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We prove that the outer automorphism group of a one-ended hyperbolic group is virtually a hierarchically hyperbolic group (HHG), under mild orientability conditions on the associated JSJ decomposition. This is done by proving that a finite-index subgroup is a central extension of a product of orbifold mapping class groups, and the extension has bounded Euler class. Our theorem is sharp: we exhibit a surface amalgam whose fundamental group has full outer automorphism group which is not a HHG.

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