The Preanesthetic Interview for the Transgender Patient

Abstract

Purpose. The purpose of this project was to increase the knowledge of anesthesia providers in conducting preoperative interviews with transgender patients, a unique and underserved population. It was essential to acknowledge the distinct needs of transgender individuals during preoperative interviews and to conduct assessments that were specifically tailored to them (Reece-Nguyen et al., 2023). This was achieved through an educational presentation session presented to National Partners in Healthcare in Mesa, Arizona. Background. Numerous research studies have highlighted a decline in the confidence levels of anesthesia providers when it comes to gender-affirming care, particularly during preoperative interviews (Akdogan & Öncu, 2021; Dale & Philomin, 2022; Ejiogu, 2022; Kosenko et al., 2013; Lund et al., 2022; Muckler et al., 2019). This is primarily attributed to their lack of adequate training. The preoperative setting is the crucial point where anesthesia providers establish trust and reassure every patient. As the transgender patient population continues to rise, there is an increasing demand to enhance the knowledge, expertise, and self-assurance of anesthesia providers. Methods. Anesthesia providers participated in an educational presentation focusing on preoperative anesthesia interviews tailored to transgender-specific care. To gauge the change in their knowledge following an educational presentation, a post-pre-survey was administered. This survey aimed to assess the effect of the educational intervention by measuring the participants’ knowledge changes. Results. The educational presentation aimed at enhancing anesthesia providers’ knowledge and confidence in conducting preoperative interviews with transgender patients yielded positive results. Of 49 participants, 14 completed both the presentation and post-survey, resulting in a 28% response rate. The majority reported increased confidence in using gender-affirming language, understanding the impact of hormones on lab values and coagulopathy, and recognizing anesthetic implications related to gender-affirming surgeries. Notably, 86% of respondents felt more knowledgeable and confident in conducting interviews with transgender patients. While most participants expressed a commitment to applying the learned strategies, feedback revealed mixed responses, with some appreciating the content and others questioning the need for specialized training. These findings suggest the presentation was effective in enhancing understanding, but continued dialogue is needed to address varying perspectives on patient care. Conclusion. The educational presentation improved anesthesia providers' understanding of preanesthetic interviews and anesthetic considerations for transgender patients, including hormone effects, coagulopathy risks, and gender-affirming surgeries. Most participants reported increased confidence. This highlights the importance of ongoing education to address both the interview process and anesthetic needs of transgender patients.