by Mona Jhaveri - July 22, 2022

Biologically speaking, members of the LGBTQ population are no different than the general population. They span a range of ages, races, ethnicities, and religions. They live in cities and rural areas and are employed in various occupations.

However, it is undeniable that members of the LGBTQ population face a unique set of challenges when it comes to cancer care.

Alongside the high cancer burden (high levels of cancer incidence and cancer mortality) in the LGBTQ community due to higher levels of smoking, alcohol consumption, obesity, and other reasons, LGBTQ individuals face a number of cancer care systemic barriers. These barriers can prevent them from receiving a cancer diagnosis, accessing treatment, and adhering to recommended follow-up care.

This blog post explores these health disparities and offers insight into how the healthcare system can work to serve the LGBTQ community better.

Systemic ignorance

The first barrier to cancer care for LGBTQ people is ignorance. This can take the form of a lack of knowledge about the specific needs of this population or a failure to recognize that members of the LGBTQ community even exist.

For example, one survey shows that nearly 60% of healthcare professionals are not sure what the breast cancer screening guidelines for transgender patients are. Another study of general practitioners revealed that only 5% of them ask their patients about their sexual orientation, and most other questions they ask are framed in the context of heterosexuality and the nuclear family.

This lack of awareness and knowledge of the cancer risk and health and cancer care needs for an LGBT person is a direct result of a lack of proper training. According to the National LGBT Cancer Network, medical students receive fewer than five hours of education on LGBTQ health issues. Many healthcare professionals are not equipped to provide culturally competent patient care.

This can have serious consequences for members of any sexual minority, who may already feel they need to hide their sexual orientation or gender identity when seeking medical care. Not only do they have to worry about the possible judgment of their healthcare professional, but they also have to worry about whether or not their provider will be able to address their specific needs.

By not being aware of the proper guidelines for LGBTQ cancer care or by not asking their patients about their sexual orientation or gender identity, healthcare providers are inadvertently contributing to the health and cancer disparities that exist in this population.

Systemic discrimination

The second barrier to cancer care for LGBTQ people is cultural insensitivity. This can take many different forms, from using the wrong pronouns to making assumptions about a person’s sexual orientation or gender identity.

It can also manifest as overt discrimination, such as refusing to provide care or denying coverage for medically necessary treatments. In terms of transgender health, research suggests that an astounding 1 in 5 transgender people have been refused medical care due to their transgender status.

These instances of discrimination can have serious consequences for members of LGBTQ patients. When people feel like they cannot trust their health care provider or that they will be treated unfairly, they are less likely to seek out care. This can lead to delayed diagnosis and treatment, which can, in turn, lead to poorer health outcomes.

It is important for healthcare providers to be aware of their personal biases and to make an effort to be culturally sensitive when interacting with members of the LGBTQ community. Providers should also be mindful of the policies and procedures in place at their institutions to ensure that everyone is treated fairly and with respect.

Socioeconomic status

Another barrier to cancer care for LGBTQ people is their socioeconomic status. This refers to the fact that members of the LGBTQ community are more likely to experience poverty, unemployment, and housing insecurity than the general population.

Reasons for this are varied: 

  • Members of the LGBTQ community may have difficulty finding and keeping jobs because of discrimination
  • They may be less likely to have access to social safety nets like family support or government assistance
  • They may also have difficulty obtaining health insurance.

All of these factors can contribute to poorer health outcomes for members of the LGBTQ community. Those who cannot afford cancer treatment are more likely to delay or forego care altogether, which can lead to more advanced disease and poorer prognosis.

Healthcare providers need to be aware of the socioeconomic status of their patients and take steps to ensure that everyone has access to the care they need. This may involve providing financial assistance or connecting patients with community resources.

Mental health issues

It is a fact that LGBTQ people are more likely to experience mental health issues than the general population. While this is not a systemic barrier in and of itself, it does stem from the other obstacles that LGBTQ people face.

The discrimination, prejudice, and violence that members of the LGBTQ community experience can lead to increased rates of anxiety, depression, and post-traumatic stress disorder. These mental health issues can make it more difficult for people to cope with a cancer diagnosis and adhere to their treatment plan.

Moreover, due to increased feelings of isolation, helplessness, fear, and anger, LGBTQ cancer patients are more likely to turn to unhealthy coping mechanisms such as substance abuse. This can further complicate their cancer treatment and negatively impact their health outcomes.

It is important for healthcare providers to be aware of the increased mental health risks in the LGBTQ community and screen their patients accordingly. Providers should also be prepared to refer patients to mental health professionals or support groups if necessary.

How to fight the disparities

Addressing all of these systemic barriers that LGBTQ people face is a daunting task. It will require a concerted effort from healthcare providers, policymakers, and the general public.

That being said, there are steps that can be taken to improve the situation. Here are a few examples:

  • Increase awareness of the issues facing the LGBTQ community: This includes increasing public awareness of the issues that members of the LGBTQ community face and increasing awareness among healthcare providers.
  • Increase access to culturally competent care: This means ensuring that members of the LGBTQ community have access to providers who are sensitive to their needs and who understand the challenges they face. It also means increasing access to LGBTQ-specific cancer resources and support groups.
  • Decrease financial barriers to care: This can be done by increasing access to health insurance, providing financial assistance for cancer treatment, and connecting patients with community resources.
  • Increase access to mental health services: This includes increasing access to mental health professionals who are sensitive to the needs of LGBTQ people and providing support groups for LGBTQ cancer patients.

Conclusion

Being a member of the LGBTQ community is not easy. The systemic barriers to cancer care that exist for this population can have a serious impact on their health and well-being. They include but are not limited to discrimination, prejudice, and violence; lack of access to culturally competent care; financial barriers to care; and mental health issues.

It is important for healthcare providers to be aware of these issues and take steps to ensure that everyone has access to the care they need. This may involve providing financial assistance or connecting patients with community resources. It is also important for policymakers and the general public to be aware of these issues and work together to find solutions.

At the same time, we cannot forget that a cure for cancer has yet to be found. If you want to help fight cancer, the best thing you can do is donate to one (or more) of our active campaigns. We are working tirelessly to ensure that the best possible cancer-fighting technology gets into the hands of those who need it most.

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