In Reply As Bai et al note, general surgery has historically been a (White, cisgendered, heterosexual) male-dominated field. Our data indicate lack of inclusion is experienced by many with minoritized identities in surgery, including lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) physicians. We agree that this lack of inclusion likely leads LGBTQ+ residents to withhold their identity. In our survey of 85.6% of all residents training in accredited general surgery programs, 305 (4.8%) self-identified as LGBTQ+, and 394 residents did not answer or selected “prefer not to answer.” Based on US Census data and prior work1 demonstrating that more than half of LGBTQ+ surgery residents choose not to disclose their identity, we too suspect our study undercounts LGBTQ+ surgery residents and therefore underestimates LGBTQ+-based mistreatment. Even if residents are able to avert mistreatment by withholding LGBTQ+ identity, the inability to authentically express one’s identity causes psychological distress and difficulty connecting with colleagues.2 Therefore, an environment in which it is safe to disclose identity is essential to the well-being of LGBTQ+ trainees.
Schlick CJR, Heiderscheit EA, Hu Y. Diversity in Surgery Residents and Unwanted Mistreatment—Reply. JAMA Surg. 2022;157(7):636. doi:10.1001/jamasurg.2022.0268
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