Sexual and Gender Minority Representation and Experiences in Orthopaedic Surgery: A Narrative Review

Trauma and orthopaedic surgery has historically been regarded as one of the least diverse specialities in medicine. Despite increasing sexual and gender minority (SGM) populations globally, there is an apparent continued underrepresentation in orthopaedic surgery, although the existing literature is fragmented and lacks synthesis. This narrative review aims to evaluate current SGM representation in orthopaedic surgery, examine barriers to entry (including workplace experiences, prospective trainee perceptions and reports of differential treatment) and assess the impact of underrepresentation on the workforce and patient care. A literature search was conducted across PubMed, Scopus, and Google Scholar, with 28 studies selected for inclusion. Available evidence demonstrates persistently low representation of SGM individuals in orthopaedics, alongside reports of discrimination, limited visibility, and negative perceptions of the speciality among medical students and prospective trainees. These factors likely act as ongoing barriers to recruitment and retention. Emerging evidence also suggests that workforce diversity may influence patient experience and doctor-patient communication, particularly in areas involving sensitive health discussions. Addressing the representation and experiences of SGM individuals in orthopaedic surgery is important for promoting workforce equity and optimising patient care. Targeted strategies, including enhanced education, mentorship, and increased visibility of SGM clinicians, may help foster a more inclusive and diverse workforce. Further research is required to better quantify representation and evaluate the effectiveness of interventions aimed at improving diversity.