ROSEMONT, Ill.—To help ensure that all patients receive high-quality, safe pain management and anesthesia care, the American Association of Nurse Anesthesiology (AANA) has published its practice considerations for care of transgender and gender-diverse patients. AANA’s position on equitable and inclusive care, regardless of a patient’s gender status, also calls for Certified Registered Nurse Anesthetists (CRNAs) to advocate for civility and help eliminate health disparities to improve health outcomes for all patients and communities.
“CRNAs are involved in many aspects of a patient’s preoperative care, including performing a comprehensive medical history and physical, and conducting a preanesthesia evaluation with concern for the whole individual,” said Daniel King, DNP, CRNA, CPPS, AANA Practice Committee chair. “The purpose of these practice and policy considerations is to highlight the impact of health inequities for transgender patients and how these may affect care outcomes. In addition, the document discusses best considerations and practices for CRNAs and facilities to develop effective policies and strategies that promote equitable and inclusive care.”
It is recommended the preoperative care should include terminology specific to LGBTQIA+ patients, where CRNAs as well as other healthcare providers address the patient by their gender-affirming name and pronouns. Also, the anesthesia provider should be familiar with gender-affirming hormone therapy as with any other medications prior to surgery.
“Studies have shown that transgender and gender-diverse persons have unique health concerns when compared to the general public,” said King. “These include hormone therapies, other prescribed medication regimens speaking to potentially relevant states of pathophysiology, and prior surgical procedures. A thorough review of the medical history of any patient is key for developing an informative plan of care and ensuring positive post-surgery outcomes. This is furthermore important with increased awareness of specific health considerations for the transgender population. As one example, this may include contour shaping items that could have an impact on lung volumes and respiration.”
The AANA recommends the personalized care during preoperative care also be applied to postoperative care for transgender patients. With attention to the specific nature of care needed for LGBTQIA+ patients, these guidelines recognize the best outcome for the patient should be the ultimate goal in providing care.
AANA’s mission supports that CRNAs have a responsibility to all patients, regardless of their gender identification, to provide high quality and patient centered care that is individualized to meet patients’ healthcare needs. AANA embraces members of the LGBTQIA+ community, including transgender and gender-diverse patients, and recognizes that nurse anesthesiologists play an integral role in promoting quality healthcare for these patients.
CRNAs are highly educated, trained, and qualified anesthesia experts. They provide 50 million anesthetics per year in the United States, working in every setting in which anesthesia is delivered. CRNAs are the primary providers of anesthesia care in rural settings, enabling facilities in these medically underserved areas to offer obstetrical, surgical, pain management, and trauma stabilization services.