AAP policy highlights persistent gender pay gaps in pediatrics

A new American Academy of Pediatrics (AAP) policy statement is calling on health systems, academic institutions, and payers to address persistent gender-based pay inequities across pediatrics, warning that disparities begin early in physicians’ careers and may contribute to workforce shortages and reduced access to pediatric care.^1,2

The policy statement, “Gender Pay Equity in Pediatrics,” published in the June 2026 issue of Pediatrics, summarizes evidence showing women physicians consistently earn less than men physicians across medical specialties and within pediatrics specifically, even after accounting for productivity, work hours, specialty, age, and years in practice.¹

According to the statement, women pediatricians earn between 76% and 87% of what men pediatricians earn, depending on adjustments for demographic and professional factors. The authors also noted that starting salaries for women pediatricians are a median of $10,000 lower than those of men immediately after training, with the gap widening to nearly $20,000 after 10 years in practice.

“Gender-based pay inequities persist in pediatrics, affecting women at all career stages and across subspecialties, even after accounting for work hours, duties, and productivity,” the authors wrote. “The consequences are profound, not only for the financial well-being and career satisfaction of women physicians, but also for the pediatric workforce and access to health care for pediatric patients.”

Workforce and subspecialty implications

The AAP noted that women now make up most pediatricians in the United States, accounting for 65% of practicing pediatricians and 70% of graduating pediatric residents as of 2021.

At the same time, pediatrics remains among the lowest-compensated specialties in medicine. The policy authors stated that lower compensation may hinder recruitment and retention efforts and limit the ability of pediatric organizations to maintain a diverse workforce.

The report also highlighted disparities within pediatric subspecialties. Women-dominated fields such as adolescent medicine and endocrinology were associated with lower earnings compared with more male-dominated subspecialties such as cardiology. According to the authors, these lower-paying subspecialties are also more likely to face workforce shortages and challenges filling fellowship positions.

“Achieving pay equity is critical to building a diverse, sustainable, and fairly compensated pediatric workforce capable of meeting the health care needs of all children,” the authors wrote. “Equity in pay is both a professional and public health imperative.”

Factors contributing to inequities

The policy statement described several contributors to compensation inequities, including implicit bias, limited mentorship and sponsorship opportunities, inequitable promotion practices, caregiving responsibilities, and inadequate parental leave policies.

Women physicians were also reported to experience higher burnout rates and greater household caregiving responsibilities than male colleagues. The statement noted that women are more likely to work part-time during childbearing years, which may affect promotion opportunities, retirement savings, and eligibility for loan repayment programs.

The policy additionally emphasized that compensation inequities may be greater among physicians with intersecting identities related to race, ethnicity, disability, and gender identity.

AAP recommendations for pediatric employers and payers

To address inequities, the AAP recommended that organizations establish transparent compensation systems using objective salary metrics and regular gender-based compensation analyses.

Additional recommendations included implementing family-friendly workplace policies, supporting paid parental leave, providing lactation accommodations, and creating flexible work arrangements that do not penalize career advancement.

The AAP also called for standardized promotion and leadership pathways, mentorship and leadership training opportunities for women physicians, and equitable access to leadership positions.

Finally, the organization urged advocacy for pediatric payment rates that are comparable to Medicare reimbursement and policies that foster discrimination-free and inclusive work environments.

The policy authors concluded that even modest improvements in compensation equity could have meaningful long-term effects on physician career satisfaction, workforce sustainability, and children’s access to care.

References

1. Catenaccio E, Lightdale JR, Bline K, et al; American Academy of Pediatrics Committee on Pediatric Workforce; Council on Health Equity; and Female Leadership and Excellence in Pediatric Subspecialties. Gender pay equity in pediatrics: policy statement. Pediatrics. 2026;157(6):e2026077023. doi:10.1542/peds.2026-077023

2. Catenaccio E. AAP policy promotes gender pay equity. AAP News. May 26, 2026. Accessed May 27, 2026. https://publications.aap.org/aapnews/news/35000/AAP-policy-promotes-gender-pay-equity?searchresult=1