Exploring lesbian, gay and bisexual patients’ accounts of their experiences of cancer care in the UK

Abstract

Despite greater recognition of rights and responsibilities around the care of cancer patients who identify as lesbian, gay or bisexual (LGB) within healthcare systems in the United Kingdom, recent quantitative evidence suggests that they experience poorer care than heterosexual counterparts and qualitative findings are limited. Therefore, in the present study, we present an analysis of the accounts of fifteen British LGB cancer patients (diagnosed with different forms of the disease) of the care received. Data were collected through in-depth individual interviews and analysed using thematic analysis. Three of the emerging themes are discussed. These include an examination of what we conceptualise as the 'awkward choreography around disclosure' opportunities and dilemmas for LGB patients, we describe 'making sense of sub-optimal care' which included instances of overt discrimination but was more frequently manifested through micro-aggressions and heteronormative systems and practices, and explore accounts of 'alienation from usual psychosocial cancer support'. We employ Meyer's Minority Stress Theory (2003) as a lens to interrogate the data and explore the ways in which actual or anticipated prejudice affected their experiences of treatment and support. We close with recommendations to enhance LGB-affirmative cancer care including enhanced training of healthcare professionals and explicit articulation of institutional commitment to LGB equality.

Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: A systematic review and meta‐synthesis

“…There is therefore significant underrepresentation of people who have been affected by other cancer types. The age ranges of participants were typically younger than average cancer populations (eg, see Glaser et al where median age was 69 years), and most participants were partnered, which is not typical of older LGB populations . It is possible that LGB people who are willing to participate in research and be open about their identity may not adequately represent the views and experiences of the general LGB population.…”

“…Two of these articles described different analyses arising from the same data set . One study investigated a broader population that included lesbians, gay men, or bisexual people previously diagnosed with any type of cancer . Some studies included participants who identified as homosexual (gay or lesbian), or bisexual, while others also included participants who reported partnering or having sex with the same gender (eg, men who have sex with men and women who report partnering with women).…”

“…The theme “heterocentric care” arose from the findings of 9 articles . Assumed heterosexuality was widely reported (“He said, ‘Would I like to bring my partner along.…”

“…The overarching theme “unmet needs” is distinct in that it includes specific areas of need clearly articulated by participants within the included studies. Seven articles contributed to this theme …”

Co‐producing knowledge of lesbian, gay, bisexual, trans and intersex (LGBTI) health‐care inequalities via rapid reviews of grey literature in 27 EU Member States

“…Broader research shows in health‐care settings where LGBTI people access care, being heterosexual is often assumed as a given . LGBTI people are marginalized due to heteronormative or gender normative assumptions conveyed in communication between health professionals and their patients where language is infused with subtle meaning . These assumptions are heard in verbal communication and seen in written communication where case notes and multidisciplinary forms often fail to recognize the lives and partnerships of LGBTI people .…”