Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols.

Cohort studyPlastic and reconstructive surgery. Global open· Jun 2025

Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols.

Caitlyn C Belza, Gaby Sendek, Miriam Becker … Amanda A Gosman

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Adolescent MedicineCohort studyTreatmentQ1IF 1.8

Outpatient protocol cut opioid prescriptions at discharge after gender-affirming mastectomy

Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols.

Caitlyn C Belza … Amanda A Gosman

Plastic and reconstructive surgery · Jun 2025

Background

Adolescents and young adults who undergo gender-affirming care require special consideration in the postoperative period.

Purpose

This study evaluated pain management and perioperative details during our clinic's transition to outpatient gender-affirming mastectomy (gender-affirming mastectomy).

Methods

Were grouped by the timing of surgery: before ("preprotocol," n = 25) or after ("postprotocol," n = 45) implementation of the outpatient protocol.

n = 70 patients

Results

opioids at discharge dropped sharply after the outpatient protocol began

28%

Preprotocol opioids at

9%

Postprotocol opioids a

More results

There were 70 patients with a mean age of 19.3 years (SD = 1.75 y).

Patients who received an erector spinae plane nerve block before the procedure received fewer morphine milligram equivalents postoperatively compared with those who received a postincision erector spinae plane nerve block ( P = 0.006).

More results

There was a trend in association such that patients who had liposuction received fewer morphine milligram equivalents ( P = 0.09).

The average hospital stay for the postprotocol group was shorter compared with the preprotocol group ( P < 0.001).

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Conclusion · 1 of 2

Our findings highlight the successful implementation of outpatient gender-affirming mastectomy for young adults at a children's hospital.

Conclusion · 2 of 2

The new protocol yielded a shorter duration of hospital stay and less frequent postoperative opioid prescriptions without impacting the incidence of complications.

Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols.

Young Adult and Adolescent Gender-affirming Care: Defining Perioperative Protocols.

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