Ep 94: Perioperative Updates for Care of Transgender Patients

As transgender patients become more common for hospitals across the country, procedures and processes continue to be updated to meet their needs. Jose D. Castillo, III, PhD, MS, CRNA, ARNP, has spent a lot of time researching this subject and educating CRNAs. Today, he’ll address some of our questions and provide us with a better understanding of how best to care for transgender patients.

Click the timestamps below to help you navigate through the many topics we discussed.

On This Episode:

As of a few years ago, there were an estimated 1.4 million adults in the United States that identified as transgender. It’s easy to assume that the number has increased since that time, which means that there’s a good chance you’ve cared for or will soon care for a transgender patient.

Because this segment of the population rather small, it can be difficult to find any information on the subject for healthcare professionals. But that’s changing thanks to FANA president Jose D. Castillo, III, PhD, MS, CRNA, ARNP. He’s been a leader in this area and we wanted to get his expertise on the subject.

You have to go back to three or four years to an experience Castillo had with his first transgender patient to understand why he’s dedicated so much time to learning more. Back on day in 2016 or 2017, there were whispers on the floor when the transgender patient came in, which he admittedly participated in. When he got home later that night, he felt that he should have handled it much differently. So he began researching the subject and found there was very little information available. The only areas that produced these materials were the ones that performed sex reassignment surgery. That’s what initiated his interest and it grew from there.

A lot of the controversy within healthcare and the public as a whole comes from pronouns and the best practices for using them. This is why procedures are put into place but at the end of the day, Castillo explains why you should ultimately just ask the question directly. Being presumptive is much more offensive than asking someone.

If this is something that you still struggle with, don’t worry that you’re alone. That’s why we wanted to have this conversation and share our experiences. By helping people what to consider both clinically and personally, we hope it can improve our practice and the environment we work in.

If you’re looking to learn more about the topic, Castillo will be presenting at the AANA Virtual Congress.

Here are some of the other topics we will cover on the show:

  • Definitions related to the care of patients
  • Pronoun use and best practices
  • Testing patients
  • Medications for hormone replace therapy
  • The emotional considerations

Check it out the interview at the top of the page and use the timestamps to help you navigate through the many topics we discussed.

2:33 – Introducing our guest today

3:58 – Why this is a timely topic

6:00 – Definitions related to the care of transgender patients 

8:20 – Pronoun use and best practices

14:30 – The different stages of transition

17:33 – Perioperative experience Sharon had

19:53 – Anesthesia considerations for transgender patients

24:15 – Common medications with hormone replacement therapy

29:10 – Be aware of your biases and prejudices for every patient you care for.

30:26 – How to get more information from our guest

“If we think of it like that in an anatomical perspective and a structural perspective, I think we can formulate better policies to address what needs to be done clinically.”

-Jose D. Castillo, III, PhD, MS, CRNA, ARNP





COVID-19 Pandemic

Ep 213: Moral Injury and Nurse Anesthesia

With the increased distress and rationing of care that arose during the COVID-19 pandemic, the topic of Moral Injury (MI) has started to garner much more attention in the world of healthcare. This repeated conflict between an individual’s morality and the management of care causes a deep emotional wound that often drives workers out of the profession altogether. Jerry Hogan, DNSc, CRNA wrote an article about this subject, so we’ve asked him to explain the effects of MI and how CRNAs can resolve this conflict.

Current Events

Ep 212: Thankful for the AANA and Its Ongoing Efforts for CRNAs

It hasn’t been the easiest year for a lot of people, but we know there’s still plenty to be grateful for as we approach another Thanksgiving. Specifically, we wanted to shine the light on the AANA and everything they do for our profession each year. New AANA President Angie Mund, DNP, CRNA is a friend of the show and someone we appreciate quite a bit so we wanted to spend some time with her on this holiday to talk about everything she’s hoping to accomplish over the next year.


Ep 211: Anesthesia Management for a Pheochromocytoma

We’ve had CRNAs and SRNAs ask us to give them the essential information needed to manage a particular case and today we’re going to do that with Pheochromocytoma. This is the second episode in our endocrine surgical procedures series and there will be some valuable info that you might find on exams as well. Here’s the power-packed episode for anesthesia management for a Pheochromocytoma that we hope you get a lot out of.




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J. Cross CRNA
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This podcast is very well put together. I love the hosts Sharon & Jeremy, they do a fantastic job at presenting topics as well as getting great speakers on the show! This is my morning commute podcast everyday! Thank you for all that you do!
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I enjoy listening every morning. Great content and always a pleasure to learn something new.
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I started listening to this podcast religiously early on in my CRNA journey, a year before applying to CRNA school. The content in this podcast was one of my most helpful resources for getting into my first choice school, Wake Forest! It has also been a huge motivator for getting involved with the AANA now and throughout my career. I highly recommend this podcast to every prospective CRNA I meet.
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I appreciate hearing the latest and greatest in the world of Nurse Anesthesiology while also getting Class B credits. Just listen on your commute for a win/win experience. I love the perspectives from Jeremy and Sharon who both ask varied and insightful questions!
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If you’re a CRNA or any medical professional, I highly recommend giving this podcast a listen. Hosts have a great rapport.