New guidance on peri-operative care of transgender and gender-diverse individuals is today published in Anaesthesia (the journal of the Association of Anaesthetists) to guide best practice to ensure the safety and dignity of transgender and gender-diverse people in the peri-operative period. The guidance has been produced by a working group of experts including Dr Stuart Edwardson, Royal Infirmary of Edinburgh, Edinburgh, UK, and Dr Luke Flower, Victor Philip Dahdaleh Heart and Lung Research Institute, Cambridge, UK, and colleagues.
The number of people openly identifying as transgender and/or gender diverse has increased significantly over the past decade, most likely as a result of emerging clarity and comfort with open expression. Census estimates from 2021 identified 262,000 people living in the UK identifying with a gender that does not correspond with that assigned at birth. It is worth noting that this is a lower estimate than others, most likely due to hesitation of people to disclose.
Around 50% of transgender and gender-diverse people are currently undergoing some form of medical treatment for gender affirmation (whether this is hormonal therapy, surgical affirmation or both), and a further 25% are not currently accessing gender-affirming medical interventions but wish to. Many aspects of these interventions provide specific and important considerations for
the anaesthetist in the peri-operative period.
The authors say: “Transgender and gender-diverse people comprise a significant and varied minority with specific healthcare needs that are often both poorly misunderstood and met. It is our collective responsibility for this inequity to be addressed. Transgender and gender-diverse people, in addition to some specific needs, experience the same health problems as everyone else and will therefore present to all services whether specialist or not. This guideline sets out a structured explanation of current evidence and practicalities to be considered for any anaesthetist looking after a transgender and gender-diverse patient in any scenario or area of the hospital.”
They add that the new guidance is necessary as there is currently no existing guidance covering the scope and focus of this document.
The working group make some key recommendations:
The authors conclude: “The objective of this document is to guide best practice to ensure the safety and dignity of transgender and gender-diverse people in the peri-operative period. While they may have specific health needs in relation to gender dysphoria, their health requirements go beyond their gender identity. Most doctors will provide care to someone who is transgender or gender-diverse at some stage in their career. It is therefore important that all anaesthetists are educated on specific considerations when caring for these patients.”
“This document provides the first guidance produced to advise on best practice to ensure the safety and dignity of trans and gender-diverse individuals in the peri-operative period.”
Dr Stuart Edwardson, Royal Infirmary of Edinburgh, Edinburgh, UK. Please e-mail with interview requests. E) stuart.edwardson@nhs.scot
Alternative contact: Tony Kirby of Tony Kirby PR. T) +44 7834 385827 E) tony.kirby@tonykirby.com
For full embargoed paper, click here
NOTE: THE ABOVE LINK IS FOR JOURNALISTS ONLY. IF YOU WISH TO PROVIDE A LINK TO THIS PAPER FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE WHEN THE EMBARGO LIFTS:
https://doi.org/10.1111/anae.16378
Anaesthesia
Disclosures found in full paper see link