Background: Female academic physician leaders (FAPLs) encounter challenges in their leadership roles, including gendered leadership expectations or fear of judgment, impacting their ability to express authenticity. This study examined FAPLs’ perceptions of authentic leadership, factors shaping their leadership behaviors, and how authenticity influences their effectiveness as a leader. Methods: Using a convergent mixed-methods design, 40 FAPLs at Texas A&M University College of Medicine were invited to participate. Nine completed the Authentic Leadership Questionnaire (ALQ), and 10 participated in semi-structured interviews. Results: Quantitative analysis revealed the strongest alignment with moral/ethical leadership dimensions, with a significant difference (P