Receiving a cancer diagnosis has an impactful effect on everyone that it touches, including the patient, caregiver, family and even members of the community. Sexual orientation and gender identity are two of the factors that influence a person’s likelihood of being diagnosed with cancer, and how they respond to that diagnosis. When doctors are open and informed, they can help to recognize and support their gay, lesbian, bisexual, transgender and queer patients, as well as their families- whether biological or created by choice.
Disparities in Health Care for LGBTQIA+
The National LGBT Cancer Network reports that LGBTQIA+ patients have a greater chance of being diagnosed with one of the top seven most-diagnosed cancers than non-LGBTQIA+ patients. The increased chance of diagnosis can be attributed to a combination of lifestyle factors and chosen behaviors. It is vital to understand that it is not because the patient is gay, lesbian, bisexual, transgender or otherwise that they end up diagnosed with cancer. It is that LGBTQIA+ people, as a group, are more likely to engage, or have engaged in, specific behaviors that have been directly linked to the development of cancer.
As an example, smoking is connected to over eighty percent of all lung cancer, and increases the patient’s overall risk for developing colon, esophageal, and anal cancers. Numerous studies have confirmed that gay men and lesbians are more likely to smoke than men and women who do not identify as gay. If you are a smoker, stop! Other behaviors, like a high-fat diet, alcohol consumption and recreational drug use, all also contribute to this increased risk of developing cancer.
In other statistical studies, evidence shows that those women who have children over age thirty, or not having children at all, face an increased risk of breast cancer. Therefore, those lesbian women who do not plan to have children, will face a higher risk rate of developing breast cancer. If you are a woman, regardless of your sexual or gender identity, older than thirty and have never had a biological child, it is important that you get your regular screenings for breast cancer.
Additionally, the human papillomavirus, or HPV, can cause cervical cancer in women and anal cancer in men. If you are a man who engages in receptive anal sex, which is how the primary mode of HPV transmission virus is transmitted between men, ask your doctor for an anal Pap smear to find out your HPV status, particularly if you are HIV-positive. HIV infection/AIDS also increases risk for testicular cancer, invasive cervical cancer, Kaposi’s sarcoma and non-Hodgkin lymphoma which are categorized as AIDS-defining cancers. Research has shown that HIV infection/AIDS also increases the risk for non-AIDS-defining cancers, including melanoma, liver cancer, mouth and throat cancer, testicular cancer, squamous cell cancer, and many other types of cancer.
Caring for the LGBTQIA+ Patient
Coming out and vocally identifying as an LBGTQIA+ person can be a difficult experience that makes it even harder for you to feel comfortable enough to seek out and receive the care you are entitled to and need. Here are some of the reason’s LGBTQIA+ people report feeling uncomfortable asking for care:
- Shame
- Fear of discrimination, judgment, or harassment
- Previously negative experiences with doctors, nurses or medical professionals
- Lack of legal or financial resources or insurance coverage
- Immigration status
- Fear of exposure
When LGBTQIA+ patients do not have a doctor or medical provider that they can trust, they are less likely to make or keep appointments. These patients report feeling unsafe sharing information that the doctor or nurse may need for comprehensive care. The Gay and Lesbian Medical Association has a special directory available for patients to search their local area for a doctor or cancer resource that is knowledgeable and can help. If you are having trouble finding an LGBTQIA+-positive physician, reach out to the National LGBT Cancer Network. Trying to locate a medical provider that you are comfortable with can make a critical difference in your healthcare.
Finding Support as an LGBTQIA+ Patient
There is one benefit of disclosing your sexual or gender identity and that is that you can then be honest with your oncology team about your true needs, support needs, and include people from your personal life to help support you through this time of chaos. Looking at support from the aspect of coping, a sense of being accepted and recognized as who you are by your medical care team can enhance feelings of trust and a sense of support which all help to build the solid foundation in which you need to heal from your cancer or illness.
Coming out and disclosing your true self means that you can now devote your energy to coping with your diagnosis and treatment, without diverting your attention to maintaining an artificial narrative about yourself and the most important relationships in your life. Finding the right medical care team that is not only knowledgeable about but sensitive to and embraces the LGBTQIA+ identity will allow you to utilize the full spectrum of support that is available to you.
Citations:
LiveStrong
National Institute of Health and Human Services
The Gay and Lesbian Medical Association
National LGBT Cancer Network