Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Gender, Equity and Human Rights Team, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 2021 Apr 1;99(4):296-303. doi: 10.2471/BLT.19.249086. Epub 2021 Jan 21.
Transforming our world the 2030 agenda for sustainable development is working towards a world that reflects equity, with universal respect for human dignity, pledging to leave no one behind. However, transgender and gender-diverse individuals experience significant health inequities, including negative health outcomes and multiple barriers to accessing care. In this article, we first highlight the health inequities that transgender and gender-diverse people face globally. We describe important aspects of transgender and gender-diverse health care, including the design and provision of health services, epidemiological considerations, transition-related care, changes in transition-related goals, cultural considerations, and political and legal issues. We then review the existing global literature on incorporating transgender health into medical curricula. We make a case for prioritizing improved education in medical schools on the specific health needs of transgender and gender-diverse people as part of addressing global health inequities in care. Our recommendations for comprehensive education on transgender health include cultural humility and anti-oppression training; involvement of transgender and gender-diverse community members; integration of transgender and gender-diverse health into curricula; practice-focused and in situ training; staff development in medical schools; and improving access to careers in medicine for transgender and gender-diverse people.
可持续发展议程 2030 年目标是建立一个体现公平的世界,普遍尊重人类尊严,承诺不让任何人掉队。然而,跨性别者和性别多样化的个人面临着严重的健康不平等,包括健康结果不佳和获得护理的多种障碍。在本文中,我们首先强调了跨性别者和性别多样化的人在全球范围内面临的健康不平等。我们描述了跨性别和性别多样化者保健的重要方面,包括卫生服务的设计和提供、流行病学方面的考虑、与过渡相关的护理、过渡相关目标的变化、文化方面的考虑以及政治和法律问题。然后,我们回顾了将跨性别者健康纳入医学课程的现有全球文献。我们提出了在医学院优先加强有关跨性别者和性别多样化者具体健康需求的教育,以此作为解决医疗保健方面全球健康不平等的一部分。我们关于全面的跨性别健康教育的建议包括文化谦逊和反压迫培训;跨性别者和性别多样化的社区成员的参与;将跨性别和性别多样化的健康纳入课程;实践为重点的实地培训;医学院的员工发展;以及改善跨性别者和性别多样化的人从事医学职业的机会。