Lee Tzu-Hao, Duong Nikki, Sutha Ken, Simonetto Douglas A, Paul Sonali
Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Division of Abdominal Transplant, Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA.
Lancet Gastroenterol Hepatol. 2023 Dec;8(12):1152-1162. doi: 10.1016/S2468-1253(23)00238-8. Epub 2023 Oct 11.
The number of people who report to be of minoritised sexual or gender identities in the USA, including lesbian, gay, bisexual, transgender, queer, and other sexuality-diverse and gender-diverse identities, has been increasing in the past decade. This diverse and unique population continues to experience not only health disparities but also psychosocial, economic, and legal disparities in accessing and receiving health care, including liver transplantations. As liver transplantation is life-saving for people with end-stage liver disease, understanding the factors that can affect access to and quality of liver transplantation care in people of minoritised sexual and gender identities in the USA, including differential social supports, insurance coverage, and medical and psychiatric comorbidities, is crucial. Actions, such as collecting sexual orientation and gender identity data, implementing inclusive language, recognising implicit biases, building diverse teams, providing a safer environment, and supporting further research to understand the unique health challenges are needed to ensure equitable access to high-quality liver transplantation care for people of minoritised sexual and gender identities.
在过去十年中，美国报告称具有少数性取向或性别认同的人数一直在增加，其中包括女同性恋、男同性恋、双性恋、跨性别者、酷儿以及其他性取向多元和性别多元的身份群体。这个多样化且独特的群体不仅在健康方面存在差异，在获得和接受医疗保健（包括肝移植）方面还面临心理社会、经济和法律等方面的差异。由于肝移植对终末期肝病患者来说是挽救生命的治疗手段，因此了解可能影响美国少数性取向和性别认同人群获得肝移植治疗的机会和质量的因素至关重要，这些因素包括不同的社会支持、保险覆盖范围以及医疗和精神共病情况。需要采取一些行动，比如收集性取向和性别认同数据、使用包容性语言、认识到隐性偏见、组建多元化团队、提供更安全的环境以及支持进一步研究以了解独特的健康挑战等，以确保少数性取向和性别认同人群能够公平地获得高质量的肝移植治疗。
