Pediatric urology holds the responsibility and privilege of protecting and elevating our youngest neighbors, whether they present with straightforward conditions or complex medical and social situations. The same spectrum of sensitive topics and intimate discussions occur in the practice of pediatric urology as in the office of our adult colleagues, with the caveat that the parent acts as proxy for the child in the earliest encounters and decisions. We have the unique opportunity to set the stage for future positive experiences with the health care setting. We can impact functioning within the home and community by meeting with young patients and their families where they are. Gaining a deep understanding of what patients and families experience daily enhances our opportunity to make a difference for the child. Outcomes and patient experience are positively impacted.

Pediatric urology is an increasingly diverse field but still falls short of reflecting the patients, families, and communities we serve. We must find ways to close that gap, particularly around representation of groups that have been marginalized historically by our health care systems.

We are fortunate to have both official Societies for Pediatric Urology (SPU) initiatives and passionate and generous champions to help us achieve our goal of a diverse and inclusive workforce. By calling upon a wider array of talents and experiences, we will advance care for all.

As a subspecialty, pediatric urology has welcomed many more women over the past 2 decades. Using a binary gender classification, the percentage of female-matched fellowship applicants ranged from as low as 29% in 2009 to 68% in 2013 and has consistently remained above 40% since then. The Accreditation Council for Graduate Medical Education data from this period show consistently low numbers of trainees from racial and ethnic backgrounds that are underrepresented in medicine (URiM) are entering pediatric urology, with 2.4% and 1.7% of fellows in the last 3 years identifying as Hispanic and Black, respectively.¹

Although increasing the number of women practicing in pediatric urology occurred relatively organically, we still have tremendous opportunities to create a diverse and inclusive workforce and to engage it. Certainly, the representation of women in academics and leadership has been more readily realized due to a full pipeline. The creation of opportunity through mentorship and sponsorship cannot be overlooked, however, and this step will remain relevant to engage all members of all our societies. All members deserve a fulfilling professional experience that will translate into improved outcomes and patient experience.

The recent 2nd Annual International Women in Pediatric Urology virtual conference, sponsored by Riley Hospital for Children, was another successful forum to discuss leadership, practice development, and mentorship. Perhaps most importantly, it promotes community and a space to discuss challenges and opportunities that many pediatric urologists navigate, regardless of gender, race, or other identity or intersectionality. This member-driven initiative is an excellent example of the pediatric urology where everyone belongs and succeeds.

Recognizing the importance of promoting diversity, equity, and inclusion (DEI) for our subspecialty and for our patients, The Societies for Pediatric Urology established a new task force to identify opportunities for proactive, transformative change in our field as it relates to DEI.

The Diversity, Equity, and Inclusion Task Force will prioritize initiatives that promote racial/ethnic diversity, gender and sexual diversity, and individuals from low-income families, with a specific focus on groups that have been historically marginalized or underrepresented in medicine. The SPU and DEI Task Force will prioritize the following three objectives:

1. creation of a clear and implementable action plan for the SPU to promote a more diverse and inclusive pediatric urologic workforce
2. collaboration with other member committees and task forces to encourage focus on research and educational curriculum that focuses on health equity topics
3. engagement of other urologic DEI committees and task forces with a goal of delineation of synergistic and complementary initiatives

The SPU and its DEI Task Force will establish a travel stipend to allow URiM students or residents to present their research at our annual meeting. Facilitated connection of students and residents with the membership and with research mentors for health equity projects will also be developed. Additionally, DEI and health equity topics will be intentionally incorporated into annual programming.

We need to reach upstream of traditional pipelines to introduce learners to the wonders of congenital conditions and to the privilege of discussing sensitive genitourinary concerns with those who seek our care. They will see that there is fit with pediatric urology. All will bring their own life experiences to the care of our patients and to enrich our future as a subspecialty. Pediatric urology can accomplish new heights with cohesion and inclusion, and the SPU DEI Task Force is an example of this growth of our specialty and the mission we all share to care for all children.