The Nurse Practitioner Pay Gap: Understanding Gender Disparities in Healthcare

Every year, Equal Pay Day serves as a reminder of the persistent gender pay gap that affects women across all professions, including the nursing field. This significant date in Women's History Month illustrates how far into the current year women must work to match their male counterparts' earnings from the previous year alone.

Recent research reveals a troubling reality: while women dominate the nursing profession, making up over 85% of nurse practitioners (NPs), the gender pay gap continues to impact their annual salary significantly. Across various industries, women earn just 82 cents for every dollar their male counterparts make – and the nursing field is no exception.

The landscape of nursing has evolved, with male nurses entering the profession at increasing rates. However, even though male nurse practitioners represent less than 15% of the NP workforce, data shows they consistently earn higher salaries than their female colleagues. This raises an important question: why does this salary difference persist in a female-dominated healthcare specialty?

As more registered nurses pursue their master's degrees to become nurse practitioners, understanding these pay disparities becomes crucial. Despite women's significant representation in advanced practice nursing roles, recent salary surveys indicate that female NPs often earn less money than male NPs in similar positions, even when controlling for factors like education level and years of experience.

Let's examine the current state of the nurse practitioner pay gap and explore how we can work toward achieving equal pay in this vital healthcare profession.

Do male nurse practitioners make more money?

Let’s not sugarcoat it: Yes, male nurse practitioners still earn more, and the gender pay gap persists in 2025.

Based on the most recent Medscape APRN Compensation Report, the average annual salary for male NPs is $143,000, while female NPs are earning just $131,000—a $12,000 pay gap that can’t be explained away by job title or practice setting. That's a nearly 9% wage gap, despite both groups having similar education levels, typically a master’s degree, and working full time.

Let’s also not forget: female nurse practitioners make up 88% of the NP workforce. So we’re talking about a profession overwhelmingly powered by women, where men still take home more pay.

The report hints at why the gender pay gap continues. Some male NPs might be taking more overtime or earning more productivity pay and supplemental income. These extras can boost average salaries, especially in urban areas or hospital-based roles, which already tend to pay more. However, the salary difference persists even when accounting for these factors.

It’s also worth noting that this isn’t just about male vs. female NPs in isolation—this gender disparity is part of a larger trend in the nursing profession. For example, across all APRN roles, the gender gap is seen again and again, with male nurse anesthetists also earning more than their female APRN peers.

And even when education goes up, the pay gap doesn't disappear. NPs with doctoral degrees make more on average than those with master’s degrees, but the report doesn't indicate that higher education levels close the gender gap—just that they raise the ceiling for what some can earn.

In short? The gender pay gap in NP salaries is real, persistent, and frustrating. And for the majority of female NPsworking in this field, it means continuing to push for equal pay, not just for recognition, but because they’ve earned it.

So why is this happening?

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Why we still have a gender pay gap in nursing

Even in a profession dominated by women, pay inequality remains stubborn. And the latest research shows it's not just about outdated policies or individual choices—it’s structural.

The study reveals that occupational segregation is a core driver: roles with more women simply pay less, even when education and experience are controlled for. For instance, as more men enter nursing roles like RNs, LPNs, and aides, the gender wage gap in those roles doesn’t improve, it actually stagnates or worsens.

This trend aligns with the "glass escalator" theory: in women-dominated jobs, men are more likely to be promoted, paid more, and steered into better-compensated specialties. So, it’s not necessarily that men choose higher-paying roles—it’s that the system tends to reward them more for the same jobs.

Education helps—but not equally. While women with college or graduate degrees have seen modest gains, those with less than a college education (a large part of the nursing workforce) haven’t seen the same progress. In fact, in many of these roles, the wage gap is widening.

There are also broader pressures: family responsibilities, unequal advancement opportunities, and even Medicare and Medicaid reimbursement structures all stack the deck. Many procedures and roles dominated by women receive lower compensation across the board, regardless of effort or impact.

So no, the pay gap isn’t just about men working more or picking different jobs. It’s a reflection of how gendered assumptions and systems continue to shape the economics of care.

Gender Pay Gap Among Anesthesiologists: A Modern Example

Let’s take a closer look at anesthesiology, one of the highest-paying specialties in the healthcare system and a prime example of how the gender pay gap hides in the fine print.

According to a U.S.-based study reviewed in a 2025 scoping analysis, male anesthesiologists are significantly more likely to be paid through fee-for-service models, while female anesthesiologists are more often placed on fixed salaries.

Why does this matter?

Because fee-for-service arrangements allow for bonuses, procedural incentives, and productivity-based pay, all of which can drastically increase a provider’s annual salary. In contrast, salaried positions are more stable but offer limited earning potential—especially in high-output specialties like anesthesia, where procedural volume drives income.

The kicker? Both men and women in these roles have similar qualifications, often with identical education levels, clinical experience, and scope of practice. Yet despite entering the OR with the same credentials, men are more likely to walk out with a bigger paycheck—not due to performance, but because of how they’re being paid.

This isn’t a question of effort. It’s a question of how compensation models in the nursing and medical fields are structured—and who they quietly favor. It also reflects a broader pattern in the healthcare economy, where male counterparts receive higher financial returns not because they’re more qualified, but because the system wasn’t designed with equity in mind.

So while some might argue that men “just work more” or “choose higher-paying roles,” this case proves that even when the work is identical, the compensation isn’t—and the reason lies in gendered pay structures, not individual merit.

Does This Really Explain the Gender Pay Gap?

Let’s do the math.

ZipRecruiter reports the average annual salary for an anesthesiologist in the U.S. is $393,215, which breaks down to about $189.05 an hour.

