Unexplained infertility

1516 www.thelancet.com Vol 392 October 27, 2018 within and outside academia is crucial and timely. However, we wish to highlight a key concern that was insufficiently add ressed in the Comment. Not all women in academia have equal privileges, and thus, systemic cyclical biases and structural sexism affect women differently. Therefore, we urge the academic community to commit to gender justice by choosing an intersectional approach to address the biases in publishing resulting from differential power and privileges bestowed in the scientific establishment. Intersection ality recognises these interdepen dent and overlapping systems of discrimination. As women in academia, we attest to the fact that our existence in the professional space is dictated by a confluence of identities, rather than our gender alone. These identities include, but are not limited to, age, disability, institutional affiliation, nationality, race, sexual orientation, socioeconomic status, and personal histories not readily classified. We have experienced and witnessed that interactions of identities have a multiplicative rather than additive effect on our participation in the scientific community. However, inadequate attention is paid to how systemic biases extend beyond select individual identities. Furthermore, an intersectional approach to counter the complex interaction of various identities that ascertain our relative privilege is absent. Lundine and colleagues point to the urgent need to collect the data required to describe the extent of gender biases in publishing. The nuance of collecting selfreported gender as opposed to sex to understand the scope of bias in publication is a promising first step that recognises the fluidity and complexity of identities. To further this trajectory, we recommend the following steps. First, the academic community, and specifically journals and publishers, should create platforms for sharing diverse perspectives on discrimination, beyond a few permutations of relatively privileged identities. Second, informed by these narratives, we should expand the list of prioritised indicators for data collection. Fin ally, analytic frameworks should incorporate an intersectional approach to identify, and ultimately address, equity disparities. This purposeful intersectional approach to gender equity would bring together isolated social justice efforts within academia, fundamentally enriching the scientific community.