Are pediatric surgery clinics LGBTQ+ inclusive?

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.