UMass Memorial Medical Center, Department of Radiology, Worcester, MA, USA.
Fenway Health, Trans Health Program, Boston, MA, USA.
J Breast Imaging. 2023 Jul 28;5(4):473-479. doi: 10.1093/jbi/wbad012.
The number of individuals identifying as lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) has doubled over the past 10 years, and this figure continues to rise. The LGBTQ+ community is diverse, encompassing a vast array of differences in gender identity and sexual orientation. Additionally, it is inclusive of people from all races, ethnicities, religions, and socioeconomic backgrounds. This intersectionality of identities and experiences impacts both access to health care and its delivery. Barriers to care for this population are multifactorial and include stigma, discrimination, bias, limited role models, issues with insurance coverage, lack of education and training for health care providers, and lack of research on LGBTQ+ health-related issues. Specific to breast cancer, the screening recommendations for this group are influenced not only by risk but also by gender-affirming hormonal and surgical therapies. This article will provide an overview of the LGBTQ+ population, review breast cancer screening compliance and recommendations, summarize the multitude of health disparities, and offer potential interventions to improve care delivery at the individual, facility, organizational, and health policy levels.
过去 10 年来,自称为女同性恋、男同性恋、双性恋、跨性别、酷儿/疑问者(LGBTQ+)的人数增加了一倍,而且这一数字还在继续上升。 LGBTQ+群体是多样化的,包括性别认同和性取向的广泛差异。此外,它还包括来自各种种族、族裔、宗教和社会经济背景的人。这些身份和经历的交叉影响了获得和提供医疗保健的机会。针对这一人群的护理障碍是多方面的,包括污名化、歧视、偏见、角色模范有限、保险覆盖范围问题、医疗保健提供者教育和培训不足,以及缺乏关于 LGBTQ+健康相关问题的研究。具体到乳腺癌,该群体的筛查建议不仅受风险影响,还受性别肯定激素和手术治疗的影响。本文将概述 LGBTQ+人群,回顾乳腺癌筛查的依从性和建议,总结众多健康差异,并提出在个人、医疗机构、组织和卫生政策层面改善护理提供的潜在干预措施。
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