, for example. Was there other research that showed benefits for more privileged groups? Including that research would be helpful in having a more comprehensive review of the literature.

Minor:

  • In your Results, in the second paragraph of Section 3.1.1, can you give an example of the societal exclusion mechanisms that Ali et al. describe in their research?
  • In Section 3.1.3, can you provide an example of the implications of the implicit biases that Fitzgerald and Hurst studied? What happened to patients because of healthcare professionals’ implicit biases?
  • In Section 3.2.3, what are “purdah practices?”
  • I would consider in your Discussion section, in your critique of the lack of interventions, how the level of analysis matters. It is difficult to create interventions for individuals and groups when much of the discrimination that you document in these reviews is at an institutional or societal level. That should be noted or considered in your Discussion.

Author Response

I'd like to thank the reviewer for their comments on the manuscript and for raising important points within their review. I will address each comment in the following reply, I truly believe the manuscript increased in its clarity now and I really appreciate the reviewer concerns, since they helped me into gaining a new perspective on the manuscript.

C1: Thematic categories and dimensions are not well differentiated: The main concern I have with your paper is in the way you organized your analysis. It was difficult for me to follow your analysis because your thematic categories and dimensions were not well differentiated. This lack of differentiation is common in research on bias, prejudice, and discrimination because implicit and explicit biases manifest in individuals, groups, institutions, and cultures.  To address this concern, I would consider a different way of organizing your analysis.  A process model might be more helpful in organizing your codes.  Something like prejudice (beliefs, attitudes, cognitions) à discrimination (bias, differential behaviors and treatment of groups) à outcomes of discrimination (negative (and positive?) impacts of discrimination for different groups) à strategies individuals and groups use and interventions to avoid, reduce, or eliminate discrimination and its harmful effects on individuals and groups.  The way your codes are organized now are difficult to distinguish as attitudes, behaviors, and cognitions are mixed together at different levels of analysis (individual, interpersonal, organizational, institutional).  Particularly when you review outcomes of discrimination, you mix levels (institutional (e.g., legal and institutional frameworks), interpersonal (e.g., exclusion from work activities), and individual (e.g., lack of promotion), which is confusing. Additionally, you may want to consider separating out different gender effects in your analysis, such as women, men, trans-gender individuals, motherhood and parental status, intersectionality, etc.

Reply:  I thank the reviewer for this valuable comment, which helped improve the clarity and organization of the Results section. As shown in the supplementary table reporting the full data analysis, two macro-themes emerged from the synthesis: gender discrimination itself and its outcomes. Accordingly, the Results are structured into Theme 1 and Theme 2. The sub-dimensions within each theme have been reorganized in a logical order, following a process-oriented model as closely as possible, while retaining the original thematic categories and without adding or removing results. To address the concern regarding the overlap between attitudes, behaviors, and levels of analysis, I introduced sub-paragraphs within each macro-section to more clearly differentiate contexts and analytical levels, thereby improving readability and conceptual clarity. Unfortunately, due to the way findings were reported in the included systematic reviews and meta-analyses, it was not possible to consistently disaggregate results by specific gender effects (e.g., women, men, transgender individuals, parental status or intersectionality). This limitation is now explicitly acknowledged in the manuscript.

C2: Your Results sections comprises many very long paragraphs. These paragraphs contain a number of sub-topics that should be highlighted as patterns you found across your reviews. For your outcomes analyses, breaking up the really long paragraphs into sub-topics and using headers would make it easier for the reader to see the patterns across outcomes you coded in the reviews as well as find information more easily. The large blocks of text are difficult to read and contain many sub-topics. Within your outcomes analyses, you may want to consider further subdividing outcomes. For example, you note that women have fewer opportunities than men at work, receive lower evaluation scores, are promoted at a slower rate than men, etc. Each of these are important outcomes to highlight and could be divided into different sub-topics (with headings) to make them more salient. You can then connect reviews across different professions, regions or areas of the world, etc. that show similar patterns in terms of gender discrimination and/or outcomes of discrimination.

