Self-Reported Patient-Perpetrated Sexual Harassment Among the US Urological Workforce

Importance: Patient-perpetrated sexual harassment is commonly experienced in medicine. Female clinicians and trainees in urology are hypothesized to be at higher risk of experiencing patient-perpetrated sexual harassment because of the sensitive topics managed and the sex discordance between female clinicians and male patients. Objective: To assess the prevalence of experiencing and witnessing patient-perpetrated sexual harassment, where it occurs, and the reporting processes and whether they differ by clinician sex and role. Design, Setting, and Participants: In this cohort study, practicing urologists, advanced practice providers (APPs), urology residents, and fellows (trainees) who participated in the 2023 American Urological Association Annual Census were eligible. A multiple-choice survey administered as part of the annual census (from April 28 to September 30, 2023) asked about patient-perpetrated sexual harassment. Data were analyzed from June 20, 2024, to April 10, 2026. Main Outcomes and Measures: Self-reported (1) experiencing and witnessing of patient-perpetrated sexual harassment, (2) where it occurred, and (3) knowledge of formal reporting processes by clinician sex and role. Results: A total of 1467 clinicians completed the survey, including 950 practicing urologists, 285 trainees, and 232 APPs. Participants were predominantly male clinicians (67.4% n = 989); 17.9% (n = 262) and 29.6% (n = 434) of clinicians reported experiencing and witnessing any patient-perpetrated sexual harassment, respectively. When stratified by sex, 41.8% (n = 200) of female clinicians and 6.3% (n = 62) of male clinicians experienced any patient-perpetrated sexual harassment (P < .001). When stratified by clinician role, 21.4% of trainees (n = 61; P = .02), 24.1% of APPs (n = 56; P = .002) compared with 15.3% (n = 145) of practicing urologists reported experiencing any patient-perpetrated sexual harassment. After adjustment for participant demographic characteristics, trainees (adjusted odds ratio, 0.51; 95% CI, 0.31-0.83) and APPs (adjusted odds ratio, 0.34; 95% CI, 0.22-0.53) had lower odds of experiencing harassment compared with practicing urologists. Clinicians reported that most forms of patient-perpetrated sexual harassment were experienced in clinics (85.5% n = 147); 67.3% (n = 987) of clinicians reported being aware of formal reporting processes, but 60.9% (n = 601) were unaware if patients were notified about the report. Conclusions and Relevance: In this cross-sectional cohort study, we found that clinician role was not associated with higher odds of experiencing patient-perpetrated sexual harassment but being a female clinician was. Our findings are a call for action to have institutional policies and national advocacy to protect the urological workforce from patient-perpetrated sexual harassment.