Assessment of LGBTQ+ Diversity, Equity, and Inclusion in Subspecialty Surgery Literature: A Scoping Review

Abstract

ObjectiveTo identify LGBTQ+ DEI publications and contextualize the current frequency of the literature across subspecialty surgical fields. MethodsA PRISMA systematic review using PubMed, MEDLINE, and Web of Science was conducted in April 2024. Inclusion criteria required intra-field DEI content of defined subspecialties while foreign language literature, poor methodology, and duplicates were excluded. The primary endpoint was the number of publications across subspecialties. Secondary endpoints included publication dates, study design, and sample size. ResultsOf the 702 articles identified, 27 were included. Neurological surgery had 2 studies while plastic surgery, orthopedic surgery, otolaryngology, and thoracic surgery had 11, 7, 5, and 2 respectively. There was a statistically significant different frequency of publications across subspecialties (p = 0.031). Post-hoc residual analysis indicated neurosurgery and thoracic surgery had statistically fewer publications, while plastic surgery had statistically more (p = 0.04, 0.002, 0.21, 0.42, 0.04 for neurological Surgery, plastic surgery, orthopedic surgery, otolaryngology, and thoracic surgery, respectively). Secondary outcomes found a majority of publication dates between 2022 to 2024. Study methodologies involved cross-sectional studies, editorials, and retrospective reviews (14, 11, and 3 respectively) and contained a median sample size of 248.5. ConclusionsThis systematic review provides objective data to contextualize DEI literature across surgical subspecialties. Overall, this review highlights the lack of LGBTQ+ DEI literature within neurosurgery and advocates for correcting this gap for the benefit of both surgeons and patients. Understanding the current numbers and evaluating progress in other surgical fields might provide solutions.