C2 Response: I truly appreciate this comment, since it helped me in clarifying the results. I tried to shorten the paragraph while addressing Major Comment n°1

C3: Define your terms at the beginning: It would be helpful to define discrimination for your reader from the beginning. You mention it in your introductory paragraph, but then you discuss gender bias in the next paragraph without linking the two concepts together. Gender bias (prejudice), the psychological mechanisms you describe, can lead to gender discrimination, treating an individual differently because of their gender, and much of the research in this study focuses on gender discrimination rather than gender bias directly. I would also note that the basic psychological mechanisms related to gender stereotyping often function below the level of consciousness but that they also often operate automatically. This automaticity underlies much of the gender discrimination that your review focuses on. It may be worth adding on page 2 in your Introduction that gender discrimination can be overt or subtle. One of the difficulties today is that a lot of gender discrimination is subtle, which makes it difficult to detect. This subtlety can exacerbate the negative effects of gender discrimination because it can go unrecognized and unaddressed, allowing gender discrimination to perpetuate. At the bottom of page 2 in your Introduction, another benefit of psychological research on gender discrimination is that systemic change has also occurred. For example, the Violence Against Women Act (VAWA) provided funding, resources, training, and legal reform to address domestic violence, lowering domestic violence rates in the U.S. over the last three decades.

C3 Response: I appreciate the reviewer's concern regarding the demonstration of psychological research's contributions to systemic change. However, I respectfully submit that the proposed example requires conceptual clarification. The Violence Against Women Act (VAWA) represents a legislative response to intimate partner violence rather than a direct outcome of psychological research on gender discrimination mechanisms. This distinction reflects fundamental differences in analytical domains: my manuscript examines cognitive and attitudinal processes underlying discriminatory treatment, exclusion, and stereotype-based bias, whereas VAWA addresses interpersonal violence through legal-structural interventions. While these phenomena intersect, they constitute conceptually distinct constructs requiring separate theoretical frameworks. Conflating policy responses to violence with psychological research on discrimination mechanisms would introduce categorical imprecision inconsistent with the manuscript's analytical focus.

C4: Who Benefits from Discrimination? Did you find research that showed the benefits of discrimination for particular individuals or groups? You mentioned the golden escalator for male nurses, for example. Was there other research that showed benefits for more privileged groups? Including that research would be helpful in having a more comprehensive review of the literature.

C4 Response:  I thank the reviewer for this important point. The issue of potential benefits of gender discrimination for more privileged groups was explicitly considered during the synthesis. Within the systematic reviews and meta-analyses included in this umbrella review, evidence on such benefits was limited and unevenly reported. The included reviews primarily focused on the negative impacts of discrimination on marginalized groups, rather than on advantages accruing to dominant groups. As this umbrella review was restricted to evidence synthesized in existing systematic reviews and meta-analyses, no additional conclusions regarding broader benefits for privileged groups could be drawn beyond what was already reported. This gap is now highlighted as an important direction for future research.

Minor:

Comments:

  • In your Results, in the second paragraph of Section 3.1.1, can you give an example of the societal exclusion mechanisms that Ali et al. describe in their research?

Done within the paragraph 3.1.2.1.

  • In Section 3.1.3, can you provide an example of the implications of the implicit biases that Fitzgerald and Hurst studied? What happened to patients because of healthcare professionals’ implicit biases?

Done within the paragraph 3.1.1.2.

  • In Section 3.2.3, what are “purdah practices?”

I clarified in paragraph 3.2.3.3.

  • I would consider in your Discussion section, in your critique of the lack of interventions, how the level of analysis matters. It is difficult to create interventions for individuals and groups when much of the discrimination that you document in these reviews is at an institutional or societal level. That should be noted or considered in your Discussion.

I thank the reviewer for this insightful comment. I have revised the Discussion to explicitly acknowledge that the limited evidence on effective interventions is closely related to the level at which gender discrimination operates. In particular, I now note that much of the discrimination documented in the included reviews occurs at institutional and societal levels, which makes the development and evaluation of individual- or group-level interventions especially challenging

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

This manuscript is much improved.  The biggest change, and the one most useful for readers, is re-organizing the analysis, breaking up your findings into sub-points with headings.  I also appreciate that you included more context for bias and discrimination in your introduction and that you discuss levels of analysis in your discussion since many of these problems, although studied at the individual and group level, are affected by institutions and societal beliefs and attitudes.  Readers will find this review helpful in understanding gender research across fields.