Are pediatric surgery clinics LGBTQ+ inclusive?

Abstract

Purpose: Creating inclusive LGBTQ+ environments is important in the provision of inclusive care. This cross sectional study assessed whether patient intake forms in pediatric surgery departments were LGBTQ+ inclusive (L-I).

Methods: North American pediatric surgery departments affiliated with pediatric surgery fellowships or general surgery residencies were contacted to retrieve patient intake forms. Forms were assessed for LGBTQ+ inclusivity using a novel L-I scoring system consisting of 6 criteria: preferred name, pronouns, preferred language, gender identity, sex assigned at birth, and l-I guardianship. Institutions without intake forms were invited to comment on their use of l-I intake questions.

Results: 59/125 programs responded to our query, 10 of which provided intake forms. Median l-I score was 2/6 points (range 1-4). l-I guardianship was the most common question asked. No intake form asked for pronouns. Of the 49 institutions without forms, 30.5% reported asking l-I questions during initial visits. Narratives from these institutions varied widely. Some institutions supported routine l-I questions while others stated l-I questions were unnecessary, irrelevant, and/or offensive.

Conclusions: Few North American pediatric surgery departments consistently ask l-I questions during the intake process. Comments questioning the appropriateness and necessity of l-I questions highlight the need for LGBTQ+ education.

Level of evidence: Level III.

Type of study: Cross sectional study.

Keywords: Cultural competency; Gender nonconforming (GNC); Gonadotropin-releasing hormone (GnRH); Health disparities; LGBTQ+; Lesbian-gay-bisexual-transgender-queer-+ (LGBTQ+); Pediatric surgery abbreviations adverse childhood experiences (aces).