Journal of general internal medicine
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Editorial Review
Strategies to Optimize Cervical Cancer Screening Rates Among Transgender and Gender-Diverse People Assigned Female at Birth.
Self-sampling for primary HPV detection for cervical cancer screening is now FDA-approved. Many persons interested in cervical cancer screening are eager to opt out of the invasive speculum exam and opt into the self-sampling. There is no limitation on which persons can choose self-sampling. ⋯ However, no clinical guidelines describe the best practices to increase screening among this underserved population. Much community work needs to occur to make the language of screening gender-affirming for all participants. Solutions to currently invasive follow-up exams after abnormal screens need to be communicated in language directed by the TGD AFAB community.
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Inpatients with impaired decision-making capacity may attempt to leave the hospital prematurely. When no surrogate decision-maker is available, clinical teams often lack a legal basis to keep these patients. ⋯ Clinicians need explicit legal authority to temporarily detain and treat incapacitated and unrepresented patients. Physician and hospital associations should lobby state legislatures to create new statutes for medical incapacity modeled after mental health laws.