An estimated 25 million people identify as transgender worldwide, approximately 1 million of whom reside in the United States. The increasing visibility and acceptance of transgender people makes it likely that they will present in general surgical settings; therefore, perioperative health care providers must develop the knowledge and skills requisite for the safe management of transgender patients in the perioperative setting. Extant guidelines, such as those published by the World Professional Association for Transgender Health and the University of California San Francisco Center of Excellence for Transgender Health, serve as critical resources to those caring for transgender patients; however, they do not address their unique perioperative needs. It is essential that anesthesia providers develop the knowledge and skills necessary for safely managing transgender patients in the perioperative setting. This review provides an overview of relevant terminology, the imperative for the provision of culturally sensitive care, and guidelines for preoperative, intraoperative, and postoperative management of the transgender patient. Accepted for publication February 27, 2018 Funding: This research was funded in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748. The authors declare no conflicts of interest. All authors were substantial contributors to the conception of the article, were active participants in the drafting and revision of the article, approved the final version of the article, and agree to be accountable for all aspects of the work. Enhancing the QUAlity and Transparency Of health Research (EQUATOR) guidelines: This article adheres to the appropriate EQUATOR guidelines Standards for QUality Improvement Reporting Excellence (SQUIRE) 2.0. Reprints will not be available from the authors. Address correspondence to Luis Etienne Tollinche, MD, FASA, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. Address e-mail to tollincl@mskcc.org. © 2018 International Anesthesia Research Society
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