Experiences of Transgender and Nonbinary Physicians During Medical Residency Program Application

Abstract

Increasing numbers of transgender and nonbinary (TNB) people seek careers in medicine, but little is known about their experiences and the effect of their gender identity during residency application. This project sought to evaluate the experiences and needs of TNB individuals during the residency application and Match process in order to inform the practice of residency programs. An online survey was distributed in 2019 via social media, professional groups, and snowball sampling to TNB persons, who were current residents or recent graduates (within the past 3 years) of a US residency program. Twenty-six eligible respondents from 10 medical specialties completed the survey. Eighteen (69.2%) respondents felt unsafe disclosing their gender identity or discussing it during interviews some or all of the time due to fear of discrimination and how it might affect their match; 26.9% (7 of 26) felt they were ranked lower than their qualifications due to their gender identity. Eleven (42.3%) were misnamed or misgendered some or all of the time during interviews through use of incorrect name and pronouns. Respondents' recommendations for programs included: (1) adopt gender-affirming practices; (2) offer gender-affirming health benefits; (3) advertise nondiscrimination policies; (4) understand experiences of discrimination during medical training; and (5) value resident gender diversity. TNB residents and recent graduates perceived gender identity discrimination during residency application, including feeling unsafe to disclose their gender identity and being misnamed or misgendered. Suggestions for programs to improve the experience of TNB applicants are included.