Anesthetic Considerations for Gender-Affirming Airway and Facial Procedures

Area of Science:

• Anesthesiology
• Gender-affirming care
• Surgical specialties

Background:

• Approximately 0.6% of the US population identifies as transgender or gender nonbinary.
• Transgender care is complex, requiring multidisciplinary expertise.
• Gender-affirming surgery prevalence is rising with increased societal acceptance.

Purpose of the Study:

• To highlight anesthetic considerations for transgender airway and facial procedures.
• To inform providers about potential perioperative challenges and hormonal therapy implications.
• To emphasize the need for comprehensive knowledge in caring for transgender patients.

Main Methods:

• Review of anesthetic concerns for masculinization and feminization airway/facial procedures.
• Discussion of risks associated with airway surgery (e.g., stenosis, perforation).
• Examination of hormonal therapy implications (e.g., thromboembolism, cardiovascular effects).

Main Results:

• Airway and facial gender-affirming surgeries present unique anesthetic challenges, including bleeding and airway injury.
• Advanced airway techniques are often necessary.
• Postoperative risks include tracheal/glottic stenosis, vocal cord dysfunction, and dysphagia.
• Hormone therapy carries risks like thromboembolic events and cardiovascular effects.

Conclusions:

• Anesthesia providers must be knowledgeable about specialized surgical procedures and hormonal therapies.
• Safe and comprehensive care requires understanding surgical risks, airway management, and hormonal effects.
• Holistic care necessitates awareness of psychosocial aspects of gender transition.