BACKGROUND AND OBJECTIVES: Representation of women in medicine is increasing, including in academic family medicine. Despite this, women continue to hold a minority of senior faculty and leadership roles. This study examines the trends of women first and senior authorship between 2002 and 2017 in five family medicine journals: Family Medicine, Journal of Family Practice, Journal of the American Board of Family Medicine, Annals of Family Medicine, and American Family Physician. The study also examines gender congruence between first and senior authors and women's membership on editorial boards. METHODS: We collected and analyzed data on a total of 1,671 original articles published in the five family medicine journals in 2002, 2007, 2012, and 2017. We also examined the gender composition of the journals' editorial boards. RESULTS: Overall, women first authorship increased significantly from 32.6% in 2002 to 47.7% in 2017. There was no significant difference in women senior authorship or editorial board representation from 2002 to 2017. Both men and women senior authors partnered with women first authors significantly more over the 15 years. CONCLUSIONS: While there was a statistically significant increase in women first authors between 2002 and 2017, there is still a gap between women's authorship and editorial board representation and their representation within academic family medicine. These gaps could help to explain the continued lack of women represented within senior faculty positions.