Confronting the Scope of LGBT Inequity in Surgery.

Abstract

This landmark paper traces anti-LGBT discrimination in surgery from history to present with particular analysis of discrimination against patients, providers, and within faith-based and military While research alone will not end healthcare iniquity, the work cannot begin until the “Don’t Ask Don’t Tell” era of scholarship on ends. institutions. Discrimination against marginalized individuals is an epidemic in American Healthcare. Research regarding gender- and race- based discrimination in healthcare and surgery is robust; scholarship on anti-LGBT (Lesbian, Gay, Bisexual, and Transgender; see Table 1 for explanations of commonly used terms) discrimination is woefully lacking. A Pubmed search of the top 10 Surgical Journals by h-index for the terms “Gay” “Lesbian” “LGBT” or “LGBTQ” turns up a single relevant article (1). This is despite the myriad of inequities LGBT surgeons and LGBT surgical patients face. The history of LGBT identity and discrimination has led to inequitable systems at both the structural and interpersonal level which are mutually reinforcing and synergistically harmful to patients (see figure 1). Addressing such inequities in surgery will require continual individual, systemic, and structural changes. Delineating all these changes is beyond the scope of any one paper. However, improving and sustaining LGBT equity cannot begin without first providing a common background to create change upon. This paper seeks to correct the discursive gap.