When using a holistic approach to cancer care, it’s important for providers to review the entire medical history, including personal information and even the patient’s sexual orientation. Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Pride Month is celebrated annually in June, and this patient population can have unique healthcare needs when it comes to cancer prevention, screening, treatment, and survivorship.
Some LGBTQ cancer survivors have had to face the following situations when seeking treatment1:
- Healthcare providers assuming that everyone is “straight” and identifies with the sex they were assigned at birth
- Receiving information, resources, and support from their providers that only address the needs of heterosexual patients with cancer
- Missing recommended follow-up cancer screenings and survivorship care visits because of perceived judgment from providers or other barriers to proper care.
Clearly, every patient with cancer deserves the same quality of care. LGBTQ patients should seek providers who understand their unique healthcare needs. For instance, transgender and intersex individuals may see the most discrepancy in care, because they take exogenous hormones that modify the risks for cancer. When looking at the screening needs for transgender and intersex individuals, many providers may not know that these individuals are still at risk for certain types of cancer, even after transitioning. Transgender women older than age 50 who have more than 5 years of estrogen exposure should schedule mammogram screenings, especially because estrogen is a known risk factor for breast cancer. Transgender men older than age 21 who still retain a cervix will still need to have cervical exams and be tested for HPV infection. Testosterone may alter their histology, which makes Pap smears difficult to read.2
The reality is that we still don’t know enough about the LGBTQ population to be able to provide adequate care. Many of the large national cancer registries and surveys of cancer incidence don’t collect data about sexual orientation or gender identity. This leaves the entire population of LGBTQ cancer survivors out of important studies and data collection that could help to improve their care.3
The LGBTQ patient population faces a disproportionate burden related to cancer because of the lack of data about this population, a misunderstanding of this population by providers, and a lack of resources and education given to these patients so they can be aware of their cancer-related risks.