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

Abstract

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.

Minority stress, psychosocial resources, and psychological distress among sexual minority breast cancer survivors.

“…This process, often referred to as “coming out,” can be stressful, particularly in the context of cancer (Boehmer & Case, 2004). Given that cancer treatment requires socially intimate interactions with multiple new providers in new clinical settings, and that the beliefs of individual providers or the culture of a healthcare system may not be immediately apparent, sexual minority cancer patients must make a decision about coming out to each provider with whom they interact and may be concerned that their care will be compromised if a provider feels negatively about their sexual identity (Kamen, Smith-Stoner, Heckler, Flannery, & Margolies, 2015). …”

Characterizing Sexual Orientation Disclosure to Health Care Providers: Lesbian, Gay, and Bisexual Perspectives

“…Recent studies of LGBQ patients in metropolitan areas revealed that approximately 70-80% of patients disclosed to providers (Durso & Meyer, 2013;Kamen et al, 2015). Alternatively, approximately 30% of patients avoid sexual orientation disclosure (Eliason & Schope, 2001;Petroll & Mosack, 2011).…”

“…Recent research has documented the prevalence of sexual orientation disclosure to providers (e.g., Durso & Meyer, 2013;Kamen, Smith-Stoner, Heckler, Falnnery, & Margolies, 2015). However, similar to other disclosure contexts, little is known about how information management of the sexual orientation disclosure occurs (Afifi & Steuber, 2009;Mosack et al, 2013).…”

Addressing Fertility Preservation for Lesbian, Gay, and Bisexual Adolescents and Young Adults with Cancer

“…[6][7][8] Stigmatizing encounters or fears of expected bias and mistreatment have resulted in a certain unwillingness to disclose sexual orientation in healthcare settings. [9][10][11][12] Non-disclosure for LGB adults may, consequently, have significant health and mental health risks. 6 A study conducted in the United States, for instance, demonstrated that non-disclosure among LGBs with cancer increased distress and negatively affected health outcomes and subsequent referrals to suitable care settings.…”