Supporting Diverse Authors as Well as Diverse Research

Introduction 

As diversity, equity, and inclusion (DEI) initiatives have come to the forefront of scholarly and scientific publishing, the acquisition, commissioning, and publication of research discussing diverse or underrepresented populations has increased. This is to be commended, as it advances the inclusion of diverse and underrepresented individuals within our communities. However, there are often not policies in place to support authors who identify as a member of a diverse or underrepresented group.  

Our journal, Clinical Pharmacology & Therapeutics (CPT), received a submission reviewing the current state of medicine for transgender patients, and along with this submission came a request that the authors be allowed to include their preferred pronouns. This case study details how our department, editorial team, society, and publisher worked to not only support this diverse research but also its diverse authors.  

Issue 

In January 2021, Lauren Cirrincione submitted a Review article titled, “Sex and Gender Differences in Clinical Pharmacology: Implications for Transgender Medicine1.” After peer review, revisions were suggested, and when the revised manuscript was received, there was a request to add Kai Huang as an author.  

“As part of my resubmission, I added a co-author who was instrumental in developing and writing the revised manuscript. My co-author would like to include their pronouns (e.g., he/him/his) within the manuscript. At this time, I’ve recommended that my co-author add a statement in the “Acknowledgements” section mentioning their pronouns. Is this ok from your perspective, or is there a different way I should approach this request (inclusion of a co-author’s pronouns) in the revised manuscript?” (February 2021, personal communication). 

Wanting to do our utmost to support this request, we reached out to our publisher, Wiley, asking if there were any policies in place or functionalities within their design templates that would allow us to include this information. Unfortunately, it became apparent that not only did our journals not have policies in place or ways to collect this information, neither did our publisher.  

Goals 

Upon learning this, our goals for this paper and these authors, along with future authors and/or research, were three-fold: 1) to support these authors and their request; 2) to highlight, promote, and publicize this paper as much as possible; and 3) to define a system that will allow authors to share their preferred pronouns if they wish.  

Challenges 

Neither our manuscript submission system, eJournal Press (eJP), nor our publisher, Wiley, had policies or practices in place to accommodate a request for preferred pronouns. eJP has recently released several new ideas and frameworks to help clients meet their DEI initiatives (i.e., additional DEI questions that authors can answer during submission and a new DEI report that gathers this information in one place). Hoping the topic of pronouns would be among the new releases, we opened discussion with one of eJP’s project managers to dig deeper into the subject. We were given two options: 1) a workaround in which we could use the already configured suffix field to add pronoun options, or 2) eJP programmers could build a separate pronoun field for us as an enhancement. We quickly decided the first option would be inadequate, as information entered into the suffix field would not be included in DEI reporting. We opted to work with eJP to build the necessary enhancement: a new, dedicated field for pronouns. A few initial decisions were needed before eJP could begin. First, where to place this new field: we decided it would best be placed within an eJP user’s profile, with authors being prompted to update their profile to answer the optional question(s). While a pronoun field can also be added to the submission form for each manuscript, this would only gather the corresponding author’s pronouns, and we want each author to answer individually. Next, we needed to determine privacy and access privileges: pronoun answers will be viewable by staff only, as we do not want to introduce any unintentional biases into the review process by making this information more readily available. The upcoming enhancement is good news, but we still face a hurdle in determining how to transmit this information to our publisher once gathered.  

Our publisher, Wiley, confirmed that it has been receiving requests from individual authors to include preferred pronouns with their bylines, but while it is working to develop a complete, end-to-end policy for the management and publication of pronouns, it does not have one in place at the moment. Currently, it is able to update PDF versions of articles to include pronouns before they are published online. Wiley is investigating possibilities in XML tagging and web capabilities so that authors’ preferred pronouns can feed seamlessly into the Wiley Online Library and other related systems or sites. Relevant internal teams are working to create appropriate fields and tagging for standardization across all its journals, and it will be making an announcement once the full policy recommendations and functionality are available. Furthermore, Wiley is encouraging authors to add their preferred pronouns to their published name on ORCID as ORCID IDs can be linked in the author byline from both PDF and full-text versions of published papers (September 2021, personal communication).  

