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加强对性少数群体和性别少数群体的全球癌症护理:区域视角与全球影响

Enhancing global cancer care for sexual and gender minority populations: regional perspectives and global implications.

作者信息

Patel Rohan K, Rosa William E, Chen Eric, Chitapanarux Imjai, Pramesh C S, Dee Edward Christopher

机构信息

Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Lancet Glob Health. 2025 Jul;13(7):e1321-e1326. doi: 10.1016/S2214-109X(25)00144-5. Epub 2025 May 23.

Abstract

Little is known about cancer disparities faced by diverse sexual and gender minority (SGM) populations globally, with unique barriers in many low-income and middle-income countries. This Viewpoint examines the intersectional challenges faced by SGM groups across multiple settings in accessing high-quality equitable cancer care. In India, the Hijra population (a legally recognised third gender) experiences compounded discrimination due to stigma and socioeconomic marginalisation. SGM individuals in Kenya and Brazil grapple with interpersonal and institutional discrimination, as well as structural barriers that prevent them from receiving timely cancer treatment. By contrast, Thailand's relative success in engaging communities and implementing inclusive health-care models offers valuable insights into ensuring equitable access to care. Through these global contexts, and cognisant of the diversity of SGM individuals' experiences, we provide multilevel recommendations to increase SGM-inclusive cancer research, foster culturally responsive clinical practices, and advocate for evidence-based policy reforms that decriminalise same-sex relations and promote inclusive health-care access for all SGM populations.

摘要

全球范围内,关于不同性取向和性别少数群体(SGM)所面临的癌症差异,人们知之甚少,在许多低收入和中等收入国家还存在独特的障碍。本观点文章探讨了SGM群体在多种情况下获得高质量公平癌症护理时所面临的交叉性挑战。在印度,希贾拉群体(法律认可的第三性别)由于耻辱感和社会经济边缘化而遭受多重歧视。肯尼亚和巴西的SGM个体则要应对人际和机构层面的歧视,以及阻碍他们及时接受癌症治疗的结构性障碍。相比之下,泰国在社区参与和实施包容性医疗模式方面取得的相对成功,为确保公平获得医疗服务提供了宝贵的见解。通过这些全球背景,并认识到SGM个体经历的多样性,我们提供多层次建议,以增加包含SGM群体的癌症研究,培养具有文化适应性的临床实践,并倡导基于证据的政策改革,将同性关系合法化,并促进所有SGM群体公平获得医疗服务。

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