An Inclusive Approach to the Preanesthetic Interview: Consensus Development of the Perioperative Gender-Diverse Assessment Tool (PGDAT)

This study aimed to develop an evidence-based perioperative assessment tool for anesthesiology professionals to supplement standard preoperative assessments, targeting the unique health needs of transgender and gender-diverse (TGD) patients to enhance the perioperative experience. Many TGD patients express dissatisfaction with their care, while numerous healthcare professionals report feeling inadequately prepared to care for this population effectively. Using a modified Delphi design, a consensus-based Perioperative Gender-Diverse Assessment Tool (PGDAT) was developed to assist anesthesiology professionals in sensitively engaging with TGD patients and creating evidence-informed, patient-focused anesthetic plans. Fourteen expert panelists from the United States appraised the quality and clinical readiness of the PGDAT through iterative online surveys. Consensus was defined as 0.8 agreement among raters, and a thematic analysis was conducted following Braun and Clarke, with three core themes emerging. The interrater reliability was 0.75707 and 0.83977 using Gwet's AC2. The 0.8 consensus threshold was achieved after two survey rounds, which content-validated the PGDAT and established an evidence-based resource that future research opportunities can use to bring about systemic changes that promote safe and inclusive healthcare environments for all.