PDF(Pubmed)
Abstract：
BACKGROUND: There is substantial corroborating evidence that orthopaedic surgery has historically been the least diverse of all medical and surgical specialties in terms of race, ethnicity, and sex. Growing recognition of this deficit and the benefits of a diverse healthcare workforce has motivated policy changes to improve diversity. To measure progress with these efforts, it is important to understand the existing representation of sexual and gender minorities among orthopaedic professionals.
OBJECTIVE: (1) What proportion of American Academy of Orthopaedic Surgeons (AAOS) members reported their identity as a sexual or gender minority? (2) What demographic factors are associated with the self-reporting of one\'s sexual orientation and gender identity?
METHODS: The AAOS published the updated membership questionnaire in January 2022 to collect information from new and existing society members regarding age and race or ethnicity and newly added categories of gender identity, sexual orientation, and pronouns. The questionnaire was updated with input from a committee of orthopaedic surgeons and researchers to ensure face validity. The AAOS provided a deidentified dataset that included the variables of interest: membership type, gender identity, sexual orientation, pronouns, age, race, and ethnicity. Of 35,427 active AAOS members, 47% (16,652) updated their membership questionnaire. To answer our first study question, we calculated the prevalence of participants who self-reported as lesbian, gay, bisexual, transgender, queer, or another sexual or gender minority identity (LGBTQ+) and other demographic characteristics of the 16,652 respondents. Categorical demographic data are described using frequencies and proportions. Median and IQR were used to describe the central tendency and variability. To answer our second study question, we conducted a stratified analysis to compare demographic characteristics between those who self-reported LGBTQ+ identity and those who did not. Visual methods (quantile-quantile plots) and statistical tests (Kolmogorov-Smirnov and Shapiro Wilk) confirmed that the age of AAOS member was not normally distributed. Therefore, a Kruskal Wallis test was used to determine the statistical associations between age and self-reported LGBTQ+ status. Chi-square tests were used to determine bivariate statistical associations between categorical demographic characteristics and self-reported LGBTQ+ status. A multivariable logistic regression model was developed to identify the independent demographic characteristics associated with respondents who self-reported LGBTQ+ identity. Further stratified analyses were not conducted to protect the anonymity of AAOS members. An alpha level of 5% was established a priori to define statistical significance.
RESULTS: Overall, 3% (109 of 3679) and fewer than 1% (3 of 16,182) of the AAOS members (surgeons, clinicians, allied healthcare providers, and researchers) who updated their membership profiles reported identifying as a sexual (lesbian, gay, bisexual, queer) or gender minority (nonbinary or transgender), respectively. No individual self-identified as transgender. Five percent (33 of 603) of women and 3% (80 of 3042) of men self-identified as a sexual minority (such as lesbian, gay, bisexual, or queer). AAOS members who self-identified as LGBTQ+ were younger (OR 0.99 [95% confidence interval (CI) 0.98 to 0.99]; p < 0.001), less likely to self-identify as women (OR 0.86 [95% CI 0.767 to 0.954]; p < 0.001), less likely to be underrepresented in medicine (OR 0.49 [95% CI 0.405 to 0.599]; p < 0.001), and less likely to be an emeritus or honorary member (OR 0.75 [95% CI 0.641 to 0.883]; p < 0.003).
CONCLUSIONS: The proportion of self-reported LGBTQ+ AAOS members is lower than the 7% of the general US population. The greater proportion of younger AAOS members reporting this information suggests progress in the pursuit of a more-diverse field.
CONCLUSIONS: The study findings support standardized collection of sexual orientation and gender identity data to better identify and address diversity gaps. As orthopaedic surgery continues to transform to reflect the diversity of musculoskeletal patients, all orthopaedic professionals (surgeons, clinicians, allied healthcare providers, and researchers), regardless of their identities, are essential in the mission to provide equitable and informed orthopaedic care. Sexual and gender minority individuals may serve as important mentors to the next generations of orthopaedic professionals; individuals from nonminority groups should serve as important allies in achieving this goal.
OBJECTIVE: (1) What proportion of American Academy of Orthopaedic Surgeons (AAOS) members reported their identity as a sexual or gender minority? (2) What demographic factors are associated with the self-reporting of one\'s sexual orientation and gender identity?
