While there are many studies being done within the LGBTQIA+ community regarding cancer studies, much more investigation and research must be done to correlate why cancer rates are so much higher within this community. None of our largest and most important cancer agencies with registries and surveys collect any data about sexual orientation or gender identity, which leaves lesbian, gay, bisexual and transgender cancer survivors embedded and invisible among the vast wealth of information these surveys are intended to provide to other groups.
On top of this, other ethnic, geographic and racial populations can use this data received from these statistics to develop prevention and treatment programs designed to help treat the most common patients- which are not those who are lesbian, gay, bisexual or transgender.
Many doctors believe that the LGBTQIA+ group of people are carrying a disproportionate cancer burden and risk because their lifestyle creates a very specific cluster of very high-risk factors for many types of cancer. These risk factors create a greater cancer incidence and a later stage diagnosis, which makes treatment very complex and difficult. It is estimated that over one million LGBTQIA+ cancer survivors currently live in the country and face this health disparity.
The health disparities in the LGBTQIA+ community are caused by multiple different factors. There are no distinct biological or physiological differences between LGBTQIA+ people and heterosexual counterparts. Instead, the disparities are caused by the combination of social and economic factors and behaviors, most of which can be traced back to the stress and complexity of living as a sexual or gender minority in this country.
An example of this if a study of health disparities done in a statewide population of lesbian, gay, bisexual and transgender women found that lesbian and bisexual women were more likely than heterosexual women to have poor mental and physical health, with asthma, diabetes, being overweight, smoking, and drinking an excess of alcohol. These women were also expected to be at a much higher risk rate for breast cancer and many other cancers linked to smoking, obesity, and alcohol use.
Unfortunately, these health disparities in the LGBTQIA+ population do not stop with the ultimate cancer diagnosis. For those over one million LGBTQIA+ cancer survivors living in the country currently, the impact of treatment quality and disease advancements for their quality of life is significantly different from that of our heterosexual counterparts when it comes to sexuality, social relationships and dealing with their medical community.
For example, changes in sexual function, one of the most ubiquitous life-altering, adverse effects of prostate cancer treatment, impacts gay and heterosexual men differently. Yet many oncologists, urologists, and proctologists ask at all about their patients’ sexual practices or know the answers when asked about the effect of prostate cancer on a gay man’s sexuality, or where they can receive culturally competent support on issues of sex, intimacy and their relationships.
Why is LGBTQIA+ cancer health so important?
Reducing and eliminating the LGBTQIA+ health disparities and improving efforts to improve and broaden LGBTQIA+ health is a necessary thing to ensure that they can lead long, healthy lives being who they are. There are many benefits of addressing these health concerns, and they are:
- Reductions in disease transmission and progression
- Increased mental and physical well-being
- Reduced health care costs
- Increased longevity
Some of these efforts to improve LGBTQIA+ health include:
- Collecting data in health-related surveys and health records to identify LGBTQIA+ health disparities
- Appropriately inquiring about and being supportive of a patient’s sexual orientation and gender identity to enhance the patient-provider interaction and regular use of care
- Providing medical students with training to increase provision of culturally competent care
- Implementing antibullying policies in schools
- Providing supportive social services to reduce suicide and homelessness among youth
- Curbing human immunodeficiency virus or HIV, and sexually transmitted infections with interventions that work
On an organizational level, health professionals can create a steering committee that oversees LGBTQIA+ inclusion initiatives at a hospital or clinic level. In 2007, the Human Rights Campaign created the Healthcare Equality Index, a national LGBTQIA+ benchmarking tool that evaluates health care facilities’ policies and practices related to the equity and inclusion of their LGBT patients, visitors and employees.
Hospitals and clinics should use the standards formulated by the HEI to guide institutional programming that meets the needs of their LGBTQIA+ community members.
If you are an LGBTQIA+ patient and feel that your healthcare is lacking in certain aspects, if you are comfortable, speak frankly with your doctor about your feelings. Ask your questions aloud, even if they do not have an answer. If you are not comfortable with speaking out on your own, contact your local LGBTQIA+ office or representative and ask them to assist you in getting your questions answered and the medical care you need.
Citations:
American Cancer Society
National Institutes of Health and Human Services
Human Rights Campaign