BU Study Finds Increased Rates of Burnout in LGBTQ+ Physicians
In a first-of-its-kind study, researchers at Boston University found that LGBTQ+ physicians and trainees report high rates of burnout and a lack of professional fulfillment. Photo via Unsplash/Jonathan Borba
BU Study Finds Increased Rates of Burnout in LGBTQ+ Physicians
More physicians are experiencing lower professional fulfillment, potentially causing them to leave their careers
Burnout is a phenomenon that can affect anybody experiencing prolonged stress—but is especially a risk factor for people in demanding jobs. It often leads to physical and mental exhaustion, causing a person to feel depleted and unsatisfied in their work; it could even make them decide to quit.
Burnout has been shown to be more likely to affect healthcare physicians than other workers in the US. And a recent Boston University–led study has found that LGBTQ+ physicians are more likely to suffer burnout than their straight, cisgender peers.
Previous research has associated physician burnout with poorer functioning of medical institutions and a reduced quality of care. It can also lead to physicians taking reduced hours or quitting their job entirely, resulting in increased costs and lower organizational efficiency. Burnout has even been shown to cause an increase in medical errors, which can potentially cause harm to patients.
The latest study, led by Carl Streed, Jr., a Boston University Chobanian & Avedisian School of Medicine associate professor of medicine, looked at data from thousands of LGBTQ+ physicians nationwide. The results were published in JAMA Network Open, an international, peer-reviewed journal published by the American Medical Association.
In the study—one of the first to examine the link between LGBTQ+ status and workplace well-being among healthcare providers—Streed and his team found that LGBTQ+ physicians and trainees reported high rates of burnout and a lack of professional fulfillment. The researchers used survey results from medical doctors collected between June 2023 and February 2024. But Streed says the situation may have worsened further since then, pointing to executive orders and memos from the Trump administration targeting transgender rights and research focusing on LGBTQ+ Americans, as well as the removal of LGBTQ+ health data collected by federal agencies from government websites. He fears that this tense political environment will only make burnout worse for LGBTQ+ health providers.
The Brink spoke with Streed, who is also the research lead for the GenderCare Center at Boston Medical Center, BU’s primary teaching hospital, about the effects of stress on LGBTQ+ physicians, potential solutions, and how the policies of the Trump administration might affect future research.
Q&A
With Carl Streed, Jr.
The Brink: What effects do you hope this study will have on the future well-being of LGBTQ+ people in medicine?
Streed: The future for LGBTQ+ folks in medicine is quite uncertain given the current political climate, with LGBTQ+ health and research, and the provision of care for transgender folks all being specifically targeted. I think this study really highlights that things weren’t going well before the current political climate, and I anticipate they’re going to be worse over the next few years. I’m hoping the study highlights that even during better times, things are not going well for LGBTQ+ physicians and trainees.
The Brink: Why did you decide to focus on burnout?
Streed: I think everybody is very fixated—appropriately so—on burnout, because it’s one of the better predictors of who leaves their profession. The reason it’s so critical is that people give a lot of their personal time, energy, and resources into becoming physicians. The [medical] system itself puts a lot of time, energy, and effort into training them up. But when people get burned out, they leave. It’s a lost investment, it’s a lost opportunity. We were particularly focused on those questions because it’s such a significant driver of how healthy our healthcare system is.
The Brink: How can this issue be addressed in the workplace?
Streed: First, we’re trying to better understand the drivers for these poorer outcomes—and see if there is a subset of folks who are doing well. In terms of solutions, there are basic changes—like, creating a more welcoming workforce, building community, allowing people to bring their whole selves to work. When bad things happen [at work], are there mechanisms that allow people to report and address it? These are all the basics of creating a workplace that is welcoming and allows people to bring as much of themselves as they want. And, typically, when people can bring more of who they are authentically, they work better, feel happier at work, and are more productive.
The Brink: Do you think there’s anything individuals can do themselves? Or is it purely a problem stemming from the top?
Streed: It’s always both. It’s a situation where individuals who are straight and cisgender need to recognize when things might not be going well for their colleagues. It’s important to be an upstander instead of a bystander, and speak up when they see something that’s going wrong. Making sure people, their significant others, are welcome. There are definitely opportunities [in an organization] for creating employee resource groups that are affinity and identity based. But there are also system-level issues: Are institutions providing equitable insurance coverage? Are they providing appropriate nondiscrimination policies? Are they, again, providing mechanisms by which people can address any kind of issues? It’s not a top-down only process.
Individuals who are straight and cisgender need to recognize when things might not be going well for their colleagues. It’s important to be an upstander instead of a bystander, and speak up when they see something that’s going wrong.
The Brink: Can you tell me a little bit more about the process for obtaining and analyzing the data that your team got?
The data is from the Healthcare Professional Well-being Academic Consortium, which has existed for a few years now and has been a partnership among several dozen academic medical institutions across the US. They have a core set of demographic questions that they ask everybody who does their surveys. They include tens of thousands of respondents. We proposed that they include questions around sexual orientation and gender identity. Those questions were optional, and not every institution chose to ask them, but we still got several thousand respondents, which was remarkable. From there, we could identify a cohort of LGBTQ+ folks within this larger consortium, and we just started looking at specific outcomes.
The Brink: How do you think the policies of the Trump administration will affect physician well-being?
The policies of the current administration are only going to worsen burnout in the healthcare workforce. And it will only widen disparities in who is experiencing burnout. Marginalized populations across multiple identities—racial, ethnic, and so forth—will experience more burnout in the healthcare system. And there will be further moral injury trying to provide care when we’re being told we should deny people access to medically necessary care. So things aren’t going to go well. The healthcare workforce will be further damaged and our patient populations in our communities will be unhealthier as a result.
The Brink: There have been a number of executive orders passed recently regarding grants and funding, both in general and specifically targeted at studies about LGBTQ+ people. Do you foresee problems with that in the future?
Yes. There’s always danger from politics intervening where expertise moves to exist. And right now, the current administration is essentially taking a hammer to our financial research enterprise. They’ve already wiped away decades of data that’s been collected, which is going to further hamper future research and ongoing efforts to improve general well-being for a variety of populations. I think it should be quite telling that people are allowing politics to cloud their better judgment. We’ve just had the administration shut down significant financial support for a number of programs, not just research. And it was only Democratic [state] administrations that spoke up, when in fact everybody was harmed.
This interview was edited for length and clarity.
This work was supported by the American Heart Association and the National Heart, Lung, and Blood Institute.
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