METHODS: The AAOS published the updated membership questionnaire in January 2022 to collect information from new and existing society members regarding age and race or ethnicity and newly added categories of gender identity, sexual orientation, and pronouns. The questionnaire was updated with input from a committee of orthopaedic surgeons and researchers to ensure face validity. The AAOS provided a deidentified dataset that included the variables of interest: membership type, gender identity, sexual orientation, pronouns, age, race, and ethnicity. Of 35,427 active AAOS members, 47% (16,652) updated their membership questionnaire. To answer our first study question, we calculated the prevalence of participants who self-reported as lesbian, gay, bisexual, transgender, queer, or another sexual or gender minority identity (LGBTQ+) and other demographic characteristics of the 16,652 respondents. Categorical demographic data are described using frequencies and proportions. Median and IQR were used to describe the central tendency and variability. To answer our second study question, we conducted a stratified analysis to compare demographic characteristics between those who self-reported LGBTQ+ identity and those who did not. Visual methods (quantile-quantile plots) and statistical tests (Kolmogorov-Smirnov and Shapiro Wilk) confirmed that the age of AAOS member was not normally distributed. Therefore, a Kruskal Wallis test was used to determine the statistical associations between age and self-reported LGBTQ+ status. Chi-square tests were used to determine bivariate statistical associations between categorical demographic characteristics and self-reported LGBTQ+ status. A multivariable logistic regression model was developed to identify the independent demographic characteristics associated with respondents who self-reported LGBTQ+ identity. Further stratified analyses were not conducted to protect the anonymity of AAOS members. An alpha level of 5% was established a priori to define statistical significance.
RESULTS: Overall, 3% (109 of 3679) and fewer than 1% (3 of 16,182) of the AAOS members (surgeons, clinicians, allied healthcare providers, and researchers) who updated their membership profiles reported identifying as a sexual (lesbian, gay, bisexual, queer) or gender minority (nonbinary or transgender), respectively. No individual self-identified as transgender. Five percent (33 of 603) of women and 3% (80 of 3042) of men self-identified as a sexual minority (such as lesbian, gay, bisexual, or queer). AAOS members who self-identified as LGBTQ+ were younger (OR 0.99 [95% confidence interval (CI) 0.98 to 0.99]; p < 0.001), less likely to self-identify as women (OR 0.86 [95% CI 0.767 to 0.954]; p < 0.001), less likely to be underrepresented in medicine (OR 0.49 [95% CI 0.405 to 0.599]; p < 0.001), and less likely to be an emeritus or honorary member (OR 0.75 [95% CI 0.641 to 0.883]; p < 0.003).
CONCLUSIONS: The proportion of self-reported LGBTQ+ AAOS members is lower than the 7% of the general US population. The greater proportion of younger AAOS members reporting this information suggests progress in the pursuit of a more-diverse field.
