Senior Certified Registered Nurse Anesthetist
Boston Children's Hospital
Winchester, Massachusetts, United States
Introduction as Speaker: Nelson Aquino, DNP, CRNA, is a Senior Certified Registered Nurse Anesthetist in Boston Children's Hospital's Department of Anesthesiology, Critical Care, and Pain Medicine for the past 15 years. Nelson received his undergraduate Nursing and Doctor of Nursing Practice degrees from Seton Hall University. He earned his MS and Nurse Anesthesia Degree from Northeastern University. Nelson is completing a two-year Global Education Institute (GEI) certification from the World Professional Association of Transgender Health (WPATH).
Nelson’s clinical anesthesia experience with transgender and gender-diverse (TGD) youth and adults having gender-affirming procedures include Histerlin implants, chest reconstruction, phalloplasty, metoidioplasty, vaginoplasty, hysterectomy, thyroid chondrolaryngoplasty, fascial femininization, vocal harmonization, and other surgeries.
Nelson founded the Gender-Affirming Surgical Perioperative Program (GASPP) Team with his Boston Children's Hospital colleagues in 2019. The GASPP team provides gender-affirming care for transgender patients and their families, with a consistent anesthesiology workforce for gender-affirming and non-gender-affirming procedures. Collaborating with multidisciplinary colleagues in the Gender Multispecialty Service (GeMs) and The Center for Gender Surgery, the GASPP team developed patient-focused pathways to advance anesthesia management and perioperative outcomes. Nelson and his collaborators demonstrated the first descriptive case series of transgender youth and adults having chest reconstruction and genital surgeries in a pediatric academic center. In addition, the evolution of a specialty anesthesia team and initiatives that necessitate interdisciplinary planning for gender affirmation surgery.
Nelson's research focuses on understanding how gender-affirming care and anesthesia management are associated with perioperative and adverse outcomes for TGD youth and adults having gender-affirming procedures.
As a Doctoral prepared Nurse Anesthetist, I have both clinical expertise in pediatric anesthesiology and a broad background in Nursing, with specific training in transgender health at the World Professional Association of Transgender Health (WPATH) Global Education Institute. My research includes understanding how gender-affirming care and anesthesia management are associated with perioperative and adverse outcomes for gender-diverse youth and young adults having gender-affirming procedures. With the lack of clinical anesthesia research studies on transgender patients having both gender-affirming surgery and non-gender-affirming procedures, it is critical to evaluate perioperative outcomes for gender-diverse youth to deliver high-quality, effective, safe, and affirming care. In 2020, I was fortunate to have departmental support in earning a Doctor of Nursing Practice from Seton Hall University, which allowed me to learn about designing research and advance my career in clinical outcomes research.
INNOVATION
In November 2019, in response to demonstrated needs of this vulnerable population, a core team of pediatric anesthesiologists, certified registered nurse anesthetists (CRNAs), an administrative lead, and a research nurse formally established the Gender Affirming Surgical Program (GASPP) at Boston Children’s Hospital. The primary objective of GASPP was to appropriately address the preoperative (e.g., anxiety and comorbidities), intraoperative (e.g., unique anesthesia considerations), and postoperative needs (e.g., pain management and outcomes) of this unique patient population. The additional objectives of the GASPP were to provide welcoming and culturally sensitive care for gender-diverse patients and their families, with a consistent team of providers, particularly for those individuals undergoing multiple procedures. As a founding leader of this program, I have been instrumental in collaborating with multidisciplinary colleagues in the Gender Multispecialty Service (GeMs) and in The Center for Gender Surgery (nurses, advanced practice nurses, surgeons, mental health providers). In 2020, I was a PI on a case series of gender-affirming surgeries in a pediatric academic hospital. I demonstrated the first descriptive anesthesia case series of transgender youth and young adults having life-changing chest reconstruction and genital surgeries, collaborating with other researchers, surgeons, dentists, and nurses and producing several peer-reviewed publications from each project.
After our initial ICCTR-funded Collaborator Meeting on July 10-11, 2023, we have created a multi-center registry known as, The Perioperative Anesthesiology Registry for Transgender Adults and Youth (PARTAY) to actively fill the knowledge gaps in clinical anesthesia outcomes for gender-diverse youth and adults.
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