ABSTRACT
INTRODUCTION: The objective of this document is to guide best practice to ensure the safety and dignity of transgender and gender-diverse people in the peri-operative period. While transgender and gender-diverse people may have specific health needs in relation to gender dysphoria, their health requirements go beyond their gender identity. Most doctors will provide care to someone who is transgender or gender-diverse at some stage in their career. It is therefore important that all anaesthetists are educated on specific considerations when caring for these patients. METHODS: A working party was assembled consisting of individuals with experience in direct clinical care of the relevant patient group, those who have expertise in endocrinology and gender-affirming hormones, educators on the topic of transgender and gender-diverse healthcare, and authors of both cisgender and transgender identities. After discussion among the working party, targeted searches of literature were undertaken. RESULTS: The authors initially came up with a list of over 25 recommendations which was subsequently revised to a list of 15 recommendations after further review by the working party. These included airway assessment and management; management of hormonal therapy; relevant issues in obstetric anaesthesia; and hospital infrastructure and processes. CONCLUSIONS: This document provides the first guidance produced to advise on best practice to ensure the safety and dignity of trans and gender-diverse individuals in the peri-operative period.
ABSTRACT
BACKGROUND: Leadership and management have become a key facet of medical training. However, there remains enormous variation in the quality and effectiveness of medical leadership training. This article describes an innovative pilot programme that aimed to prove a new method of developing clinical leaders. METHODS: We undertook a 12-month pilot integrating a doctor in training onto our trust board in a role called the 'board affiliate'. We collected qualitative and quantitative data throughout our pilot programme. RESULTS: Qualitative data demonstrated a clear positive impact of this role on senior management and clinical staff. Our staff survey results increased from 47.4% to 50.3%. The pilot programme has had such an impact on our organisation that we have expanded the single pilot role into two positions. CONCLUSION: This pilot programme has demonstrated a new and effective method of developing clinical leaders.
