In the summer of 2021, amidst significant racial tension in the United States, the Executive Committee of the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) created a Task Force to evaluate diversity, equity, and inclusion (DEI) within SUFU. The SUFU Executive Board appointed Drs Larissa Rodriguez and Tracey Wilson to select and chair the DEI Task Force. SUFU members self-nominated to serve and wrote a letter of intent describing their expertise in the area of DEI. The Task Force held monthly meetings to identify areas of need and opportunities to educate SUFU members on important DEI content. Shortly thereafter, the Task Force organized the first DEI breakout session during SUFU’s annual Winter Meeting in 2022 with a focus on physicians’ needs. The breakout session equipped the members with tools to work through challenges on the job and the importance of allyship. It was so well received that another breakout session is planned for the 2023 Winter Meeting.

In addition to providing educational options, the Task Force has been dedicated to evaluating the following 3 areas: (1) developing, distributing, and analyzing a survey of the SUFU membership in areas of DEI; (2) evaluating trends in sex representation amongst the speakers, panelists, and moderators in SUFU meetings; and (3) evaluating the society’s bylaws with a critical DEI lens to ensure they do not contribute to perpetuating discriminatory practices.

A DEI survey developed to assess the overall perception of the organization’s standing with diversity was conducted, with 122 of 694 responses. The majority of respondents (54% women, 50% under the age of 50) expressed satisfaction with the overall diversity within the organization and within the annual meetings; however, some areas for improvement were identified (Figure 1). Fifty-six percent of respondents felt that SUFU leadership was diverse, 18% did not, and 25% had a neutral opinion. When evaluating the experience of our underrepresented minority members, 6% felt a lack of acceptance and belonging, 13% felt uncomfortable and disempowered to voice their opinions, and 6% expressed having experienced or witnessed inappropriate actions or comments based on identity from other SUFU members.

Figure 1. Members’ perception of diversity within the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU). This represents answers to the following survey items: (1) There is diversity among SUFU leadership, Executive Board, and SUFU Committees; (2) There is diversity among the presenters, moderators, and panelists at SUFU meetings and events; (3) SUFU invests time and energy into building diverse teams, panels, and committees.

The survey also revealed themes of perceived lack of transparency and equity, perceived lack of engagement toward inclusivity, and perceptions of overt discrimination (Figure 2). Respondents reported being unclear of existing paths to participation in SUFU leadership, limited avenues for sponsoring SUFU members for activities outside of the organization, and a lack of investment in building diverse teams and fostering an inclusive environment. Survey results suggest that SUFU can improve by promoting allyship and focusing on professional development and inclusivity in their strategic plans. Respondents also provided suggestions for promoting health equity for patients.

Figure 2. Members’ perception of transparency and equity within the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU). Figure represents the responses to following items: (1) I believe SUFU provides transparency and equity about paths to leadership roles within the organization; (2) I believe SUFU provides transparency and equity with regard to opportunities to participate in committees and programs within SUFU; (3) I believe SUFU provides transparency and equity in sponsoring individuals to represent SUFU in activities outside of the organization (eg, AUA courses, guidelines committees).

We conducted a review of equitable sex participation in SUFU Winter Meetings from 2019-2022. The following categories were analyzed: Moderators/Directors; Panelists and Speakers; Abstract, Video, and Grant Reviewers; Award Recipients; and Abstract Session Moderators, and compared them with the overall sex distribution in our membership. The number of women participating in the meeting has increased from 2019 to 2022, representing the intentionality of the meeting organizers to have representative participants (Figure 3). One main area for improvement was identified: Award Recipients and Moderator/Director categories were slightly underrepresented relative to the makeup of SUFU membership. To better understand representation beyond sex, the Task Force recommended development of a SUFU Speaker Database to include the following: voluntary identification of characteristics such as self-identified gender, sexual orientation, underrepresented in medicine status, race or ethnicity, years out of training, and academic vs private practice. The Task Force also recommended that the abstract management tracking system be adapted to include the ability to track speakers, moderators, and panelists to ensure an equitable distribution of such responsibilities and to avoid repetition of speakers. Lastly, inclusion of a DEI Task Force member on the SUFU Planning Committees for the SUFU Winter Meeting and the SUFU at AUA Meeting was requested.

Figure 3. Proportion of women with a role (presenter, moderator, etc) in annual Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) meetings.

Our survey’s findings that SUFU members are concerned about lack of transparency and inclusion within SUFU leadership warranted a critical evaluation of the organization’s bylaws (https://sufuorg.com/about/bylaws.aspx). To this end, the Task Force made several recommendations to the Executive Committee in July 2022. Some of these recommendations include:

1. Revisions to term limits.
2. Soliciting SUFU membership for participation on all committees and member-at-large positions with special attention allowing for diversity in training, practice location, gender, and underrepresented minority status.
3. Revising the structure and participation of the nominating committee with a goal of improving transparency and inclusion.
4. Revision of the selection process for members-at-large to enable more transparency and inclusion.
5. Incorporating a standing DEI committee as well as DEI representation on the SUFU Planning Committees.
6. Development of a speaker database with optional participation by all SUFU members.
7. Offering DEI educational opportunities at all SUFU meetings.
8. Review by the DEI Committee of all released statements from SUFU in response to social injustice and/or political decisions.

The Executive Committee debated and accepted the majority of recommendations made by the Task Force, thus ensuring a more transparent and inclusive structure that fosters and celebrates the diversity within our organization.

SUFU commissioned the DEI Task Force to take a critical look at the organization and its practices. In doing so, the Task Force found the organization to be in good standing in many areas, while others needed improvement. The response rate to the DEI survey was low but better than most SUFU surveys, suggesting a true interest regarding this topic within the society. The SUFU Executive Committee has been receptive to the feedback provided by the Task Force, is working through the recommendations, and hopes that implementation of those recommendations will improve engagement going forward. The SUFU membership can expect to vote on the proposed bylaw changes later in 2023, which in the end will make the organization more diverse, inclusive, and representative of its membership and the patients it serves.