Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols

Area of Science:

• Surgical oncology
• Adolescent medicine
• Gender-affirming care

Background:

• Young adults undergoing gender-affirming care (GAC) require specialized postoperative management.
• This study focuses on pain management and perioperative outcomes during the transition to outpatient gender-affirming mastectomy (GAM).

Purpose of the Study:

• To evaluate pain management strategies and perioperative outcomes.
• To assess the impact of transitioning to an outpatient protocol for gender-affirming mastectomy (GAM).

Main Methods:

• Retrospective review of demographic and perioperative data (2019-2022).
• Comparison of patients before (preprotocol) and after (postprotocol) outpatient protocol implementation.
• Statistical analysis using multivariate regression and independent t-tests.

Main Results:

• Outpatient GAM protocol led to a shorter hospital stay (P < 0.001).
• Fewer postoperative opioid prescriptions at discharge (28% preprotocol vs. 9% postprotocol).
• Preoperative erector spinae plane nerve blocks reduced postoperative opioid use (P = 0.006).

Conclusions:

• Successful implementation of outpatient GAM for young adults.
• The new protocol improved efficiency and reduced opioid reliance.
• No significant difference in complication rates was observed.