Fewer than half of dermatologists who identify as lesbian, gay, bisexual, or transgender (LGBT) are open about their sexual orientation at work with their patients, according to study findings published in JAMA Dermatology.

The findings are based on a secondary analysis of the American Academy of Dermatology (AAD) 2020 Member Satisfaction Survey, which was distributed to 10,060 dermatologists from January 3, 2020, to January 31, 2020. Respondents who lived outside the United States, were retired or semiretired, or were adjunct or lifetime AAD members were excluded.

Dermatologists were considered LGBT if they self-identified as nonheterosexual (based on response options of “lesbian, gay, or homosexual,” “bisexual,” or “something else”) or transgender in the survey.


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A total of 1339 dermatologists completed the survey, and the analysis included 1271 survey respondents,of whom 47 (3.7%; 95% CI, 2.7-4.9) identified as LGBT. Of this group of 47 dermatologists, 43 (3.4%; 95% CI, 2.5-4.5) identified as nonheterosexual and 4 (0.3%; 95% CI, 0.1-0.8) identified as both nonheterosexual and transgender. The LGBT identity prevalence was 40 of 593 male respondents (6.7%; 95% CI, 4.8-9.1) and 7 of 675 female respondents (1.0%; 95% CI, 0.4-2.1).

LGBT dermatologists were more likely to be men, younger, and to practice in academic settings, compared with non-LGBT dermatologists. Among 45 nonheterosexual respondents, 47% were open about their sexual orientation identity at work with their patients, and80% were open at work with their colleagues. Of the 2 transgender respondents, both were open at work with their patients and colleagues.

“This lack of disclosure may be related to fears of discrimination, which likely has adverse effects on physicians’ well being and may limit their visibility to patients,” the study authors stated.

A recent Gallup survey of 15,349 adults in the general adult population found that 4.9% of men and 6.9% of women identify as LGBT, which suggests that LGBT women may be under-represented among US dermatologists in comparison with the current findings. Dermatology has the lowest percentage of female medical students who identify as lesbian, gay, or bisexual, according to the investigators.

Study limitations include the cohort of only AAD-member dermatologists, nonresponse bias, potential misclassification bias owing to missing or undisclosed LGBT identity data, and possible variation in LGBT identity prevalence over time.

“Sexual orientation and gender identity data collection should be standardized in all trainee and physician workforce surveys to better identify and close diversity gaps,” the researchers advised. “Dermatology residency training programs and medical organizations should explicitly include LGBT identity in recruitment and diversity efforts to cultivate a visibly diverse and inclusive workforce.”

Reference

Mansh MD, Dommasch E, Peebles JK, Sternhell-Blackwell K, Yeung H. Lesbian, gay, bisexual, and transgender identity and disclosure among dermatologists in the US. JAMA Dermatol. Published online November 10, 2021. doi: 10.1001/jamadermatol.2021.4544