With gender affirmation surgery becoming increasingly common, there is developing need for surgeons to be aware of the complexities of caring for transgender individuals. Transgender individuals commonly avoid seeking healthcare due to fears of actual or perceived discrimination, and have significantly poorer health outcomes than cisgender patients.1,2 Globally, there is limited guidelines on caring for transgender patient populations, especially within surgical fields. This review aims to analyse existing literature on surgeons understanding of caring for transgender patients and determine areas in need of further education. We aim to seek greater understanding of what surgical doctors know about how to care for transgender patients to strive for equality.

This scoping review uses the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). A research librarian assisted with the initial literature search performed in February 2025 in electronic medical database Embase. Hand searching for grey literature was performed on google scholar and relevant medical journals. A search strategy was utilised including search terms ‘transgender’ ‘trans women’ ‘trans men’ and ‘education’ and ‘surgeons’. To broaden the search strategy, terms such as ‘urology’ ‘plastic surgery’ in conjunction with ‘registrar’ ‘resident’ and ‘trainee’ were used to capture all available literature relevant to various surgical specialties typically involved with gender affirmation surgery. The findings are presented as a scoping review given the wide variety of included study types along with the small amount of global literature available and the heterogeneity of results.

A total of 16 studies were included in our review. Almost all studies highlighted the lack of formalised education in surgically focused doctors. There was limited exposure to learning how to care for transgender patients from the beginning of medical school right through to surgical fellowship level education. Interestingly, most education was of an informal nature and often occurred when doctors were seeking assistance from their superior colleagues in the context of caring for transgender patients (eg. a patient admitted under urology who had a history of gender affirmation surgery). Most education and knowledge was taught during medical school and often with a focus on teaching students how to care for LGBTQI individuals rather than specific education around caring for transgender individuals.

Surgical trainees and doctors working within surgical fields have limited exposure and education to managing and appropriately caring for transgender patients throughout training. Significant change to both formal and informal training opportunities needs to be implemented in most surgical training programs and junior doctor education sessions to improve health outcomes and reduce commonly held fears of discrimination.