CONCLUSIONS: The study findings support standardized collection of sexual orientation and gender identity data to better identify and address diversity gaps. As orthopaedic surgery continues to transform to reflect the diversity of musculoskeletal patients, all orthopaedic professionals (surgeons, clinicians, allied healthcare providers, and researchers), regardless of their identities, are essential in the mission to provide equitable and informed orthopaedic care. Sexual and gender minority individuals may serve as important mentors to the next generations of orthopaedic professionals; individuals from nonminority groups should serve as important allies in achieving this goal.
摘要：
背景：有大量确凿的证据表明，就种族而言，骨科手术历来是所有医疗和外科专业中最不多样化的，种族,和性爱。人们越来越认识到这一赤字和多元化医疗劳动力的好处，这促使政策发生变化，以改善多样性。为了衡量这些努力的进展，重要的是要了解骨科专业人员中性别和性别少数群体的现有代表性。
目标：（1）美国骨科医师学会（AAOS）成员报告自己的性别或性别少数群体身份的比例是多少？（2）哪些人口因素与自我报告的性取向和性别认同有关？
方法：AOS于2022年1月发布了有关新种族和现有社会成员的新种族和性别认同的最新成员问卷，以收集信息性取向,和代词。问卷是根据整形外科医生委员会和研究人员的输入进行更新的，以确保面部有效性。AAOS提供了一个去识别的数据集，其中包括感兴趣的变量：成员类型，性别认同,性取向,代词,年龄,种族,和种族。在35,427名活跃的AAOS成员中，47%(16,652)的人更新了会员问卷。为了回答我们的第一个研究问题，我们计算了自我报告为女同性恋的参与者的患病率，同性恋,双性恋,变性人,酷儿,16,652名受访者的其他性或性别少数群体身份(LGBTQ+)和其他人口统计学特征。分类人口统计数据使用频率和比例进行描述。中位数和IQR用于描述中心趋势和变异性。为了回答我们的第二个研究问题，我们进行了分层分析,比较了自我报告LGBTQ+身份者和未报告LGBTQ+身份者的人口学特征.视觉方法（分位数-分位数图）和统计检验（Kolmogorov-Smirnov和ShapiroWilk）证实了AAOS成员的年龄不是正态分布的。因此,使用KruskalWallis检验来确定年龄与自我报告的LGBTQ+状态之间的统计学关联.卡方检验用于确定分类人口统计学特征与自我报告的LGBTQ状态之间的双变量统计关联。建立了多变量逻辑回归模型，以确定与自我报告LGBTQ身份的受访者相关的独立人口统计学特征。没有进行进一步的分层分析以保护AAOS成员的匿名性。先验地建立5%的α水平以定义统计显著性。
结果：总体而言，3％（3679人中的109人）和不到1％（16,182人中的3人）的AAOS成员（外科医生，临床医生,联合医疗服务提供者，和研究人员)，他们更新了他们的会员资料，报告认定为性伴侣(女同性恋，同性恋,双性恋,酷儿)或性别少数群体(非二元或变性者)，分别。没有人自我认定为变性人。5%(603人中的33人)的女性和3%(3042人中的80人)的男性自我认定为性少数群体(如女同性恋，同性恋,双性恋,或酷儿)。自我认定为LGBTQ+的AAOS成员年龄较小(OR0.99[95%置信区间(CI)0.98至0.99];p<0.001)，自我识别为女性的可能性较小(OR0.86[95%CI0.767至0.954]；p<0.001)，在医学中代表性不足的可能性较小(OR0.49[95%CI0.405至0.599]；p<0.001)，不太可能成为名誉会员或名誉会员(OR0.75[95%CI0.641至0.883]；p<0.003)。
结论：自我报告的LGBTQ+AAOS成员的比例低于美国普通人群的7%。报告此信息的年轻AAOS成员比例更高，这表明在追求更多样化的领域方面取得了进展。
结论：研究结果支持标准化收集性取向和性别认同数据，以更好地识别和解决多样性差距。随着骨科手术的不断转变，以反映肌肉骨骼患者的多样性，所有骨科专业人员(外科医生，临床医生,联合医疗服务提供者，和研究人员)，不管他们的身份,在提供公平和知情的骨科护理的使命中至关重要。性别和性别少数的个人可能是下一代骨科专业人员的重要导师；非少数群体的个人应成为实现这一目标的重要盟友。
目标：（1）美国骨科医师学会（AAOS）成员报告自己的性别或性别少数群体身份的比例是多少？（2）哪些人口因素与自我报告的性取向和性别认同有关？
方法：AOS于2022年1月发布了有关新种族和现有社会成员的新种族和性别认同的最新成员问卷，以收集信息性取向,和代词。问卷是根据整形外科医生委员会和研究人员的输入进行更新的，以确保面部有效性。AAOS提供了一个去识别的数据集，其中包括感兴趣的变量：成员类型，性别认同,性取向,代词,年龄,种族,和种族。在35,427名活跃的AAOS成员中，47%(16,652)的人更新了会员问卷。为了回答我们的第一个研究问题，我们计算了自我报告为女同性恋的参与者的患病率，同性恋,双性恋,变性人,酷儿,16,652名受访者的其他性或性别少数群体身份(LGBTQ+)和其他人口统计学特征。分类人口统计数据使用频率和比例进行描述。中位数和IQR用于描述中心趋势和变异性。为了回答我们的第二个研究问题，我们进行了分层分析,比较了自我报告LGBTQ+身份者和未报告LGBTQ+身份者的人口学特征.视觉方法（分位数-分位数图）和统计检验（Kolmogorov-Smirnov和ShapiroWilk）证实了AAOS成员的年龄不是正态分布的。因此,使用KruskalWallis检验来确定年龄与自我报告的LGBTQ+状态之间的统计学关联.卡方检验用于确定分类人口统计学特征与自我报告的LGBTQ状态之间的双变量统计关联。建立了多变量逻辑回归模型，以确定与自我报告LGBTQ身份的受访者相关的独立人口统计学特征。没有进行进一步的分层分析以保护AAOS成员的匿名性。先验地建立5%的α水平以定义统计显著性。
结果：总体而言，3％（3679人中的109人）和不到1％（16,182人中的3人）的AAOS成员（外科医生，临床医生,联合医疗服务提供者，和研究人员)，他们更新了他们的会员资料，报告认定为性伴侣(女同性恋，同性恋,双性恋,酷儿)或性别少数群体(非二元或变性者)，分别。没有人自我认定为变性人。5%(603人中的33人)的女性和3%(3042人中的80人)的男性自我认定为性少数群体(如女同性恋，同性恋,双性恋,或酷儿)。自我认定为LGBTQ+的AAOS成员年龄较小(OR0.99[95%置信区间(CI)0.98至0.99];p<0.001)，自我识别为女性的可能性较小(OR0.86[95%CI0.767至0.954]；p<0.001)，在医学中代表性不足的可能性较小(OR0.49[95%CI0.405至0.599]；p<0.001)，不太可能成为名誉会员或名誉会员(OR0.75[95%CI0.641至0.883]；p<0.003)。
结论：自我报告的LGBTQ+AAOS成员的比例低于美国普通人群的7%。报告此信息的年轻AAOS成员比例更高，这表明在追求更多样化的领域方面取得了进展。
结论：研究结果支持标准化收集性取向和性别认同数据，以更好地识别和解决多样性差距。随着骨科手术的不断转变，以反映肌肉骨骼患者的多样性，所有骨科专业人员(外科医生，临床医生,联合医疗服务提供者，和研究人员)，不管他们的身份,在提供公平和知情的骨科护理的使命中至关重要。性别和性别少数的个人可能是下一代骨科专业人员的重要导师；非少数群体的个人应成为实现这一目标的重要盟友。
