Microaggressions in European versus American Workplace Environments of Otolaryngology-Head and Neck Surgery

H Steven Sims; Krystal Kan; Jerome R Lechien

doi:10.1002/lio2.1178

Microaggressions in European versus American Workplace Environments of Otolaryngology-Head and Neck Surgery

Laryngoscope Investig Otolaryngol. 2023 Nov 3;8(6):1589-1601. doi: 10.1002/lio2.1178. eCollection 2023 Dec.

Authors

H Steven Sims^{1

2}, Krystal Kan², Jerome R Lechien^{3

4

5

6}

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery Chicago Institute for Voice Care, University of Illinois at Chicago Chicago Illinois USA.
² Department of Otolaryngology-Head & Neck Surgery University of Illinois at Chicago Chicago Illinois USA.
³ Division of Laryngology and Broncho-esophagology, Department of Otolaryngology and Head and Neck Surgery EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons Mons Belgium.
⁴ Department of Otolaryngology-Head & Neck Surgery CHU Saint-Pierre Brussels Belgium.
⁵ Elsan Polyclinic of Poitiers Poitiers France.
⁶ Research Committee of Young Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS) Paris France.

Abstract

Objective: To compare the workplace experience of European and U.S. members of the otolaryngology community.

Methods: European and U.S. otolaryngologists-head and neck surgeons (OTO-HNS) were surveyed through three otorhinolaryngological societies. We inquired about personal and observed experiences of differential treatment in the workplace related to age, biological sex, ethnicity, disability, gender identity, political belief, and sexual orientation. Results were compared according to the world region. Differential treatment was used as a proxy for microaggressions.

Results: A total of 348 practitioners participated in the survey: 148 American and 230 European OTO-HNS. European OTO-HNS reported significantly higher proportions of observed or personal experiences of differential treatment based on age (p = .049), language proficiency (p = .027), citizenship (p = .001), hair texture (p = .017), height/weight (p = .002), clothing (p = .011), and professionalism (p = .002) compared with U.S. OTO-HNS. Differential treatment related to political belief (p = .043), socioeconomic status (p = .018), and ethnicity (p = .001) were higher in the United States compared with Europe. Feelings of exclusion (p = .027) and consideration of leaving their position (p = .001) were significantly higher in the United States compared with Europe. In both the United States and Europe, female OTO-HNS reported more frequent differential treatment related to biological sex than males.

Conclusion: Differential treatment, or microaggressions, related to personal characteristics or behavior varied in the United States and Europe with more ethnicity-based microaggressions in the United States and physical characteristic-based microaggressions in Europe. In both regions, females were more subject to microaggressions than males. More efforts are needed to tackle microaggressions and discrimination in the clinical and academic workplace of the Western otolaryngology community.

Level of evidence: 4.

Keywords: discrimination; ethnicity; head neck; microaggression; otolaryngology; race; racism; religion; surgery; survey; workplace.