196 - Perioperative Guidelines for Transgender and Gender Diverse Patients

Description: Transgender and gender-diverse (TGD) patients experience persistent disparities in healthcare due to systemic stigma, discrimination, and a widespread lack of provider knowledge. These inequities are especially pronounced in the perioperative setting, where a lack of standardized, inclusive care practices can lead to negative outcomes. Many TGD individuals report delaying or avoiding care due to past experiences of misgendering, deadnaming, and breaches of privacy, which contributes to mistrust in the healthcare system. Furthermore, clinicians may be unfamiliar with the anatomical and physiological implications of gender-affirming surgeries and hormone therapies, leading to missed or inappropriate assessments, clinical errors, and compromised patient safety. This educational activity addresses these critical gaps by offering comprehensive, evidence-informed guidelines to support perioperative nurses and interprofessional teams in providing culturally competent and patient-centered care for TGD individuals. Participants will explore gender-affirming terminology, inclusive communication strategies, and trauma-informed care principles that reduce psychological harm and help build trust with patients. Emphasis is placed on the importance of using chosen names and pronouns, understanding the nuances of gender identity, and maintaining the patient's dignity throughout all phases of care. The content covers preoperative considerations such as accurate history-taking, hormone therapy management, and risk assessment tools that are adjusted for the individual's affirmed gender identity rather than sex assigned at birth. Intraoperative guidance includes airway management implications of gender-affirming surgeries, venous thromboembolism (VTE) prevention in patients on estrogen therapy, and positioning accommodations for patients with chest or genital implants. Postoperative topics include tailored pain management strategies, psychosocial support, and discharge planning that reflects the patient's identity, surgical history, and available support systems. In addition to clinical best practices, the activity outlines institutional measures to create safer, more inclusive environments, such as private or identity-affirming room assignments, careful handling of gender-affirming devices (e.g., binders, prostheses), and neutral or affirming documentation. Legal and privacy considerations are addressed to ensure compliance and minimize harm, especially in settings where a patient's legal documents may not match their gender identity. Ultimately, this activity aims to equip providers with the competencies needed to deliver affirming, ethical, and equitable care. It underscores the importance of multidisciplinary collaboration, continued professional development, and institutional reform to close the gap between current practice and best practice. By integrating these guidelines, perioperative teams can significantly enhance the safety, experience, and outcomes for transgender and gender-diverse patients undergoing surgical care.