One final challenge is that, while we wanted to highlight and promote this important paper as much as possible, we wanted to be respectful of the authors’, one of whom is a transgender individual, boundaries and personhood. We in no way wished to make them feel as if they were expected to represent the experiences and thoughts of the entire transgender community, nor did we wish to subject them to uncomfortable scrutiny and questioning.  

Outcomes 

After consulting with Wiley, we elected to publish the authors’ preferred pronouns in the Acknowledgments section of the article. Ultimately, this section read, “Kai J. Huang uses they/them/theirs, he/him/his, and ze/zir/zirs pronouns. Lauren R. Cirrincione uses she/her pronouns1.” Discussions about this topic on various staff meetings also prompted the American Society for Clinical Pharmacology and Therapeutics (ASCPT) to encourage all staff members to list their preferred pronouns in email signatures, both because they may wish to and also to demonstrate our acceptance and awareness of the many different genders and identities people espouse. Uptake by the ASCPT staff was 100%.  

Working with CPT’s Editor-in-Chief, Piet van der Graaf, we decided to design the cover (Figure 1) for the October 2021 issue around this article. Moreover, we combed through available articles (both recently accepted but not yet included in a print issue and articles under review) for content that also addressed gaps and needs in diverse medicine and translational science. The culmination of this process is an issue with much of its content centered around van der Graaf’s editorial “Diversity in Clinical Pharmacology and Therapeutics 2.” The issue will also include an invited Commentary3 by Monette M. Cotreau that will continue the conversation started by Cirrincione and Huang’s article. 

To further promote the paper and the issue as a whole, we invited Cirrincione and Huang to participate in a webinar in which they would detail the issues raised in their Review article and participate in a live question and answer session.  

Once the article had been accepted, we tried to involve the authors as much as possible in all planning aspects for publication and promotion of their work. We openly acknowledge that our journal staff is composed of three straight, cis-gender White women, and our fear was that our privileged status would blind us to potential unintentional biases or microagressions, so gathering outside perspectives on our ideas was essential. We shared our cover design with the authors and asked for feedback before final approval with Wiley; we held a planning call for the webinar during which we discussed what would and would not be covered during the presentation, including insuring that the presenters and moderator would be able to approve questions put into the chat or discussion before they were visible to the live audience (thus preventing inappropriate or insensitive questions from being made public); and we made a point to share the paper, cover, and upcoming webinar on our social media platforms, both as a Society and as individuals (Figure 2). We also made them aware of this case study in advance of its publication.  

Next Steps 

One of our immediate goals going forward is to work with eJP and Wiley to make the inclusion of preferred pronouns an (optional) part of our submissions and publications. We certainly do not want to force all authors to list their preferences, but we want future authors to have this option without having to request it specifically. Additionally, we want to make this more standard so that authors who do wish to share pronouns do not feel singled-out or “othered.” 

We also plan to use our experiences here as a template for handling and disseminating future papers on important topics, as well as considering requests from authors that we may not have previously considered. It is important to us that ALL of our authors feel seen, heard, supported, and accepted while interacting with all facets of our society. We hope this small change will pave the way for more substantive changes in the future.  

Acknowledgments 

We would like to thank Lauren Cirrincione and Kai Huang for allowing us to share the publication process for their paper. We would also like to thank Brian Coughlin, our publisher at Wiley, for his input on what steps Wiley has taken so far to include preferred pronouns as well as what the organization plans to do going forward to enable broader use of this functionality.  

References 

1. Cirrincione, L.R. & Huang, K.J. Sex and Gender Differences in Clinical Pharmacology: Implications for Transgender Medicine. Clin. Pharmacol. Ther. 110, 897-908 (2021).  

2. van der Graaf, P.H. Diversity in Clinical Pharmacology and Therapeutics. Clin. Pharmacol. Ther. 110, 837-840 (2021). 

3. Cotreau, M.M. Commentary on “Sex and Gender Differences in Clinical Pharmacology: Implications for Transgender Medicine. Clin. Pharmacol. Ther. 110, 863-865 (2021).