Cancer's Margins: Trans* and Gender Nonconforming People's Access to Knowledge, Experiences of Cancer Health, and Decision-Making

Abstract

Purpose: Research in Canada and the United States indicates that minority gender and sexuality status are consistently associated with health disparities and poor health outcomes, including cancer health. This article investigates experiences of cancer health and care, and access to knowledge for trans* and gender nonconforming people diagnosed with and treated for breast and/or gynecologic cancer. Our study contributes new understandings about gender minority populations that will advance knowledge concerning the provision of culturally appropriate care. This is the first study we are aware of that focuses on trans* and gender nonconforming peoples' experiences of cancer care and treatment, support networks, and access to and mobilization of knowledge.Methods: This article analyzes trans* and gender nonconforming patient interviews from the Cancer's Margins project (): Canada's first nationally-funded project that investigates the complex intersections of sexual and/or gender marginality, cancer knowledge, treatment experiences, and modes of the organization of support networks.Results: Our analysis documents how different bodies of knowledge relative to cancer treatment and gendered embodiment are understood, accessed, and mobilized by trans* and gender nonconforming patients. Findings reported here suggest that one's knowledge of a felt sense of gender is closely interwoven with knowledge concerning cancer treatment practices; a dynamic which organizes knowledge mobilities in cancer treatment.Conclusions: The findings support the assertion that cisgender models concerning changes to the body that occur as a result of biomedical treatment for breast and/or gynecologic cancer are wholly inadequate in order to account for trans* and gender nonconforming peoples' experiences of cancer treatments, and access to and mobilization of related knowledge.

Care delivery, patient experiences, and health outcomes among sexual and gender minority patients with cancer and survivors: A scoping review

“…Several gaps in content areas readily covered in other disparity populations, including experiences of health care discrimination, access to care, and stigma, have received little research attention for SGM cancer populations, despite the inclusion of SGM as a health disparity population . Nearly all the research in this review covered SM, not GM (transgender, nonbinary gender) groups; this is a major gap in the literature, as has been previously suggested . In addition, construct development and measurement of topics salient to cancer survivors have not been fully explored in the SGM population .…”

“…Of the studies that listed sources of funding, the most commonly cited sources were the National Institutes of Health (n = 5), the American Cancer Society (n = 3), and the Susan G. Komen Foundation (n = 4). In total, 7 studies reported on GM status: 5 studies collected GM status and combined those individuals with SMs, 1 additional study included GMs as a distinct group, and 1 study focused on transgender and gender‐nonconforming patients …”

“…We identified 14 studies that characterized the mental health impact and degree of adjustment to cancer . In 1 large survey study of individuals with a history of cancer that compared SGM with propensity score‐adjusted heterosexual peers, SGM survivors reported higher rates of depression and relationship difficulty .…”

Breast and reproductive cancers in the transgender population: a systematic review

“…BRCA testing was performed in three cases; all tested negative . Thirteen transmen had been taking androgens for 1–15 years . Eight of these transmen had also undergone a mastectomy …”

“…Cross‐sectional studies and case reports . Five cases of ovarian cancer were reported, three in case reports and two in a cross‐sectional study . Three of these transmen had taken gender‐affirming hormones for 1–18 years .…”