Experiences of LGBTQ+ Residents in US General Surgery Training Programs

Heiderscheit, Evan A.; Schlick, Cary Jo R.; Ellis, Ryan J.; Cheung, Elaine O.; Irizarry, Dre; Amórtegui, Daniela; Eng, Joshua; Sosa, Julie Ann; Hoyt, David B.; Buyske, Jo; Nasca, Thomas J.; Bilimoria, Karl Y.; Hu, Yue-Yung

doi:10.1001/jamasurg.2021.5246

Cited by 70 publications

(86 citation statements)

References 47 publications

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“…These diverging trajectories may reflect additional stressors sexual minority physicians face, including high rates of harassment and discrimination and a lower sense of belonging, and may contribute to disparities in burnout, suicidal thoughts, and attrition. 2 , 3 , 4 , 5 …”

Section: Discussionmentioning

confidence: 99%

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Assessment of the Prevalence and Trajectory of Depressive Symptoms by Sexual Orientation During Physician Training

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…Although sexual minority trainees experience higher rates of mistreatment and other unique stressors, little is known about their mental health. 2 , 3 , 4 , 5 Here, we assess the prevalence and development of depressive symptoms among sexual minority and heterosexual physicians over the course of residency training.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Prevalence and Trajectory of Depressive Symptoms by Sexual Orientation During Physician Training

et al. 2022

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“…9 Additionally, a substantial amount of LGBTQIA+ residents experience discrimination and mistreatment from both patients and other health care providers, highlighting a critical structural need to boost diversity, equity, and inclusion. [31][32][33] Although most program directors desire inclusion of sexual and gender minority-adjacent curricula, few emergency medicine residencies have incorporated LGBTQIA+ health into their conference and didactic curricula. 9…”

Section: Studentsmentioning

confidence: 99%

“…A 2014 study reported a median of 45 min of LGBTQIA+ content in EM didactics, and a related study in 2018 found that a significant proportion of EM residents felt less comfortable caring for LGBTQIA+ patients when compared to cisgender and heterosexual patients 9 . Additionally, a substantial amount of LGBTQIA+ residents experience discrimination and mistreatment from both patients and other health care providers, highlighting a critical structural need to boost diversity, equity, and inclusion 31‐33 . Although most program directors desire inclusion of sexual and gender minority–adjacent curricula, few emergency medicine residencies have incorporated LGBTQIA+ health into their conference and didactic curricula 9 …”

Section: Introductionmentioning

confidence: 99%

Block by block: Building on our knowledge to better care for LGBTQIA+ patients

Driver

Egan

Hsiang

et al. 2022

AEM Education and Training

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Background Emergency physicians need to recognize the diversity of identities held by sexual and gender minorities, as well as the health implications and inequities experienced by these communities. Identities such as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, aromantic, and many others fall under the LGBTQIA+ acronym. This wide spectrum is seldom discussed in emergency medicine but nonetheless impacts both patient care and patient experience in acute and critical care settings. Aims This commentary aims to provide a brief but nonexhaustive review of LGBTQIA+ identities and supply a critical framework for applying this understanding to patient encounters in the emergency department, as well as describe the challenges and educational aims at the level of medical school, residency, and postresidency. Materials and Methods The commonly used and widely accepted definitions of LGBTQIA+ terms are described, as well as implications for patient care and emergency physician education. The authors of this writing group represent the Society for Academic Emergency Medicine, LGBTQ Task Force of the Academy of Diversity Inclusion in Medicine. Results LGB terms are addressed, with LGBTQIA+ adding “intersex,” “asexual,” and “+,” to include other gender identities and sexual orientations which are not already included. This paper also addresses the terms “transition,” “nonbinary,” “polyamorous.” “two‐spirit,” “queer,” and others. These acronyms and terms continually expand and evolve in the pursuit of inclusivity. Additionally, with some health issues potentially related to medications, hormones, surgery, or to internal or external genitalia, important EM physician tools include gathering an “organ inventory,” asking about sexual history, and conducting a physical exam. Discussion Most persons have congruent biological sex, gender identity, and attraction to the “opposite” gender. However, humans can have every imaginable variation and configuration of chromosomes, genitalia, gender identities, sexual attractions, and sexual behaviors. Terms and definitions are constantly changing and adapting; they may also vary by local culture. Obtaining relevant medical history, conducting an “organ inventory,” asking about sexual history in a nonjudgmental way, and conducting a physical exam when warranted can all be important in delivering best possible medical care. Although there has been increased focus on education at the medical school, residency, and faculty level on LGBTQIA+ patient care in the ED, much work remains to be done. Conclusion Emergency physicians should feel confident in providing a model of care that affirms the sexual and gender identities of all the patient populations we serve. Optimal patient‐centric care requires a deeper understanding of the patient’s biology, gender identity, and sexual behavior encapsulated into the ever‐growing acronym LGBTQIA+.

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“…Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQIA+) health care workers experience harassment, discrimination, and mistreatment. 1 , 2 , 3 Although approximately 1.2% of matriculating medical students in 2021 identified as transgender and/or gender expansive (TGE; gender expansive is an umbrella term encompassing individuals and gender identities that may exist beyond the binary framework [eg, may include nonbinary, genderqueer, and agender individuals]), there is a paucity of understanding of the experiences of TGE physicians, as most studies include few to no TGE individuals (glossary of terms in eTable 1 in the Supplement ). 4 One 2019 survey of 36 TGE medical students and physicians found that 50% experienced barriers attributed to their gender identity when applying for jobs.…”

Section: Introductionmentioning

confidence: 99%