280 - Perioperative Care Practices for Transgender Patients: A Scoping Review

Description:

Background:
As a professor in the undergraduate nursing program at a public university in Brazil, I face various challenges in my professional practice. One important issue identified during clinical immersions at a high-complexity hospital is the delivery of perioperative care for transgender patients, considering their specific healthcare needs. Transgender patients face significant barriers and disparities in healthcare, particularly in the perioperative setting. Despite recent advances, prejudice and stereotypes may still influence care provided by health professionals. To address this issue, discussions with students led to the idea of developing educational material focused on perioperative care for transgender patients. To underpin this material with scientific evidence, we conducted a scoping review. Nursing education must address these gaps to ensure safe, respectful, and inclusive perioperative care.

Objective:
To summarize national and international scientific evidence on perioperative care practices for transgender patients, providing guidance for clinical practice and professional education.

Methods:
A scoping review was conducted following the Joanna Briggs Institute methodology. The PCC framework (Participants: transgender patients; Concept: perioperative care; Context: surgical setting) guided the research question. Comprehensive searches were performed in PubMed, CINAHL, SCOPUS, Web of Science, and LILACS using controlled descriptors and keywords. Of 607 initial records, 32 full-text articles were reviewed, and 20 were included in the final synthesis.

Results:
Findings emphasize the importance of creating a safe and welcoming environment for transgender patients, such as displaying inclusive symbols and ensuring appropriate restroom access. Admission and documentation should respect patients affirmed names, pronouns, and gender identities. Preoperative assessments must consider hormone therapy interactions, potential airway changes from gender-affirming surgeries, and pregnancy testing for patients assigned female at birth. Intraoperative teams should confirm name and pronoun preferences and address anatomical variations. Postoperative care must maintain patient privacy and continue the use of inclusive communication. Increasing gender diversity among surgical team members and leadership may enhance cultural sensitivity and patient-centered care. Staff training at all levels is essential to reduce bias, promote cultural competence, and ensure consistent, respectful interactions.

Conclusion:
Perioperative care for transgender patients should be evidence-based, patient-centered, and tailored to respect each individual's preferences and needs. Implementing these practices can enhance patient safety, satisfaction, and overall surgical outcomes. Ongoing interprofessional education and inclusion of gender diversity content in nursing curricula are critical to breaking down barriers and advancing equitable care. These findings support perioperative nurses in developing inclusive protocols, fostering staff training, and creating welcoming surgical environments, ultimately improving patient safety, satisfaction, and equitable outcomes for transgender patients. Furthermore, in our context, these findings will support the construction of educational material about this care for students and professionals.