Exogenous Sex Hormones and Postoperative Nausea and Vomiting Risk in Transgender Patients

Transgender female (AMAB) patients on estrogen GAHT required rescue antiemetics more often than cisgender males and cisgender females after orchiectomies and augmentation mammoplasties. Transgender male (AFAB) patients on testosterone GAHT required rescue antiemetics less often than cisgender females after hysterectomies. These findings underscore the need for individualized perioperative care and antiemetic prophylaxis to promote equitable anesthetic care for transgender patients. This study's retrospective design limits causal inference and is subject to coding errors and residual confounding. Prospective studies with detailed perioperative and hormonal data are needed to validate these findings and clarify how the timing, dosage, and duration of GAHT influence PONV risk.