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Improving culturally safe engagement with sexual and gender minority populations

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.

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  1. Rosa, W. E., Metheny, N. & Banerjee, S. C. LGBTQIA+ affirming palliative care and communication in liver transplantation. Lancet Gastroenterol. Hepatol. 9, 106–107 (2024).

    Article  PubMed  Google Scholar 

  2. Lee, T.-H., Duong, N., Sutha, K., Simonetto, D. A. & Paul, S. Liver transplantation for people of minoritised sexual and gender identities in the USA. Lancet Gastroenterol. Hepatol. 8, 1152–1162 (2023).

    Article  PubMed  Google Scholar 

  3. Mukerjee, R., Wesp, L., Singer, R. & Menkin, D. (eds) Clinician’s Guide to LGBTQIA+ Care: Cultural Safety and Social Justice in Primary, Sexual, and Reproductive Healthcare (Springer Publishing, 2021).

  4. Velez, C., Casimiro, I., Pitts, R., Streed, C. Jr & Paul, S. Digestive health in sexual and gender minority populations. Am. J. Gastroenterol. 117, 865–875 (2022).

    Article  PubMed  Google Scholar 

  5. Paul, S. Overcoming the challenges and mitigating the disparities in our LGBTQI+ patients. Am. J. Gastroenterol. 116, 1815–1818 (2021).

    Article  PubMed  Google Scholar 

  6. Sevelius, J. M., Chakravarty, D., Dilworth, S. E., Rebchook, G. & Neilands, T. B. Gender affirmation through correct pronoun usage: development and validation of the transgender women’s importance of pronouns (TW-IP) scale. Int. J. Environ. Res. Public Health. 17, 9525 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Advancing Health Equity: A Guide to Language, Narrative and Concepts. American Medical Association (2021).

  8. Damaskos, P., Amaya, B., Gordon, R. & Walters, C. B. Intersectionality and the LGBT cancer patient. Semin. Oncol. Nurs. 34, 30–36 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Sonali Paul.

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Nikzad, N., Duong, N. & Paul, S. Improving culturally safe engagement with sexual and gender minority populations. Nat Rev Gastroenterol Hepatol 21, 372–373 (2024).

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