Let’s say a male anesthesiologist works just three more hours a week than a female colleague. That’s roughly $28,467 more per year... Okay, fine. That explains part of the difference.

But what about the rest?

Other considerations apart from salary

In the spirit of fairness, we should mention that there are some other considerations that might contribute to the wage gap.

These considerations are not necessarily negative, nor they have to do with gender discrimination.

For example, the Medscape surveys showed that male APRNs worked more in acute care settings (see above), did more overtime, and supplemented their regular income with something else more than female APRNs did.

Male APRNs also own more private practices, though the difference is only 5% more. Their results from 2019 are consistent with those of 2020.

However, supplemental income and private businesses do not count when talking about yearly salaries. The gender pay gap persists because there's always extra money that's not accounted for when talking about male workers.

With this in mind, all of our cards are now on the table. Men seem to do a bit more, but it still doesn't justify the fact that women doing the same (or almost the same) amount of work as them earn A LOT less money.

Also worth pointing out: we're talking about APRNs here. We have to push for more NP-specific research on this topic, but that comes later.

These considerations are important, but don't rule out gender discrimination as an important factor. Thus, we continue.

What you can do to help eliminate the gender wage gap

Another interesting thing about Medscape's reports is that they asked APRNs the following question: do you feel like you're properly compensated?

54% of NPs in 2019 said yes, a number that grew to 61% in 2020. For CRNAs, which we mentioned earlier, that percentage was 68% in 2019 and 76% in 2020.

On the surface, we could suggest that only male respondents answered “yes,” and that the remaining 30 or 40 percent of NPs and CRNAs were females who didn't feel okay with their salaries.

However, this might not be the case. The numbers don't really add up. It's possible that there's a large number of female respondents who felt comfortable with their salaries, even after earning 20 or 30 thousand less a year.

Now, male nurses are not to blame for this problem at all.

We should blame clinics and institutions, or actually the healthcare industry in general, but we can't keep waiting on them to take action while the work of women is under-appreciated every day. We can't blame those women who felt comfortable with their salaries either, but we can try to help them understand why they shouldn't settle for less!

So, what could we all do to not allow this injustice to perpetuate?

Step one: Discuss and practice salary negotiation

This particular idea might seem contentious for some nurses. “Are you telling me that it's my fault I'm not earning more?! Just because I didn't negotiate my salary in the beginning?!”

We don't believe this is the main cause of the gender pay gap in nursing. That would amount to victim blaming.

We are mentioning this, in particular, because female professionals tend to negotiate their salaries less than men, which leads to women earning less in general, adding up to the gender pay gap problem that is already there.

There are a lot of reasons why female NPs don't negotiate. Are men more assertive? Sure, but that's not because they're males.

It's because society doesn't reward this kind of behavior in women, and they learn not to do it.

The fact that men negotiate their salaries more doesn't mean they're successful 100% of the time.

They just do it more than women, and thus, they get a higher chance of earning more as a group.

One of the ways that we can change that is to empower other female NPs to negotiate more often. In every NP job, across all specialties.

Companies and clinics will always try to pay you less, regardless of gender. Even though they might consider paying men a higher salary, it will still be less.

So, yes, it's harder for women to negotiate due to societal judgement, but we're living in a new era, and it's time to do things differently.

One of the reasons we have Women's History Month is to remember that the only way society ever changes is when women do the things they aren't supposed to do according to orthodox rules, like fighting for their right to vote.

However, negotiating salaries is not a panacea for the gender pay gap in nursing, or anywhere. That's just step one.

Step two: Raise your voice

As a nurse practitioner, you have a myriad of options to start doing some activism.

This might sound like a very big word… Am I supposed to organize a march? Or something?

Well, no, but getting involved with the different initiatives to bridge the gender pay gap is a good start.

You're already doing well by reading this article, and by learning a little bit more about the fact that, yes, male nurses seem to go harder (which is great) but that's not the whole picture. Many female nurses work as hard, or even harder, and are still underpaid in comparison.

The gender pay gap can be seen in RNs, LPNs, physicians, CNSs, ER nurses, you name it.

It's important to share this information with NPs of all genders. We all can be allies and advocate for a fair treatment!

If you find arbitrary discrepancies between your salary and that of your male colleagues, here are some things you can do:

• Call the National Committee on Pay Equity to learn more.

• If you have the means, file a charge with the EEOC.

• Talk to your colleagues about it (we're serious). It might have consequences, but the worst thing you can do is stay silent. Find out what's going on.

• Check out this guide on Pay Discrimination by Equal Rights Advocates. Know your rights!

Get involved with nursing associations like the AANP to find out more about the current legislation affecting NPs. There, you will also find a community of people concerned about issues like this one.

The future of the gender pay gap in nursing

While we were doing research for this article, we came across a source which stated that the gender pay gap in nursing wouldn't be solved until 2039, or something like that.

That sounds terrible, doesn't it? But things doesn't necessarily have to go that way. Don't worry.

To be honest, when you tally up some of the wage differences from the surveys above, you could make the case that the wage gap is actually being reduced. Not enough, but it is lower.

However, that is also not always the case. Sometimes it's bigger.

When it comes to clinicians, this process is ongoing. The road ahead looks wider, but there's still a lot of work to do.

Women earn less for a variety of reasons concerning womanhood itself. And yes, women can become better at negotiating, but that doesn't eliminate how orthodox people think about women, and the consequences that carries for women.

If you're a male NP reading this: thank you. Your support is appreciated. Nobody's mad at you for earning more, and we know that you suffer from discrimination too!

All NPs working in the same position for the same amount of time should earn the same amount of money. Gender should not be a determining factor in salary allocation!

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