Women’s authorship position in science, technology, engineering, mathematics and medicine research reflects career progression, especially the transition from first to last (usually senior) author. Employment of women in mental health sciences has increased, and so should have had an impact on the change to senior author position.

To identify if first or last women’s authorship has changed, and mental health has better representation.

We investigated women’s authorship position in a systematic review and meta-analyses, following PRISMA guidelines and using random-effects regression analyses.

We identified 149 studies with sampling periods from 1975 to 2020 (excluding potential COVID-19 pandemic effects) that showed a large variation of women authors, and found an average proportion for first (26.2%) and last (16.1%) author position. In mental health (psychology and psychiatry), there was a higher representation, with 40% first author and 36.7% last author position, whereas medicine was 25.9% and 19.5%, respectively. The rate of change for psychology and psychiatry women authors was also higher every 10 years: 8.56% (95% CI 6.44–10.69%) for first and 6.86% (95% CI 4.57–9.15%) for last author, and rate was 2.35% higher for first author and 2.65% higher for last author than in medicine. Different methods of classifying gender and identification method did not affect our results.

Although mental health topics seem to fare better, our comprehensive review highlighted that the proportions of women first compared with last authors shows the same leaky pipeline as in other analyses, so we cannot be complacent about gender equality and career progression.