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For Pride Month, we celebrate the LGBTQ+ community and take stock of the challenges they continue to experience. Gastroenterologists and hepatologists can and should advocate, improve inclusion and be effective allies for our LGBTQ+ colleagues and patients.
The lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) community navigates a complex social landscape marked by strides in acceptance alongside enduring discrimination. Allies — individuals outside of the LGBTQIA+ spectrum who support and advocate for this community — are paramount, with allyship playing a critical part in influencing the health and well-being of LGBTQIA+ individuals.
Transgender and gender-diverse patients in the United States can have difficulty finding providers who are knowledgeable about their unique health-care needs. In many states, legislation limits the ability of physicians to provide gender-affirming and supportive care. Further awareness, advocacy and research is needed to help mitigate the discrimination and stigma endured by the transgender community.
Cultural safety seeks to remediate health inequities through empowering marginalized and minoritized patient populations, minimizing implicit bias and incorporating social determinants of health into practice. Here, we propose a cultural safety framework to guide communication with patients from sexual and gender minorities.
Receptive anal intercourse (RAI) is an important consideration in gastrointestinal disorders and cancers. This Review discusses the anorectum as a sexual organ, providing an overview of pleasurable and problematic RAI and how gastrointestinal disease itself and associated treatments (such as surgery) can affect RAI. Strategies to manage problematic RAI to improve sexual health are also described.
In this Review, Whelan and colleagues summarize and discuss evidence for the effects of ultra-processed foods and food additives on gut health and diseases, including inflammatory bowel disease, colorectal cancer and irritable bowel syndrome.
Here, an overview of group 3 innate lymphoid cells (ILC3s) is provided in gastrointestinal health and disease, highlighting their role in tissue physiology, immunity, inflammation and cancer. The biology and physiological function of ILC3s are described across different states and diseases along with a discussion on opportunities for therapeutic targeting.
In this article, the authors discuss the use of total neoadjuvant therapy for locally advanced rectal cancer. They highlight ongoing trials and discuss future treatment options, including the potential use of multi-omics and artificial intelligence to facilitate treatment selection and prediction of response.
