100. Patterns of Perioperative Hormone Therapy for Gender-affirming Surgery

PURPOSE: There is no consensus regarding perioperative hormone replacement therapy (HRT) for gender-affirming surgery (GAS). Continuing HRT prior to GAS may be associated with increased risk of complications such as deep vein thrombosis (DVT). Our study aimed to investigate current patterns of HRT prior to GAS using Delphi technique. METHODS: First stage of Dephi technique was implemented by sending a 27-item survey to all surgeons (total n=150, 94 Plastic surgeon, 35 Urologist, 21 OBGYN) of the World Professional Association for Transgender Health (WPATH) who perform GAS. Survey themes included: hormone type, duration, usage of DVT prophylaxis. RESULTS: Overall survey response rate was 32.7% (total n=49, n=8 for Urologist, 34 for Plastic Surgery, 7 for OBGYN). Majority of surgeons are US-based (n=38, 77.6%). About half of their patients’ HRT are in injection form (n=27, 55.1%). Majority of surgeons do not stop HRT prior to GAS and do provide DVT prophylaxis to all patients<1 week after GAS. The most common procedure that surgeons discontinue HRT is feminizing bottom surgery (44.8%). For surgeons who do stop HRT prior to GAS, there is a wide variation on the time when they stop HRT. CONCLUSION: There is considerable variation in perioperative HRT patterns for GAS. Further research is needed to develop a data-driven consensus guideline to provide high quality of care for transgender and non-binary patients.