Impact of Discrimination on Job Satisfaction in the LGBT Plastic Surgery Community

Purpose: Prior studies have demonstrated that underrepresented social groups often face increased overt and covert workplace discrimination, decreased professional success, and may find less overall workplace satisfaction. Despite increasing social acceptance and lessening social stigmatization, many individuals are uncomfortable working with lesbian, gay, bisexual, transgender (LGBT) peers. We sought to assess the existence and impact of overt and covert discrimination against LGBT members of the academic plastic surgery community and to determine if this resulted in a measurable impact on work satisfaction. 

 

Methods: A link to an internet-based, anonymized survey was distributed to all plastic surgery program directors and resident coordinators with instructions to distribute to their respective attendings, fellows, and residents.  Three reminder emails were sent, each at two-week intervals.  Demographic information, career information, sexual orientation, and markers of both overt at covert discrimination were collected.  A previously validated scale to assess work satisfaction was included as well.  Responses of LGB trainees and LGB attendings were compared to their heterosexual counterparts using a two-tailed t-test and considered significant if p<0.05.

 

Results: 385 responses were recorded, 30 (8% who identify as LGB, none as transgender).  18% of this cohort report personally experiencing a direct homophobic remark by a resident, 27% report experiencing a direct homophobic mark by an attending.  5% of LGB respondents report that they believe they are treated differently by residents, 11% feel they are treated differently by attendings. LBG respondents report hearing general homophobic remarks from nurses, residents, and attendings at 62%, 38%, and 34% respectively. This is compared with 25%, 18%, and 17% in heterosexual peers. 19% of LGB respondents report witnessing discriminatory care of LGB patients or their partners, this is in contrast to 6% of their heterosexual peers.  100% percent of LGB respondents feel that nondiscrimination policies should include sexual orientation, only 91% of their heterosexual peers feel similarly.  0% of heterosexual respondents feel uncomfortable working with an LGB colleague, 0% feel sexual orientation affects job performance or would affect referral patterns.  No significant difference exists in job satisfaction between LGB and heterosexual trainees or LGB and heterosexual attendings.

 

Conclusion: While generally reassuring, the results of this study suggest that LGB plastic surgeons experience an undue amount of both covert and overt discrimination within the workplace.  It is interesting to note that the LGB is, general, subject to more covert discriminatory practices as a smaller percentage of LGB respondents report experiencing a direct homophobic remark.  This is further evidenced by the somewhat discouraging statistic that only 91% of heterosexual plastic surgeons feel that nondiscrimination policies ought to include sexual orientation.  It is likely, however, that real progress has been made from a presumed historical baseline as no respondent reported to feel uncomfortable working with a LGB colleague.  It is comforting to know, however, that despite the existence of discrimination, our LGB colleagues suffer no loss of job satisfaction.