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Kant et al. Plast Aesthet Res. 2026;13:4 Page 15 of 20

Figure 1. The role of the behavioral health provider in the perioperative time period.

CONCLUSION
The historical reliance on psychological screening as a means of gatekeeping access to care has obscured the far
more important role of behavioral health providers. In improving perioperative experience and helping ensure
a safe and successful recovery from gender-affirming genital surgery [ Figure 1]. While past standards
of care have generally limited behavioral health providers to assessment - potentially creating an adversarial
dynamic in which patients fear that their answers to basic screening questions may undermine their
eligibility for surgery beyond what is medically necessary - there is growing recognition that individuals can
benefit from psychosocial support throughout the perioperative period. Patients experience a wide range of
emotions and support needs during the perioperative period that assessment alone does not address.
Psychosocial support and counseling during the post-anesthesia, critical care, and inpatient stays can help
mitigate iatrogenic distress. This is best achieved by providing comprehensive information about the range
of psychosocial challenges involved in recovering from reconstructive surgery and by facilitating the
necessary support. This support can be provided either through an integrated behavioral health provider on
the surgical team or through appropriate referral to providers with sufficient knowledge about the surgery,
thereby reducing the burden on individuals to educate their own providers. There is also a need for
improved trauma-informed care training for providers working in perioperative settings to enhance the
treatment experiences of not only transgender patients but also the broader population of trauma survivors.

DECLARATIONS

Authors’ contributions
Formulated the idea for this manuscript, wrote the initial draft, and reviewed and edited the final draft: Kant
JD
Helped write the initial draft and reviewed and edited the final draft: Kuhn-Kutteh KM
Provided comments and suggestions on the initial draft and reviewed and edited the final draft: Grimstad
FW
Helped write the initial draft and reviewed and edited the final draft: Boskey ER