OHSU is one of the highest volume centers for gender-affirming surgery in the country. Our institution is therefore in a position to study the outcomes of these procedures and incurs a responsibility to identify safety concerns affecting a vulnerable population of patients. Anesthesiologists caring for patients undergoing gender-affirming surgeries at OHSU have observed a higher than expected rate of postoperative peripheral nerve injuries. Postoperative peripheral nerve injuries are a known complication of anesthetic care and have been attributed to a variety of mechanisms related to the perioperative environment including stretch, compression, and ischemia. Our aim was to validate the clinical observation of increased nerve injuries by quantifying the incidence of new postoperative peripheral nerve injuries in patients undergoing gender affirming surgery.