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Apr 27, 2023

Host, Dr. Catherine Cerulli, a professor of Psychiatry at the University of Rochester, is joined by her guests, Ash B. Alpert, MD, MFA, a Hematologist and Medical Oncologist and an AHRQ T32 Post-Doctoral Fellow in Health Services Research at the Brown University School of Public Health and Sabrina Jamileh Sayegh, a queer and nonbinary third-year medical student at the University of Rochester School of Medicine and Dentistry. Dr. Alpert and Sabrina share insights regarding their research to understand and address cancer risk factors as a result of violence for multiply marginalized populations. They explore the mechanisms by which violence plays a role in social determinants of health and how violence can contribute to cancer and/or cancer risk factors. Dr. Alpert explains that there are 4 major ways violence can lead to cancer and/or cancer risk factors including: 1) increased stress, otherwise known as allostatic load, which can lead to a higher risk of cancer through inflammatory pathways, 2) increased exposure to viruses including HPV, HIV and hepatitis for those exposed to sexual violence, 3) increased distress which can lead to increased substance use which can increase the risk of certain cancers including lung and liver cancer, and 4) increased mental distress and illness, which is linked to increased mortality for people living with cancer. To address this, Dr. Alpert and Sabrina discuss exploring strategies such as ensuring adequate training is provided to clinicians caring for transgender people, implementing screening questions related to violence to be asked to all patients, and on a structural level, considering the ways that legislation might facilitate or diminish violence against transgender people.  Dr. Alpert and Sabrina are dedicated to better serving transgender patients as well as other multiply marginalized populations.