“Everything's a fight”: A qualitative study of the cancer survivorship experiences of transgender and gender diverse Australians

Abstract

Background: There is widespread recognition of the need to achieve equitable outcomes for all cancer survivors. This requires understanding of the experiences and outcomes of vulnerable groups. People who identify as sexually or gender diverse are known to be at risk of inferior cancer and survivorship outcomes, however, the posttreatment survivorship experiences of transgender and gender diverse (TGD) people have not been well studied. This study explored the survivorship experiences of people who identify as TGD, focusing on the physical and psychological aspects of the posttreatment survivorship phase and their experiences of follow-up cancer care.Methods: A qualitative study of 10 TGD cancer survivors. Interviews were transcribed verbatim and data were analyzed by thematic analysis.Results: Six themes were generated from the data. TGD people reported (1) anxiety when attending appointments and avoidance of necessary follow-up care, (2) experiences of transphobia and discrimination within oncology care settings and(3) lack of consideration of TGD identity by providers. Themes further describe (4) physical aspects of being both TGD and a cancer survivor, (5) absence of inclusive and diverse supportive care resources, as well as (6) positive growth after cancer. Conclusion:Approaches to mitigate these issues are urgently called for. These include training in TGD health for health-care providers, inclusion of TGD health in medical and nursing curricula, processes to collect and use gender identity and preferred pronoun data in clinical settings, and development of TGD-inclusive information and peer-support resources. K E Y W O R D Shealth Services for transgender persons gender identity, healthcare disparities, neoplasms, survivorship, transgender persons How to cite this article: Lisy K, Kerr L, Jefford M, Fisher C. "Everything's a fight": A qualitative study of the cancer survivorship experiences of transgender and gender diverse Australians.

People affected by cancer and their carers from gender and sexually diverse communities: their experiences and the role of smartphone applications

“…Participants reported disclosure could impact on their ability to receive medical care, psychosocial support and to feel seen by clinicians. Similar to previous studies, hesitancy to disclose gender or sexuality occurred due to fear of poor medical care and judgement either from clinicians or family [ 6 , 9 , 40 ]. As awareness and acceptance of LGBTQIA + communities grow, there is a need to provide safe spaces for people to disclose their gender or sexuality in healthcare settings [ 7 ] and to be met with culturally competent care [ 8 ].…”

“…Peer support among LGBTQIA + groups has strong evidence in supporting mental wellbeing, particularly within the transgender community [ 50 , 51 ]. However, there are few peer support programs for people affected by cancer and who are from LGBTQIA + communities [ 40 ], and a systematic review in 2021 highlighted that these gaps also exist in the provision of psychosocial care [ 41 ]. Participants described that peer support could be delivered in apps through the inclusion of chat rooms.…”