Omission of Sexual and Gender Minority Patients

Bare, Michael; Margolies, Liz; Boehmer, Ulrike

doi:10.1200/jco.2014.55.6126

Cited by 16 publications

(8 citation statements)

References 5 publications

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“…11 , 20 , 33–35 However, trans* and gender nonconforming people have been overlooked consistently in the research on cancer health and care. 22 , 36 To address this gap, the Cancer's Margins project ( ) critically examines binary constructions of sex and gender that are reified in the biomedical classification of certain cancers—breast, cervical, ovarian, uterine, vaginal, and vulvar—as “women's cancers.” 37 , 38 We seek to add a perspective informed by models of intersectional, gender-based health disparities, and report herein on trans* and gender nonconforming patients' cancer care and treatment experiences.…”

Section: Introductionmentioning

confidence: 99%

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

2016

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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.

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Section: Introductionmentioning

confidence: 99%

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

2016

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“…In the limited literature on LGBT cancer‐related outcomes and side‐effects, males and females have reported different engagements in health behaviors and different levels of health‐related quality of life . Much of the work on psychological distress among LGBT cancer survivors has focused specifically on lesbian and bisexual females ; more research is needed on gay and bisexual males , as well as transgender survivors .…”

Section: Introductionmentioning

confidence: 99%

Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors

et al. 2015

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Objective Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress. Methods Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex. Results Relative to heterosexuals, LGBT cancer survivors reported a higher number of depression and relationship difficulty symptoms. Exploratory analyses revealed that disparities in number of symptoms were visible between gay, bisexual, and transgender versus heterosexual men but not between lesbian, bisexual, and transgender versus heterosexual women. Conclusions This study highlights several disparities in psychological distress that exist between LGBT and heterosexual survivors. A need remains for interventions tailored to LGBT survivors and for studies examining disparities within subgroups of LGBT survivors.

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“…Lesbian, gay, bisexual, and transgender (LGBT) patients with cancer are often invisible in cancer studies conducted in the United States (Bare, Margolies, & Boehmer, 2014). Large, nationwide cancer registries do not collect data on sexual orientation, making identification of these patients difficult or impossible (Howlader et al, 2010).…”

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confidence: 99%

Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers

Kamen

Smith-Stoner

Heckler

et al. 2014

Oncology Nursing Forum

Self Cite

125

102

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Purpose/Objectives To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health. Design Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches. Setting Online, Internet-based. Sample 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers. Methods Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point. Main Research Variables Demographics, which provider(s) delivered the patients’ cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health. Findings 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients’ support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health. Conclusions Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients. Implications for Nursing Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients’ care.

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Omission of Sexual and Gender Minority Patients

Cited by 16 publications

References 5 publications

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

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

Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors

Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers

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