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Surgery Applicant Values: Perceptions of Residency Programs Based on Gender-affirming Surgery Training and LGBTQ+ Inclusion
Calvin R. Schuster
*1, Jennifer Lee
1, Agata A. Szulia
1, Cecilia Rogers
1, Lee D. Yang
1, Keeley Newsom
2, Amanda Gosman
2, Scott Lifchez
1, Wendy Chen
1, Fan Liang
11Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; 2Division of Plastic Surgery, University of California San Diego, San Diego, CA
Background: As demand for gender-affirming surgery (GAS) continues to rise, it has become an increasingly important component of comprehensive surgical care and training. Residency programs vary widely in availability of formalized exposure and training related to GAS. Little is known about how applicants perceive and prioritize GAS training when evaluating programs.
Methods: An anonymous cross-sectional survey was distributed to fourth year medical students who applied to plastic surgery and urology residency programs during the 2024-2025 cycle. Survey domains included demographics, importance of faculty and trainee composition, and importance of exposure to both general and gender-affirming surgical training. Responses were measured using 5-point Likert scales.
Results: A total of 119 applicants completed the survey (plastic surgery: n=70, urology: n=49). Respondents represented a broad geographic distribution across the United States and internationally. Respondents reported that LGBTQ+ diversity, gender-affirming care (GAC) training, in-state legislative trends restricting GAC, and exposure to specific GAS procedures were important factors in residency training and program ranking. Over 65% rated GAC training as somewhat or very important to their residency training. Vaginoplasty emerged as the most important procedure overall across plastic surgery and urology applicants, rated as important or very important by 65.5% of respondents. Among plastic surgery applicants, facial feminization (44.5%) and chest masculinization surgery (43.7%) were most frequently rated as important or very important.
Conclusion: In this national survey, GAS training, LGBTQ+ diversity, and state-wide legislation related to GAC were important to a majority of applicants applying into plastic surgery and urology residency programs. Applicants view GAC as an important component of contemporary surgical education. Therefore, residency programs may benefit from structured integration of GAS training to meet the evolving educational expectations of trainees and to improve recruitment.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
Back to 2026 Abstracts
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
