Most LGBTQ+ orthopedic trainees and professionals report workplace bias: Study

Most lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) orthopedic trainees and professionals openly identify their sexual orientation or gender identity to at least some colleagues, but many report experiencing bullying, discrimination, or differential treatment in their workplaces, according to research presented in Clinical Orthopaedics and Related Research (CORR).

"This juxtaposition of increased visibility and persistent discrimination highlights the need for continued efforts toward creating a more supportive environment in orthopedic surgery," says senior author Julie Balch Samora, MD, Ph.D., MPH, an orthopedic surgeon at Nationwide Children's Hospital in Columbus, Ohio, and colleagues.

Internet-based survey quantified adverse experiences

The researchers analyzed data provided by 156 individuals who completed a voluntary survey when they registered online for membership in Pride Ortho, a mentorship and inclusivity initiative for LGBTQ+ orthopedic surgeons and allies. Most respondents (64%) identified as LGBTQ+, with 50% being at the attending stage of their careers and most others being trainees (27% medical students, 12% residents, and 5% fellows).

Key findings of the survey were:

• Of the 100 LGBTQ+ respondents, 94 said they were out in their workplace (open about their identity), but 31 of those 94 were out only to certain co-workers
• Most LGBTQ+ respondents, 74%, reported either "yes" or "maybe" to questions about perceived experiences of bullying, discrimination, or being treated differently in the workplace
• Of the straight or heterosexual respondents, 92% answered "no" to experiencing any sort of bullying, discrimination, or being treated differently
• There was no geographic variation in reported experiences of bullying and discriminatory behaviors

Creating safer, more inclusive environments

The authors note that bullying and discrimination can deter individuals from beginning and completing their training in orthopedic surgery. While they favor enforcing no-tolerance policies against bullying and discrimination, they caution that focusing purely on punitive measures has been shown to be ineffective in addressing the root problem in the workplace.

Dr. Samora's group suggests additional steps that health care institutions can take to support LGBTQ+ orthopedic trainees and professionals and improve their sense of belonging and engagement:

• Establish protective reporting policies and procedures
• Continuously collect feedback from all professionals in the workplace about their perceptions of the environment and current policies, and refine policies as needed
• Implement diversity and sensitivity training programs such as training about implicit bias, allyship, and bystander intervention
• Promote LGBTQ+ surgeons into leadership roles

"Addressing these issues is key to creating a more diverse and empathetic workforce within orthopedic institutions," Dr. Samora and her co-authors conclude, "which in turn can lead to improved patient care and a better work environment."