BACKGROUND Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. MAIN BODY Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to gender-affirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. CONCLUSION There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

中文翻译：

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辩论：为什么要在健康科学课程中包含性别肯定的医疗保健？

背景 每个寻求医疗保健的人都应该得到肯定、尊重、理解而不是评判。然而，跨性别和性别多元化的人在医疗保健环境中经历了严重的边缘化和歧视。目前的课程通常没有为卫生专业人员做好充分准备，无法为跨性别和性别多样化的人提供适当的医疗保健。这强烈暗示医疗保健学生将从有助于学习性别肯定医疗保健的课程中受益。主体 通过《精神疾病诊断和统计手册》（DSM）和国际疾病分类（ICD）中的精神疾病分类，跨性别和性别多样化的人已被医学界病态化。虽然这在新的 ICD-11 中有所改变，去病态化言论和获得性别肯定的医疗保健之间仍然存在紧张关系。跨性别和性别多样化的人经历着巨大的健康差异和增加的疾病负担，特别是在心理健康、人类免疫缺陷病毒、暴力和受害领域。许多这些健康差异源于减少获得护理的歧视和系统性偏见，以及卫生专业人员的无知。本文将概述在不同背景下描述的健康科学课程中的差距，以及试图提高与性别确认医疗保健相关的意识、知识和技能的具体教育干预措施。与世界大部分地区一样，初级保健提供者的教育至关重要，性别确认保健的专业服务并不广泛。将讨论由服务提供者决定谁可以获得护理的把关模式的伦理，并与知情同意模式进行对比，后者通过授权患者做出自己的医疗保健决定来维护自主权。结论 对于卫生专业人员来说，在社会正义和文化谦逊的医疗保健价值观范围内，减少跨性别和性别多元化人群的医疗保健差异和实践在道德上是必不可少的。作为健康科学教育者，我们有道德义务将确认性别的健康纳入健康科学课程，以防止对我们的学生将来提供护理的跨性别和性别多样化患者造成伤害。服务提供者决定谁可以获得护理，将与知情同意模式进行讨论和对比，后者通过授权患者做出自己的医疗保健决定来维护自主权。结论 对于卫生专业人员来说，在社会正义和文化谦逊的医疗保健价值观范围内，减少跨性别和性别多元化人群的医疗保健差异和实践在道德上是必不可少的。作为健康科学教育者，我们有道德义务将确认性别的健康纳入健康科学课程，以防止对我们的学生将来提供护理的跨性别和性别多样化患者造成伤害。服务提供者决定谁可以获得护理，将与知情同意模式进行讨论和对比，后者通过授权患者做出自己的医疗保健决定来维护自主权。结论 对于卫生专业人员来说，在社会正义和文化谦逊的医疗保健价值观范围内，减少跨性别和性别多元化人群的医疗保健差异和实践在道德上是必不可少的。作为健康科学教育者，我们有道德义务将确认性别的健康纳入健康科学课程，以防止对我们的学生将来提供护理的跨性别和性别多样化患者造成伤害。结论 对于卫生专业人员来说，在社会正义和文化谦逊的医疗保健价值观范围内，减少跨性别和性别多元化人群的医疗保健差异和实践在道德上是必不可少的。作为健康科学教育者，我们有道德义务将确认性别的健康纳入健康科学课程，以防止对我们的学生将来提供护理的跨性别和性别多样化患者造成伤害。结论 对于卫生专业人员来说，在社会正义和文化谦逊的医疗保健价值观范围内，减少跨性别和性别多元化人群的医疗保健差异和实践在道德上是必不可少的。作为健康科学教育者，我们有道德义务将确认性别的健康纳入健康科学课程，以防止对我们的学生将来提供护理的跨性别和性别多样化患者造成伤害。