The Society of Genitourinary Reconstructive Surgeons (GURS) was established in 1989 to elevate the standards of genitourinary reconstructive surgery, promoting surgical education and scholarly work in this field, thereby advancing surgical care for all reconstructive urology patients. Inherent to this mission are values of diversity, equity, and inclusion (DEI).

Our GURS DEI strategy is focused on advocacy for marginalized patients with reconstructive urology needs, sponsorship of underrepresented groups in urology, and collaboration across communities. To date, focused initiatives have included creation of a board of directors (BOD) position dedicated to DEI, planning of biyearly GURS academic conferences with an equity lens, development of the Women of GURS community, commitment to gender-affirming care, and international collaborations to expand access to reconstructive urology in resource-restricted settings.

DEI Leadership

As successful DEI planning must begin with full support from organizational leaders, GURS created an ad hoc BOD position with full voting privileges to develop a DEI agenda. This BOD member works closely with the GURS president and secretary to provide a DEI perspective in all BOD activities, serves on the program committee for the GURS Academic Congress and AUA meetings, and identifies DEI priorities.

DEI at GURS Meetings

The 2023 GURS Academic Congress included an inaugural DEI program, featuring presentations on Gay Men’s Urology by Dr Jeffery Lin and Legislative Challenges in Transgender Care by Dr Blair Peters. This annual forum seeks to address pressing DEI topics in reconstructive urology, in order to improve GURS members’ understanding of health inequities and our role in caring for marginalized patient populations. In planning each meeting, the program committee seeks to ensure broad representation across GURS conference speakers, representing diversity of gender and gender identity, race and ethnicity, sexual orientation, seniority, and geographic backgrounds.

Women of GURS

The gender gap in urology exceeds other specialties,¹ with underrepresentation of women as authors of scientific publications in high-impact urology journals² and as speakers in urology conferences.³ Women of GURS was created in 2022 to
advance gender equity in GURS; this committee seeks to support women members through networking opportunities (ie, AUA Women of GURS Happy Hour, WhatsApp group), a Women of GURS featured lecture at GURS Congress, and sponsorship of women for leadership opportunities. Future efforts include a GURS Article of the Month curated by a Women of GURS editor.

Gender-Affirming Care

An estimated 2 million US adults identify as transgender and gender diverse (TGD),^4-6 and a growing number of TGD individuals seek surgical transition in the face of systemic barriers. Reconstructive urologists are well positioned to alleviate health disparities among TGD patients through high-quality, compassionate, gender-affirming care and impactful research. GURS fellowships are the primary means by which urology trainees receive advanced training in genital gender-affirming surgery and management of complications. Transgender health is a core area in GURS conference programming. In light of growing anti-transgender legislation in the US, GURS is developing a position statement regarding the health care and support of TGD individuals.

Fellowship Training

As the discipline of reconstructive urology has grown in scope and diversity, GURS fellowship training has followed suit. Rather than programs potentially withdrawing from the GURS fellowship match because of an inability to satisfy any one specific case log threshold, the consensus of fellowship program directors has been to adopt this emerging diversity in training with expansion and revision of training requirements. GURS fellowship training has recently been redefined into 4 more inclusive categories, including urethral reconstruction, genital reconstruction, abdominal/pelvic reconstruction, and genitourinary prosthetics. As reconstructive urology continues to grow and evolve, there will also be a need to educate more broadly, especially internationally.

Future initiatives include visiting scholar programs to introduce trainees from underrepresented backgrounds in medicine to reconstructive urology fellowships, in collaboration with pipeline organizations such as Urology Unbound.

International GURS Community

As an international professional society, GURS is committed to improving access to reconstructive urology expertise in settings where this care has historically been lacking. In addition to promotion of International Volunteers in Urology initiatives, GURS members support the creation of new reconstructive urology centers in resource-restricted environments and are helping well-established centers outside of the US start fellowships.

To advance the field of genitourinary reconstructive surgery, we must invest in education, research, and advocacy instilled with values of DEI. We welcome input from members on how to fulfill our DEI mission with sustainability, ongoing improvement, and a commitment to serving GURS members and reconstructive urology patients globally.