Addressing the Unique Needs of LGBTQ+ Cancer Patients

Individuals who identify as LGBTQ+ along with their families, loved ones and support systems have unique health care needs. While we celebrate the diversity, strength, and resilience of the LGBTQ+ community, we must also call attention to unique needs and challenges of these individuals who are faced with cancer. Joan Hogan, DSW, LCSW, OSW-C, manager of Social Work Services and Rosemarie Slirzewski, MSW, LCSW, social worker at Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-designated Comprehensive Cancer Center, who both specialize in LGBTQ+ equity, share more.

What are some of the cancer care challenges faced by the LGBTQ+ community?

A person with cancer who identifies as lesbian, gay, bisexual, transgender or non-binary may have unique concerns about communicating with their cancer care team, navigating the healthcare system and coping with their diagnosis. According to the American Cancer Society, LGTBQ+ individuals may have worse health outcomes due to fear of discrimination, past negative healthcare experiences, and lack of adequate insurance coverage. According to the National LGBT Cancer Network, because the LGBTQ+ population faces unique barriers when accessing any health care system, both preventative and essential care are affected, which can result in disparities in cancer risk and treatment.

How does sexual orientation and gender identity impact cancer screening?

A person’s sex assigned at birth, hormones or surgeries they may have had will be relevant for some types of cancer screening. The most recent information regarding cancer screening and treatment, the Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, published by the University Of California Center Of Excellence for Transgender Health, include the following recommendations:

• For transgender women, breast cancer screening beginning 5-10 years after the use of feminizing hormones.
• For transgender men who have not had mastectomy or who had breast reduction rather than mastectomy, routine breast cancer screening based on personal and/or family history.
• Genetic counseling and/or testing if there is a known mutation in a BRCA or other gene that increases cancer risk or if the patient has a personal or family history of cancer that meets national guidelines for genetic counseling and testing.
• Screening for other cancers (e.g., cervical, endometrial, prostate, etc.) should be based on an individual’s personal and/or family history of cancer.

How can cancer care teams become better allies to the LGBTQ+ community?

Despite the barriers and disparities that many LGBTQ+ individuals with cancer face, education for medical professionals on the topic of healthcare and cancer is growing to support this community. Each day, we strive to create an environment where everyone who enters our facilities feels safe, comfortable, and respected. We are committed to advancing hope and healing for all affected by cancer, including our LGBTQ+ patients, friends, families, and community, which will lead to improvements in cancer care from screening to diagnosis, treatment, and survivorship.

For example, Rutgers Cancer Institute of New Jersey has partnered with the Proudly Me! Transgender Edu-port, an education support program at Robert Wood Johnson University Hospital, an RWJBarnabas Health facility, to offer a series of educational sessions for staff to learn the basics on how to respectfully address and care for transgender patients.