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Injury in the transgender population: What the trauma surgeon needs to know

Morrison, Shane D., MD, MS; Kolnik, Sarah M., MD; Massie, Jonathan P., MD; Crowe, Christopher S., MD; Dugi, Daniel III, MD; Friedrich, Jeffrey B., MD; Pham, Tam N., MD; Berli, Jens U., MD; O’Keefe, Grant E., MD, MPH; Bulger, Eileen M., MD; Maier, Ronald V., MD; Mandell, Samuel P., MD, MPH

Journal of Trauma and Acute Care Surgery: October 2018 - Volume 85 - Issue 4 - p 799–809
doi: 10.1097/TA.0000000000001859
REVIEW ARTICLES

ABSTRACT Gender dysphoria, or the distress caused by the incongruence between a person’s assigned and experienced gender, can lead to significant psychosocial sequelae and increased risk of suicide (>40% of this population) and assault (>60% of this population). With an estimated 25 million transgender individuals worldwide and increased access to care for the transgender population, trauma surgeons are more likely to care for patients who completed or are in the process of medical gender transition. As transgender health is rarely taught in medical education, knowledge of the unique health care needs and possible alterations in anatomy is critical to appropriately and optimally treat transgender trauma victims. Considerations of cross-gender hormones and alterations of the craniofacial, laryngeal, chest, and genital systems are offered in this review. Further research on the optimal treatment mechanisms for transgender patients is needed.

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington (S.D.M., C.S.C., J.B.F.), Division of Trauma, Critical Care, and Burn, Department of Surgery, University of Washington School of Medicine, Seattle, Washington (S.M.K., T.N.P., G.E.O., E.M.B., R.V.M., S.P.M.); Division of Plastic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (J.P.M.); Department of Urology, Oregon Health & Sciences University, Portland, Oregon (D.D.), and Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health & Sciences University, Portland, Oregon (J.U.B.).

Submitted: June 24, 2017, Revised: August 2, 2017, Accepted: August 9, 2017, Published online: February 27, 2018.

Address for reprints: Samuel Mandell, MD, MPH, FACS, Division of Trauma, Critical Care, and Burn, University of Washington Department of Surgery, Harborview Medical Center, 325 9th Avenue, Mailstop #359796 Seattle, WA 98104; email: mandells@uw.edu.

© 2018 Lippincott Williams & Wilkins, Inc.