Considerations in gender-affirming hormone therapy in transgender and gender diverse patients undergoing liver transplantation.

Management of gender-affirming hormone therapy during the perioperative period of liver transplantation is unknown and without clear guidelines.

• No established protocols exist for GAHT management in liver transplant candidates and recipients.
• The paper identifies this as a 'health care gap' that the transplant community is ethically obligated to address.
• The authors note that GAHT can be lifesaving for TGGD patients who experience gender dysphoria, parallel to the lifesaving role of transplantation for end-stage liver disease.

Gender-affirming hormone therapy plays an integral role in the care of transgender and gender diverse liver transplant candidates and recipients.

• The authors characterize GAHT as potentially 'lifesaving' for TGGD patients experiencing gender dysphoria.
• The paper calls for the transplant community to 'acknowledge the integral role of GAHT in the care of TGGD liver transplant candidates and recipients.'
• TGGD patients are described as a 'minoritized patient population' with distinct healthcare needs.

The transplant community is described as ethically obligated to address healthcare gaps in GAHT management for TGGD liver transplant patients.

• The authors review current literature to support the ethical obligation framing.
• The paper argues that 'profound strides can be made in improving care for TGGD patients through gender-affirming care and appropriate management of GAHT in liver transplantation.'
• The ethical obligation is presented as a central thesis requiring action from the transplant community.

The authors propose tangible clinical steps to improve health outcomes for TGGD patients undergoing liver transplantation.

• The paper suggests 'tangible steps that clinicians may take to improve health outcomes for this minoritized patient population.'
• Recommendations are directed at the broader transplant community, not just individual clinicians.
• The paper frames these steps within the context of gender-affirming care principles.