Self-Reported Patient-Perpetrated Sexual Harassment Among the US Urological Workforce.

Abstract

Patient-perpetrated sexual harassment is commonly experienced in medicine. Female clinicians and trainees in urology are hypothesized to be at higher risk of experiencing patient-perpetrated sexual harassment because of the sensitive topics managed and the sex discordance between female clinicians and male patients. To assess the prevalence of experiencing and witnessing patient-perpetrated sexual harassment, where it occurs, and the reporting processes and whether they differ by clinician sex and role. In this cohort study, practicing urologists, advanced practice providers (APPs), urology residents, and fellows (trainees) who participated in the 2023 American Urological Association Annual Census were eligible. A multiple-choice survey administered as part of the annual census (from April 28 to September 30, 2023) asked about patient-perpetrated sexual harassment. Data were analyzed from June 20, 2024, to April 10, 2026. Self-reported (1) experiencing and witnessing of patient-perpetrated sexual harassment, (2) where it occurred, and (3) knowledge of formal reporting processes by clinician sex and role. A total of 1467 clinicians completed the survey, including 950 practicing urologists, 285 trainees, and 232 APPs. Participants were predominantly male clinicians (67.4% [n = 989]); 17.9% (n = 262) and 29.6% (n = 434) of clinicians reported experiencing and witnessing any patient-perpetrated sexual harassment, respectively. When stratified by sex, 41.8% (n = 200) of female clinicians and 6.3% (n = 62) of male clinicians experienced any patient-perpetrated sexual harassment (P < .001). When stratified by clinician role, 21.4% of trainees (n = 61; P = .02), 24.1% of APPs (n = 56; P = .002) compared with 15.3% (n = 145) of practicing urologists reported experiencing any patient-perpetrated sexual harassment. After adjustment for participant demographic characteristics, trainees (adjusted odds ratio, 0.51; 95% CI, 0.31-0.83) and APPs (adjusted odds ratio, 0.34; 95% CI, 0.22-0.53) had lower odds of experiencing harassment compared with practicing urologists. Clinicians reported that most forms of patient-perpetrated sexual harassment were experienced in clinics (85.5% [n = 147]); 67.3% (n = 987) of clinicians reported being aware of formal reporting processes, but 60.9% (n = 601) were unaware if patients were notified about the report. In this cross-sectional cohort study, we found that clinician role was not associated with higher odds of experiencing patient-perpetrated sexual harassment but being a female clinician was. Our findings are a call for action to have institutional policies and national advocacy to protect the urological workforce from patient-perpetrated sexual harassment.