<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD with OASIS Tables with MathML3 v1.1 20151215//EN" "JATS-archive-oasis-article1-mathml3.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" xmlns:oasis="http://www.niso.org/standards/z39-96/ns/oasis-exchange/table" id="anae16378" dtd-version="1.1" xml:lang="en" article-type="practice-and-policy" specific-use="VoR">
<front>
<journal-meta>
<journal-id journal-id-type="doi">10.1111/(ISSN)1365-2044</journal-id>
<journal-id journal-id-type="publisher-id">ANAE</journal-id>
<journal-title-group>
<journal-title xml:lang="en">Anaesthesia</journal-title>
<abbrev-journal-title abbrev-type="publisher" xml:lang="en">Anaesthesia</abbrev-journal-title>
</journal-title-group>
<issn publication-format="ppub">0003-2409</issn>
<issn publication-format="epub">1365-2044</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.1111/anae.16378</article-id>
<article-id pub-id-type="publisher-id">ANAE16378</article-id>
<article-id pub-id-type="society-id">ANAE.2024.00393</article-id>
<article-categories>
<subj-group subj-group-type="overline" xml:lang="en">
<subject>Guidelines</subject>
</subj-group>
<subj-group subj-group-type="heading" xml:lang="en">
<subject>Guidelines</subject>
</subj-group>
</article-categories>
<title-group>
<article-title xml:lang="en">Peri‐operative care of transgender and gender‐diverse individuals: guidance for clinicians and departments</article-title>
<alt-title alt-title-type="right-running-head">Peri‐operative care of transgender/gender‐diverse patients</alt-title>
<alt-title alt-title-type="left-running-head">Edwardson et al.</alt-title>
</title-group>
<contrib-group>
<contrib id="anae16378-cr-0001" contrib-type="author" corresp="yes">
<name>
<surname>Edwardson</surname>
<given-names>Stuart</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2715-8233</contrib-id>
<email>stuart.edwardson@nhs.scot</email>
<xref ref-type="corresp" rid="correspondenceTo">*</xref>
<xref ref-type="aff" rid="anae16378-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0002" contrib-type="author">
<name>
<surname>Flower</surname>
<given-names>Luke</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0002">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="anae16378-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0003" contrib-type="author">
<name>
<surname>Fawcett</surname>
<given-names>Erik</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0004">
<sup>4</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0004" contrib-type="author">
<name>
<surname>Medlock</surname>
<given-names>Rebecca</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0005">
<sup>5</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0005" contrib-type="author">
<name>
<surname>Cheung</surname>
<given-names>Ada S.</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0006">
<sup>6</sup>
</xref>
<xref ref-type="aff" rid="anae16378-aff-0007">
<sup>7</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0006" contrib-type="author">
<name>
<surname>Kamaruddin</surname>
<given-names>Kamilla</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0008">
<sup>8</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0007" contrib-type="author">
<name>
<surname>McCormack</surname>
<given-names>Victoria L.</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0009">
<sup>9</sup>
</xref>
</contrib>
<contrib id="anae16378-cr-0008" contrib-type="author">
<name>
<surname>Agarwal</surname>
<given-names>Seema</given-names>
</name>
<xref ref-type="aff" rid="anae16378-aff-0010">
<sup>10</sup>
</xref>
<xref ref-type="aff" rid="anae16378-aff-0011">
<sup>11</sup>
</xref>
</contrib>
</contrib-group>
<aff id="anae16378-aff-0001">
<label>
<sup>1</sup>
</label>

<named-content content-type="organisation-division">Department of Anaesthesia and Intensive Care Medicine</named-content>

<institution>Royal Infirmary of Edinburgh</institution>

<city>Edinburgh</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0002">
<label>
<sup>2</sup>
</label>

<named-content content-type="organisation-division">Department of Medicine, Victor Phillip Dahdaleh Heart and Lung Research Institute</named-content>

<institution>University of Cambridge</institution>

<city>Cambridge</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0003">
<label>
<sup>3</sup>
</label>

<institution>Department of Intensive Care Medicine, London School of Intensive Care Medicine</institution>

<city>London</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0004">
<label>
<sup>4</sup>
</label>

<named-content content-type="organisation-division">Department of Anaesthesia</named-content>

<institution>Queen Elizabeth Hospital</institution>

<city>Woolwich</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0005">
<label>
<sup>5</sup>
</label>

<named-content content-type="organisation-division">Department of Anaesthetics and Critical Care Hospital</named-content>

<institution>Great Western Hospital, Great Western Hospitals NHS Foundation Trust</institution>

