AWIS’s president wrote a letter, threatened a boycott and met with the company’s leaders. The efforts didn’t go unrewarded: the publisher eventually yanked its new book off shelves and promised to remove the photos (and the chauvinistic captions—which allegedly included “Unfortunately, gentlemen, none of your patients will look as good as this”—that accompanied them).

That textbook dustup is a story that AWIS likes to tell. It appears throughout the group’s website and in assorted articles—partly a nod to AWIS’s history, partly a reminder of how far things have come.

But have they really come that far? As the largest multi-disciplinary organization for women in STEM careers—more then 20,000 members and counting—AWIS’s current causes are less visible and more nuanced than erotic photos on a page: fair pay, professional isolation, work-life balance, equal recognition. They’re high-stakes problems that an irate letter won’t solve, and as a result, the changes happen more gradually.

“I think the progress has been slow, but cultural change is difficult, and that’s what we’re talking about,” says Janet Bandows Koster, AWIS’s CEO and executive director since 2006. “How do you change cultural practice?”

Even as a known organization with a wide reach, it’s not easy to replace the scientist-equals-man image that’s so deeply embedded in our culture, she says. Four years ago, in a literal fight against that idea, AWIS led a grassroots initiative to have more women appear in Google image searches for the word scientist.

“Up until then, all you saw were men, and if there was [a photo of] a woman, she was standing behind a man, who was mentoring her,” Koster says. “In people’s minds, the scientist is male. I think one reason is that the only female [scientist] we ever talk about is Marie Curie. Really? That was how many years ago—how many centuries ago? There are women who have currently achieved incredible recognition in their fields and we don’t talk about them. Those are the images we need to be putting out there. Enough with the Curie.”

Koster says it’s also a matter of vigilance—something that requires more time and resources than are often available. In 2010 and 2012, AWIS partnered with 22 scholarship-focused scientific societies because women were winning so few scholarly and research awards. They ran several interventions, including implicit bias training for awards committees, and the numbers did go up… Until the intervention grant ended.

“As soon as we stopped—well, we just got the 2014 numbers, and some of the societies that were doing so well just dropped right back down again,” Koster says. “I think it’s constant vigilance. It’s constantly paying attention.”

Progress has even been stymied by some within AWIS. “We’ve had some of our older members say, ‘We really don’t see that there’s a problem for young women anymore. We solved the problem,’” Koster says. “A lot of people think that there are no more problems for women, and I think that truly is one of the big issues.”

Most of the roadblocks are external, though. AWIS often hears the “we’re-not-going-to-lower-our-standards” argument when it tries to get prestigious research organizations to recruit more women—and there’s the fact that fewer women are in leadership roles, which means there’s less opportunity for women to promote other women. Koster also mentions something she calls the Queen Bee Syndrome, a mentality that “there are only so many seats at the table, and I had to work really hard my entire life to get this seat at the table, and I’m not sharing it with anybody.”

But AWIS keeps pushing forward. They’ve had some notable wins over the years, from successfully suing the National Institutes of Health in 1974 to include more women on peer review panels, to their ongoing push to strengthen Title IX’s application in STEM departments—as a means of protecting educational equality for girls and women, and of championing equal lab space and other resources at research universities.

They also have a public policy fellow who works with Congress and federal agencies on issues that impact women in STEM fields. Last year, AWIS had what Koster calls “a great victory” when the Office of Management and Budget revised its guidelines, allowing federal grant money to be used to support parental leave and childcare.

While their advocacy centers on women, Koster says issues like parental leave affect everyone. Making that known is one of the group’s current strategies. In a book published last year, Equitable Solutions for Retaining a Robust STEM Workforce: Beyond Best Practice, AWIS surveyed men and women on work-life balance. Rather than dividing by gender, Koster says the responses were split by age.

“Both men and women were equally concerned about work-life integration issues,” she says. “It makes that statement we’re trying to promote: a lot of these aren’t just gender issues, they’re workplace issues. If the workplace does not change to accommodate a younger cadre of workers, we’re going to have a difficult time maintaining and retaining a skilled workforce—and we’re going to be losing a lot of good folks.”