Opportunities for Gender-Affirming Care Exposure Across Otolaryngology Programs

Opportunities for otolaryngology residents to gain exposure and training in gender-affirming care (GAC) are not well-described. The authors examined the prevalence of US otolaryngology residency programs with GAC clinics, surgeons performing gender-affirming surgery (GAS), and faculty that published GAC research.

US otolaryngology residencies were identified with the AMA FREIDA, the AMA Residency & Fellowship Database®. Public program websites were used to identify facial plastic surgeons, laryngologists, and GAC clinics. Faculty were queried in PubMed for publications specific to GAC. Data were collected in January 2024.

A total of 92 (70.0%) out of 131 programs had an institutional GAC clinic. Presence of GAC clinics varied between regions, and 42 (32.1%) programs encompassing 765 (41%) residents had ≥ 1 otolaryngology-trained specialist offering GAS. Within each region, programs with any faculty performing GAS were most prevalent in the midwest, with 47% of residencies (16/34 programs) publicly advertising ≥ 1 otolaryngology department faculty member working in the affiliated institutional gender clinic. The next highest region was the west (42%, 9/21 programs), followed by the northeast (29%, 10/34 programs), and lastly the south, with only 17% (7/42 programs) (P = .03). Nationally, 29.0% of programs (36/126), encompassing 652 residents (35.0% of all US trainees) had ≥ 1 otolaryngology faculty member with ≥ 1 GAC publication.

Most otolaryngology residents in the United States train at institutions with a GAC clinic, but involvement of otolaryngology faculty is highly variable. A minority of residents have any department faculty who perform GAS or research in GAC.

Opportunities exist to improve otolaryngology resident exposure to both clinical and scholarly GAC, particularly in the southern region of the United States.