<city>Swindon</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0006">
<label>
<sup>6</sup>
</label>

<named-content content-type="organisation-division">Trans Health Research Group, Department of Medicine</named-content>

<institution>University of Melbourne</institution>

<city>Melbourne</city>
 <country country="AU">Australia</country>

</aff>
<aff id="anae16378-aff-0007">
<label>
<sup>7</sup>
</label>

<institution>Department of Endocrinology, Austin Health</institution>

<city>Heidelberg, Melbourne</city>
 <country country="AU">Australia</country>

</aff>
<aff id="anae16378-aff-0008">
<label>
<sup>8</sup>
</label>

<institution>General Practitioner in Transgender Health Care and Clinical Lead East of England Gender Service</institution>

<city>Cambridge</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0009">
<label>
<sup>9</sup>
</label>

<named-content content-type="organisation-division">Department of Anaesthesia and Critical Care Medicine</named-content>

<institution>Manchester Royal Infirmary, Manchester Foundation Trust</institution>

<city>Manchester</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0010">
<label>
<sup>10</sup>
</label>

<named-content content-type="organisation-division">Department of Anaesthesia and Critical Care Medicine</named-content>

<institution>Wythenshawe Hospital, Manchester Foundation Trust</institution>

<city>Manchester</city>
 <country country="GB">UK</country>

</aff>
<aff id="anae16378-aff-0011">
<label>
<sup>11</sup>
</label>

<institution>Manchester University</institution>

<city>Manchester</city>
 <country country="GB">UK</country>

</aff>
<author-notes>
<corresp id="correspondenceTo"><label>*</label>

Correspondence to: Stuart Edwardson<break/>
Email: <email>stuart.edwardson@nhs.scot</email>
<break/>

</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="electronic"><day>23</day>
<month>07</month>
<year>2024</year>
</pub-date><fpage/><lpage/><history>

<date date-type="accepted">
<day>12</day>
<month>06</month>
<year>2024</year>
</date>

</history>
<permissions>
<copyright-statement content-type="issue-copyright">© 2024 Association of Anaesthetists</copyright-statement>
<copyright-statement content-type="article-copyright">© 2024 The Author(s). <italic>Anaesthesia</italic> published by John Wiley &amp; Sons Ltd on behalf of Association of Anaesthetists.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>© 2024 The Author(s). Anaesthesia published by John Wiley &amp; Sons Ltd on behalf of Association of Anaesthetists.</copyright-holder>
<license>
<ali:license_ref>http://creativecommons.org/licenses/by-nc-nd/4.0/</ali:license_ref>
<license-p>This is an open access article under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution‐NonCommercial‐NoDerivs</ext-link> License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.</license-p>
</license>
</permissions>
<abstract xml:lang="en" abstract-type="main">
<title>Summary</title>
<sec id="anae16378-sec-0001" xml:lang="en">
<title>Introduction</title>
<p xml:lang="en">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 transgender and gender‐diverse people 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.</p>
</sec>
<sec id="anae16378-sec-0002" xml:lang="en">
<title>Methods</title>
<p xml:lang="en">A working party was assembled consisting of individuals with experience in direct clinical care of the relevant patient group, those who have expertise in endocrinology and gender‐affirming hormones, educators on the topic of transgender and gender‐diverse healthcare, and authors of both cisgender and transgender identities. After discussion among the working party, targeted searches of literature were undertaken.</p>
</sec>
<sec id="anae16378-sec-0003" xml:lang="en">
<title>Results</title>
<p xml:lang="en">The authors initially came up with a list of over 25 recommendations which was subsequently revised to a list of 15 recommendations after further review by the working party. These included airway assessment and management; management of hormonal therapy; relevant issues in obstetric anaesthesia; and hospital infrastructure and processes.</p>
</sec>
<sec id="anae16378-sec-0004" xml:lang="en">
<title>Conclusions</title>
<p xml:lang="en">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.</p>
</sec>
</abstract>
<kwd-group kwd-group-type="author-generated" xml:lang="en">
<kwd id="anae16378-kwd-0001">anaesthesia</kwd>
<kwd id="anae16378-kwd-0002">guidelines</kwd>
<kwd id="anae16378-kwd-0003">peri‐operative</kwd>
<kwd id="anae16378-kwd-0004">transgender</kwd>
</kwd-group>
<counts>
<fig-count count="3"/>
<table-count count="4"/>
<page-count count="15"/>
<word-count count="10254"/>
</counts>
</article-meta>
</front>
</article>