社会背景与挑战 - 报告指出，25年前蒙特雷对LGBT群体非常不友好，该群体面临警察的迫害和监禁[1] - 报告强调，跨性别者在争取LGBTQ+权利方面一直处于前沿，但他们拥有的权利却最少[1] - 报告揭示，80%-90%的跨性别者失学，同样比例的跨性别女性从事性工作，这并非出于自愿，而是因为其他机会被剥夺[1] - 报告强调，即使在21世纪，仍然存在以“违反道德和良好习俗”为由逮捕跨性别者的警察法规[1] - 报告指出，跨性别者的平均寿命仅为35岁[1] 倡议与行动 - 报告提到，2001年，由于LGBT运动中跨性别者被忽视，报告人决定发出自己的声音，并与其他跨性别女性一起在Nuevo León发起了第一次性别多样性游行[1] - 报告强调了在各个领域（包括学术界、文化界、艺术界和政治界）实现LGBTQ+群体正常化的必要性[7] - 报告呼吁团结各方力量，真正加强对那些没有相同机会的人的支持，并避免停留在口头承诺[5] 身份与交叉性 - 报告强调了跨性别者身份的复杂性，以及贫困、阶级和性别认同等因素如何相互作用，从而阻碍了个人的发展[4] - 报告强调了跨性别者在生活各个方面面临的劣势，包括工作、学术和个人生活[1] - 报告强调了“有目的的可见性”的重要性，以促进对LGBTQ+群体的理解和接受[6]

Health Equity & Disparities - The US ranks 38th globally in health outcomes out of 196 countries [6] - The US has the highest rates of infant mortality, low birth weight, and maternal mortality, ranking 55th globally in maternal mortality with almost 33 deaths per 100,000 [7] - Maternal mortality rates are 3-9 times higher for African-Americans and 19 times higher for Native Americans [8] - Mortality rates for white non-Hispanics in the US have increased, primarily due to suicide, poisoning/overdose with opioids, and alcoholic liver disease [12] Social Determinants of Health - Health is significantly affected by poverty, discrimination, powerlessness, housing affordability, mental health, and the opioid crisis [4] - Policies such as seat belts, education, transportation, housing, and living wages impact health [6][31] - Lack of prenatal care is a significant issue, with approximately 30% of American counties lacking such care [11] Medical Education & Systemic Issues - Academic medicine is described as a highly toxic environment needing cultural change from the top down [18][19] - Medical education needs to change its culture, admissions processes, and curricula to address health equity [16] - There is a lack of empathy from physicians, with only 20% of patient visits reflecting empathy [20] - Significant disparities exist in medical education, with only 8% of American medical students being African-American and low representation in faculty and clinical chairs [24] - Women in medicine earn an average of $2 million less than men with the same specialty over their careers [27] Proposed Solutions & Initiatives - Implementing community-based programs before medical students begin their studies to build trust and address social determinants of health [21] - Supporting free education to improve economic outcomes and overall well-being [15] - Changing pre-med requirements and focusing on character and virtues like humility and empathy [24][29][30] - Embedding students in the community to understand the plight of underserved populations [28]

Today I want to share with you a story. A story not just of one individual but the story of an entire country's fight for social justice and fairness. This memoir is titled Niskam Karmmayogi which is Nepali for selfless worker.And the man you see on the cover of this memoir is Ratna Prasad Karel my grandfather. There are 195 countries in the world among which there are only seven which have never been colonized. My home country Nepal is one of them.But just because we were never colonized doesn't mean that ...