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“The beginning of wisdom is to call things by their right names.” – Chinese Proverb.
Because race is a social construct, racial disparities in palliative and end-of-life care most often stem from social causes, namely systemic, structural, institutional, and interpersonal racism. The fact that only 7% of research articles focusing on racial disparities in palliative care specifically name racism points to a major barrier to addressing root causes of these disparities. While it is heartening that this self-censorship and/or lack of awareness seems to be lessening over time, there is clearly much more work to be done.
There is a paucity of attention in the literature to the care of older transgender and gender diverse adults. The authors present practical guidance to improve the quality of care for this population, including the use of trauma-informed care for people who have been traumatized both within and outside of medical settings, and clinical considerations for medical and surgical gender-affirming interventions. Finally, they discuss unique considerations for end-of-life and palliative care, including concerns about discrimination in long-term care and access to gender-affirming care at end of life.