Table 5. Association of LGBTQ+ Status With Thoughts of Attrition and Suicidality Before and After Adjusting for Mistreatment.
| Characteristic | OR (95% CI)a | |||||
|---|---|---|---|---|---|---|
| Burnout | Thoughts of attrition | Suicidality | ||||
| Unadjusted | Adjusted | Unadjusted | Adjusted | Unadjusted | Adjusted | |
| Types of mistreatment | ||||||
| Discrimination | NA | 1.53 (1.31-1.77) | NA | 1.39 (1.10-1.77) | NA | 0.95 (0.65-1.39) |
| Sexual harassment | NA | 1.59 (1.40-1.80) | NA | 1.66 (1.38-2.00) | NA | 2.47 (1.86-3.26) |
| Bullying | NA | 2.87 (2.49-3.30) | NA | 3.58 (2.80-4.57) | NA | 3.49 (2.32-5.25) |
| Sexual orientation and gender identity | ||||||
| Non-LGBTQ+ | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| LGBTQ+ | 1.22 (0.97-1.52) | 1.02 (0.81-1.29) | 2.04 (1.52-2.74) | 1.79 (1.31-2.45) | 1.95 (1.26-3.04) | 1.47 (0.90-2.39) |
| Gender | ||||||
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Female | 1.45 (1.31-1.61) | 0.95 (0.82-1.10) | 1.73 (1.47-2.03) | 1.14 (0.91-1.41) | 1.38 (1.07-1.79) | 1.05 (0.71-1.57) |
| PGY level | ||||||
| 1 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 2 or 3 | 0.79 (0.68-0.91) | 0.79 (0.67-0.92) | 1.28 (1.03-1.59) | 1.31 (1.04-1.65) | 0.83 (0.61-1.14) | 0.79 (0.56-1.12) |
| 4 or 5 | 0.77 (0.66-0.90) | 0.75 (0.64-0.88) | 0.72 (0.56-0.91) | 0.72 (0.55-0.93) | 0.86 (0.64-1.15) | 0.79 (0.57-1.09) |
| Program type | ||||||
| Academic | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Community | 0.89 (0.77-1.03) | 0.90 (0.75-1.09) | 1.00 (0.78-1.29) | 1.09 (0.84-1.40) | 0.96 (0.68-1.35) | 1.00 (0.69-1.44) |
| Military | 1.00 (0.72-1.39) | 1.10 (0.63-1.91) | 1.13 (0.67-1.91) | 1.29 (0.80-2.09) | 0.40 (0.16-0.99) | 0.50 (0.23-1.09) |
| Geographic location | ||||||
| Northeast | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Southeast | 1.09 (0.90-1.30) | 1.14 (0.95-1.37) | 0.99 (0.76-1.30) | 1.01 (0.76-1.35) | 0.93 (0.67-1.30) | 0.95 (0.67-1.35) |
| Midwest | 0.98 (0.82-1.18) | 1.02 (0.84-1.23) | 1.00 (0.77-1.30) | 1.05 (0.81-1.38) | 0.91 (0.64-1.29) | 0.87 (0.59-1.29) |
| Southwest | 0.95 (0.74-1.22) | 0.98 (0.76-1.25) | 0.98 (0.68-1.42) | 1.04 (0.72-1.51) | 0.87 (0.55-1.37) | 0.76 (0.46-1.27) |
| West | 1.25 (0.99-1.59) | 1.31 (1.01-1.69) | 1.24 (0.91-1.69) | 1.32 (0.95-1.82) | 1.02 (0.69-1.52) | 1.02 (0.70-1.49) |
| Program size | ||||||
| <26 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 26-36 | 1.03 (0.84-1.26) | 1.05 (0.87-1.28) | 1.00 (0.73-1.36) | 1.02 (0.74-1.40) | 1.14 (0.76-1.71) | 1.26 (0.83-1.93) |
| 37-50 | 1.20 (0.95-1.53) | 1.23 (0.98-1.55) | 0.97 (0.72-1.29) | 1.03 (0.76-1.38) | 1.08 (0.70-1.67) | 1.16 (0.74-1.82) |
| ≥51 | 1.17 (0.92-1.49) | 1.21 (0.95-1.56) | 1.08 (0.77-1.53) | 1.18 (0.83-1.67) | 1.21 (0.77-1.91) | 1.43 (0.89-2.29) |
Abbreviations: LGBTQ+, lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority; NA, not applicable; OR, odds ratio; PGY, postgraduate year.
a
Models were adjusted for all characteristics listed, first without and then with mistreatment included as a covariate.