LGBTQ+ Inclusivity in Neurosurgery: Exploring Physicians' Knowledge, Experience, and Competence

Area of Science:

• Neurosurgery
• Medical Education
• Health Equity

Background:

• Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals experience delayed and disparate medical care.
• Affirming and informed neurosurgical care is essential for improving LGBTQ+ patient outcomes.
• Growing visibility of the LGBTQ+ community necessitates better-prepared neurosurgeons.

Purpose of the Study:

• To assess neurosurgeons' (residents and attendings) comfort and knowledge in providing care to LGBTQ+ patients.
• To identify factors influencing neurosurgeons' competence in LGBTQ+ care.
• To evaluate the impact of training and clinical experience on LGBTQ+ patient care.

Main Methods:

• A survey was administered across 9 US academic neurosurgery centers.
• The survey assessed training, preparation, knowledge, clinical practice experience, and comfort/competence in LGBTQ+ care using a 5-point Likert scale.
• Linear regression and mediation analysis were employed to examine relationships between variables.

Main Results:

• Eighty-seven neurosurgeons completed the survey; increased training/knowledge correlated with higher comfort (0.31-point increase per 1-point increase, P < .01).
• Attendings reported less comfort than residents regarding LGBTQ+ care specifics.
• Clinical experience mediated the relationship between training/knowledge and perceived competence; care for transgender individuals was rated lower than for LGB individuals.

Conclusions:

• Neurosurgical providers exhibit limited knowledge and comfort in LGBTQ+ care, particularly for transgender patients.
• Neurosurgeon training and clinical experience positively impact comfort and competence in LGBTQ+ care.
• Enhanced neurosurgical training programs are vital for creating an inclusive and equitable healthcare environment for LGBTQ+ individuals.