Is #Gender Affirmation Surgery Trending? An Analysis of Plastic Surgery Residency Social Media Content

Purpose: Given rising demand for gender affirmation surgery (GAS), lesbian, gay, bisexual, transgender, queer, and others' (LGBTQ+) patient care, and sexual and gender minority (SGM) representation in plastic surgery, we sought to analyze integrated residency programs' posts for LGBTQ+ content.Methods: Programs were identified from the American Council of Academic Plastic Surgeons website. Accounts were searched for on Instagram, Facebook, and Twitter. Posts uploaded through June 24, 2021 were analyzed. Mann-Whitney U- and Kruskal-Wallis tests were used to compare content between programs.Results: Of 82 programs, 76 (92.7%), 31 (37.8%), and 30 (36.6%) have Instagram, Facebook, and Twitter accounts, respectively. Two hundred eighty-one (1.3%) posts displayed LGBTQ+ content, including educational (29.9%), research (17.4%), news (11.0%), resident interests (10.7%), pride/diversity (9.6%), posts to attract applicants/patients (7.5%), operative/clinic cases (6.8%), faculty spotlights (6.4%), and patient testimonials (1.1%). One hundred eighty-one (64.4%) posts described GAS overall, 42 (23.2%) described top, 32 (17.7%) described genital, and 32 (17.7%) described facial surgery. Instagram and Facebook have more LGBTQ+ content than Twitter (p <= 0.037). Newly accredited programs have significantly more LGBTQ+ content on Facebook (p=0.036). Programs in the West, having more perceived prestige, or GAS fellowships tended to have more LGBTQ+ content.Conclusion: Despite growing demand for GAS and thus training, 1% of content on plastic surgery residency social media accounts is LGBTQ+ related. Reasons for lack of representation require further investigation but may include (1) limited GAS and LGBTQ+ patient exposure during training or (2) lack of SGM inclusivity for residents, faculty, and patients.