高齡與性別──多元性別高齡照護與政策建議

Aging and Gender: Inclusive Care Practices and Policies for Lesbian, Gay, Bisexual and Transgender Older Adults

隨著全球人口高齡化，多元性別高齡人口逐漸增加。相較於異性戀高齡者，多元性別高齡者具有較差的生理或心理健康、擁有較少的社會支持系統以及較常面臨健康服務使用障礙，進而導致多元性別高齡群體的健康差距與較差的生活品質。針對多元性別高齡者健康需求與照護挑戰，因醫護人員多元性別文化照護知識與技能不足，多元性別高齡者常被迫接受不符合期待與健康需求的照護服務，群體也可能因顧慮在醫療服務體系中遭遇的挑戰或歧視而選擇不就醫。依據聯合國與世界衛生組織全民健康覆蓋宣言，為實現多元性別群體健康平等與全民健康覆蓋，醫療保健與長期照護機構應提供多元性別文化照護訓練課程，並積極營造多元性別友善環境與氛圍；政府機構應定期整理並公告同志友善照護機構名單、納入同志相關性別評鑑於機構證照核定或更換，以及納入多元性別文化照護訓練課程於機構認證與醫事人員繼續教育積分，以期降低多元性別高齡群體健康差距並提升群體之生活品質。

In line with global population aging, the number of lesbian, gay, bisexual, and transgender (LGBT+) older adults is expected to continue to increase. Compared to their heterosexual peers, LGBT+ older adults have poorer physical and psychological health status, experience less social support, and face more barriers when accessing healthcare services, which may lead to higher health disparities and a lower quality of life within LGBT+ older populations. Healthcare providers have been shown to be inadequately prepared to address the unique healthcare needs and challenges of LGBT+ older adults, often leaving these individuals forced to receive care that does not meet their health needs and expectations. Based on the Declaration on Universal Health Coverage proposed by the United Nations and the World Health Organization, medical care and long-term care facilities must provide to healthcare providers training courses in culturally competent care and foster LGBT-friendly care environments to achieve health equity and universal health coverage for LGBT+ populations.