Time for a (Minority) Tax Cut: Examining the Responsibilities Faced by Women and Minorities Fostering Inclusivity in Orthopaedics.

Background: The existence of a "minority tax," defined as the burden of extra responsibilities placed on minorities relative to non-minorities of the same position, has been documented across various fields, including and beyond medicine. This study sought to quantify the types and extent of the minority tax faced by minority orthopaedic surgeons, as well as evaluate the degree to which this work was recognised and/or compensated. Methods: A survey was distributed via email and social media through the international network of associations, collectives, and societies of minorities in orthopaedics. The survey assessed demographics, involvement in diversity, equity, and inclusion (DEI) work, and characteristics of this work. Results: 290 orthopaedic surgeons from 37 countries completed the survey. Respondents were 91% female and 9% LGBTQ + . Fifty-seven percent reported engaging in DEI work. When asked if they worked on nights, weekends, or workdays, 22% indicated all three, and 30% indicated they worked on personal vacations. Only 18% had a title associated with their DEI work, with only one respondent (4%) indicating this was a paid position. Forty-six percent reported spending their own money on DEI work. Conclusions: This study is the first, to our knowledge, to quantify the minority tax in orthopaedic surgery. The results demonstrate that more than half of minority-identifying orthopaedic surgeons engage in DEI work, which involves a substantial investment of time and financial resources. Greater attention should be paid to deficits in compensation and recognition, with increased advocacy for fairness and equity for orthopaedic surgeons engaged in DEI work. Level of Evidence: III. Graphical abstract: Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-025-01392-8.