Background: Gender bias is preference and preferential treatment for one gender over another. This has problematic implications for women and is well documented through the gender pay gap, the lack of women in leadership positions, and the amount of unpaid care work women undertake compared with men. This review examined how gender operates in nursing prompted by an awareness that much discussion about gender is about men, and this led to curiosity about how women and transgender people are represented and what their experiences are in relation to gender. This scoping review critically evaluated the research and grey literature to present an in-depth discussion of gender power in the nursing profession, with a particular view on Aotearoa New Zealand.

Methods: A scoping review was conducted. CINAHL, Scopus, Medline via EBSCO, Business Source Complete and Joanna Briggs Institute databases were searched with inclusion criteria of research from New Zealand, Australia, Canada, and the United States of America with an aim to establish a possible relationship between gender, nursing and Indigenous or First Nation people. Grey literature was included from the websites of New Zealand, Canada, Australia, and the United States nursing unions and registering boards.

Results: The findings highlighted four main themes of 1) touch, 2) money, 3) glass elevator and glass ceiling, and 4) gender identity and assumptions of nurses. 1) Men in nursing experience judgement from patients when required to perform touch as part of their clinical duties and this judgement may influence the area where a male nurse will work. 2) In careers where women are the majority and significantly outnumber men, gender bias exists for men to occupy more senior positions and better paid jobs. 3) Women in nursing experience a glass ceiling effect that prevents upward promotion yet men in nursing experience a glass escalator effect whereby they are more largely represented at leadership and management levels. 4) In nursing, gender bias is also present due to gender stereotypes of nursing being seen as women’s work, and men in nursing are subject to negative stereotypes. Sub-themes within ‘gender identity and assumptions of nurses’ are gender role strain, gender as active challenge to social norms, sexuality, and the need for muscle. Men in nursing are often stereotyped as homosexual or less compassionate than their female peers and report frustration at the gender-based assumptions they are faced with.

Discussion: Men and women in nursing experience gender bias which operates in different ways. The research focuses on the experiences of men, leaving gaps in the literature for experiences of women, and people who are not cisgendered. Very minimal intersectionality occurred, leaving experiences of gender bias within nursing and people of colour, minority groups and religious perspectives mostly absent. The research focus of men in nursing reinforces the viewpoint that men’s experiences are more valuable than women’s, which strengthens the gender bias found in most healthcare systems. Additional research is required to include women, transgender, gender non-binary, and gender-neutral people’s struggles of gender bias within nursing and a strong focus is recommended to recognise the weight of intersectionality within such research.