Perceptions of LGBT Members in Plastic Surgery

Purpose: The monumental 2015 U.S. Supreme Court decision of Obergefell v. Hodges affirmed the universal right to marriage equality within the United States.  In spite of legal equality, lesbian, gay, bisexual, transgender (LGBT) plastic surgery residents, fellows, and attendings may face significant academic and/or social forces to hide aspects of their personal life and conform to gender normative behaviors.  To better understand if this pressure exists, and if so, the effect that is has on LGBT members of the plastic surgery community, a survey instrument was designed.

 

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, sexual orientation, and participant’s comfort level within the academic environment were collected.  Respondents were also asked to assess their departments/divisions openness towards LGBT faculty and residents.

 

Results: 385 responses were recorded, 30 (8% who identify as LGB, none as transgender).  Of this cohort, 22 (73%) are current trainees (residents/fellows).  95% of LGB trainees are open to some/all residents whereas only 88% of LGB trainees are open to some/all attendings.  36% of LGB trainees report purposely concealing their sexual orientation from either residents or attendings for fear of reprisal.  4% of trainees disclosed their sexual orientation during interviews, of those that did not, 24% were concerned that disclosure would risk acceptance.  13% of LGB trainees report being advised by faculty mentors to not disclose their LGB status during interviews.  79% of LGB trainees are in long term same sex relationships, and while most (93%) feel comfortable bringing their significant other (SO) to events with residents, less feel comfortable bringing their SO to events with attendings (86%) or formal events (79%).  13% of LGB faculty feel uncomfortable bringing their SO to department events regardless of attendees. 

 

Conclusion: No historical control exists with which to compare current attitudes toward LGB acceptance within academic plastic surgery.  However, multiple comments received during the survey administration suggest that modern attitudes have changed significantly.  While the results of this survey are largely positive, it is somewhat disheartening to learn that even some LGB residents are uncomfortable bringing their partner, and presumed support network, to work functions even if attendings will not be present.  Equally frustrating is the ongoing belief that identification as a member of the LGB community may hamper placement in an applicant’s program of choice.  It is only through further discussion of this issue that the greater plastic surgery academic community can help dispel this myth.