Out but Not Safe: A Cross-Sectional Analysis of Workplace Experience Among LGBTQIAP+ Emergency Physicians

Background Brazil holds the highest global rates of violence against LGBTQIAP+ individuals. Emergency Medicine lacks data on the professional realities and mental health of LGBTQIAP+ practitioners. This study explores identity, workplace conditions, discrimination, leadership access, and psychiatric morbidity among LGBTQIAP+ emergency physicians. Objectives To compare sociodemographic characteristics, leadership roles, workplace discrimination, and mental health outcomes between LGBTQIAP + and non-LGBTQIAP+ emergency physicians in Brazil. Methods A national cross-sectional survey was conducted with Emergency physicians across Brazil. The anonymous online questionnaire collected data on gender identity, sexual orientation, mental health, discrimination and leadership. Statistical analyses included chi-square and Wilcoxon rank-sum tests. Results 116 emergency physicians completed the survey; 35 (30.2%) identified as LGBTQIAP+. LGBTQIAP+ physicians were significantly more likely to report psychiatric diagnoses (75.6% vs. 47.9%, p < 0.005). Among LGBTQIAP+ participants, 67.5% reported discomfort in disclosing their identity at work, 29.7% experienced workplace discrimination, and 25.7% believed their sexual orientation hindered their access to leadership positions. Conclusions LGBTQIAP+ emergency physicians in Brazil report high rates of psychiatric morbidity and workplace discrimination despite similar occupational profiles. These findings underscore the need for inclusive work environments, targeted mental health support, and policies that promote equity in leadership within emergency medicine.