Experiences of LGBTQ+ Plastic Surgeons in the US and Canada

Background: The LGBTQ+ community faces discrimination within the workplace, with growing evidence emerging about the mistreatment of LGBTQ+ surgeon trainees. The purpose of this study was to better understand the experiences of LGBTQ+ surgeons in plastic and reconstructive surgery (PRS). Methods: A web-based survey was made available to all plastic surgeons who identified as LGBTQ+ across the US and Canada from October 2021 to November 2022. The questionnaire used validated tools assessing "outness" and microaggressions, as well as rates of censorship of speech and/or mannerisms and experiences of discrimination. Outcomes were measured as frequencies and analyzed as a function of location (US vs Canada), gender identity (transgender and gender-diverse (TGD) versus cisgender), and level of training (attending vs in-training). Qualitative responses were also recorded. Results: A total of 43 self-identified LGBTQ+ individuals engaged with the survey, 38 of which completed it (88%). Nearly all (96.8%) reported experiencing heteronormative microaggressions, 36.7% reported discrimination from plastic surgery attendings, and 73.3% censor themselves around Plastic Surgery attendings. TGD respondents were more likely to have experienced discrimination than cisgender respondents (P < .01). One-third (33%) of respondents indicated that they hesitate to be out at their institution for fear of bias and/or discrimination. Conclusion: LGBTQ+ plastic and reconstructive surgeons reported a significant amount of microaggressions, self-censorship, and discrimination while at work, and these experiences varied as a function of level of training and gender identity. PRS should strive to eliminate these mistreatments, educate its workforce, and address LGBTQ+ underrepresentation within the field.