Perspectives of Nephrologists on Gender Disparities in Access to Kidney Transplantation

Background: Gender disparities in access to kidney transplantation are apparent with women being up to 20% less likely to receive kidney transplant compared to men across different settings and socioeconomic backgrounds. We aimed to describe nephrologists’ perspectives on gender disparities in access to kidney transplantation. Methods: Fifty-one nephrologists (55% women) from 22 countries participated in semi-structured interviews from October 2019 to April 2020. We analyzed the transcripts thematically. Results: We identified three themes: caregiving as a core role (coordinators of care for partners; fulfilling family duties over own health; maternal protectiveness; and inherent willingness and generosity), stereotyping and stigma (authority held by men in decision-making; protecting the breadwinner; preserving body image and appearance; and safeguard fertility), social disadvantage and vulnerability (limited information and awareness; coping alone and lack of support; disempowered by language barriers; lack of financial resources; and without access to transport). Conclusions: Gender disparities in access to kidney transplantation are perceived by nephrologists to be exacerbated by gender norms and values, stigma and prejudice, and educational and financial disadvantage that are largely encountered by women compared with men across different socioeconomic settings.