Knowledge of and access to family-building resources among LGBTQ+ medical residents in the United States: a cross-sectional survey.

OBJECTIVE

To assess the knowledge, need, and utilization of reproductive services among LGBTQ+ medical residents compared with non-LGBTQ+ counterparts.

DESIGN

A survey with multiple-choice and Likert-type items was sent to US medical residents to collect demographic information and family-building goals. Descriptive statistics and univariate comparisons between cisgender/heterosexual and LGBTQ+ groups were performed.

SUBJECTS: All medical residents training in the United States in 2024.

EXPOSURE: Cross-sectional survey.

MAIN OUTCOME MEASURES: Family-building knowledge and goals.

RESULTS

Out of 660 participants, 547 identified as cisgender/heterosexual and 104 identified as LGBTQ+. More cisgender/heterosexual residents either had/were planning on having children during residency compared with their LGBTQ+ peers (40.6% vs. 13.5%). Despite no differences in infertility diagnoses, LGBTQ+ respondents were more likely to use gestational carriers (23.1% vs. 3.1%), in vitro fertilization (IVF) (39.4% vs. 24.5%), sperm cryopreservation (14.4% vs. 7.9%), gamete donation (12.5% vs. 1.6%), or reciprocal IVF (5.8% vs. 0.9%) compared with their peers who were more unsure about reproductive services they would use (32.7% vs. 50.5%). LGBTQ+ residents have more barriers to reproductive services (mean 1.67 [SD 1.4] vs. 1.37 [SD 1.4]), including cost (61.5% vs. 50.8%) and relationship status (20.2% vs. 7.5%) compared with their counterparts to whom some barriers were not applicable (41.3% vs. 52.3%). All respondents reported similar rates of program support and distress about family building. Only 9.1% of all respondents had received educational lectures about relevant family-building options, and 80.2% believe that their graduate medical education (GME) should offer more support.

CONCLUSIONS

LGBTQ+ residents report a lack of information and resources for family building during residency training, but many report a desire to engage in family building despite cost and relationship status barriers. More than half of medical residents indicate the need for reproductive services. Increased education and support regarding family-building services during training is needed to expand access to all residents, including LGBTQ+ residents.