Do women experience microaggressions in orthopaedic surgery? Current state and future directions from a survey of women orthopaedists

Abstract

Background: Microaggressions are verbal, nonverbal, or environmental slights or insults that convey hostile, derogatory, or otherwise negative messages. Repeated, long-term exposure to microaggressions can have damaging consequences. We sought to determine the prevalence of microaggressions in the field of orthopaedic surgery, as perceived among women. Methods: An anonymous 32-item survey was distributed to members of Women in Orthopaedics (N=1123), a private online group exclusive to female orthopaedic surgeons in practice or training. Demographic information was collected including information on orthopaedic subspecialty and location of residency, fellowship, and current practice. Respondents were asked a series of questions detailing instances of microagressions based on four categories: microinsults, microassaults, microinvalidations, and physical barriers. Respondents were asked to detail instances of microaggressions during each professional stage of their medical career. Results: A total of 264 (24%) surveys were collected. Among respondents, 74% had experienced some form of microaggression in their training, with 13% having been a perpetrator of a microaggression against someone else. Only 7.6% of respondents had not experienced a microaggression. Residents were more likely to experience microaggressions than fellows or attending surgeons. The most common perpetrators identified were patients and their families, male surgeons, and female support staff. There was no association between race, age, demographic region, or specialty and the likelihood of experiencing microaggressions. Conclusions: Microaggressions are commonly experienced by women in orthopaedics. The most common perpetrators of microaggressions are patients and their families, but other medical and support staff contribute to the environment. Awareness is crucial to address the issue. Level of Evidence: Level IV.