LGBTQI+ Allyship in Postgraduate Surgical Education: A Scoping Review

Allyship to individuals identifying as Lesbian, Gay, Bisexual, Trans, Queer, Intersex (LGBTQI+) in surgical education is critical to supporting the development of inclusive learning and training environments, and equipping trainees with appropriate knowledge and insight to provide competent care to LGBTQI+ populations. Despite this, significant gaps persist in the integration of LGBTQI+ topics and allyship training within surgical curricula. This study aims to evaluate contemporary educational interventions, identify barriers to their introduction, suggest early strategies to support LGBTQI+ trainees and their inclusion in postgraduate surgical training and provide insights into the surgical care of this key minority population.

Using the Arksey and O'Malley framework and the PRISMA-ScR guidelines, a scoping review was conducted of 714 records identified through systematic database searches. Thirty-six studies meeting inclusion criteria were reviewed to assess themes related to LGBTQ+ education, allyship, and surgical training. Data were extracted using a standardized proforma and synthesized to highlight strengths, gaps, and potential interventions.

The review identified key deficits in LGBTQI+ education, including limited exposure to gender-affirming surgery and lack of formal allyship training. Inequities in access to training opportunities, particularly in gender-affirming surgery, were noted across specialties and regions. Mistreatment of trainees, including discrimination and harassment, negatively impacted mental health and career satisfaction. Promising interventions, such as structured allyship programs and multidisciplinary training models, demonstrated improved cultural competence and inclusivity. However, the absence of standardized national guidelines exacerbates disparities in education and training.

This review provides an overview of the limited literature on LGBTQI+ postgraduate allyship education in surgery. The findings align with NHS England LGBTQI+ health priorities to inform future education and policy development aimed at promoting inclusivity and equity in surgery.