Cancer Care in LGBTQ+ Communities: Closing the Gap

Cancer affects everyone, but LGBTQ+ communities face extra challenges, and closing this gap requires equitable, respectful, and informed cancer care. Discrimination, socioeconomic marginalisation, and non-inclusive policies worsen this burden. This healthcare inequality is widespread and needs our attention to create inclusive oncology care.

What are the different risk factors?

LGBTQ+ communities face different risk factors. For transgender people, using gender-affirming hormone therapy (GAHT) can induce certain risks, like high-dose estrogen increasing breast cancer risk. Low screening rates are another main issue; gay and bisexual men may not get their HPV vaccinations or anal cancer screenings. Some other factors include minority stress and coping mechanisms, like higher smoking and alcohol consumption rates, which are linked to cancer risks as well. 

Barriers that delay early diagnosis

Some other factors include minority stress and coping mechanisms, like higher smoking and alcohol consumption rates, which are linked to cancer risks as well. Fear of isolation or discriminatory treatment often leads people to delay or avoid screenings. Heteronormative healthcare systems often lead to misgendered intake forms and limited privacy during preventive care. Oncologists, staff, and other healthcare workers must ask affirming, comprehensive sexual orientation and gender identity (SOGI) questions to check the risk factors associated with them.

Treatment challenges

Once treatment begins, many LGBTQ+ patients struggle with provider bias and a lack of LGBTQ+-specific training among oncology staff. When doctors don’t understand hormone therapy or surgical history, the care they provide often falls short. When care teams ignore needs such as gender-neutral facilities or recognition of chosen family, treatment adherence and quality of life suffer. These challenges require competency training on inclusive oncology care. In 2022, a free cancer-screening drive for 75 transgender individuals in Nagpur (HCG NCHRI Cancer Centre) highlighted both the urgent need and the potential for inclusive, community-driven oncology care in India.

What true care needs

Minority stress and long-term stigma strongly affect mental health in LGBTQ+ communities. Systemic prejudice, discrimination, and a non-affirming environment for cancer care can cause chronic stress and can negatively impact treatment adherence, resulting in poorer outcomes. Psychosocial support and sensitivity to their unique identity and relational structures need to be integrated into the care.

Inclusive cancer care requires many structural and cultural changes. With the development of affirming clinics that focus on supporting LGBTQ+ patients. Simple changes like inclusive forms and pronouns are essential. Communication that respects patients' identities and life context can build trust in these patients. Policies must mandate SOGI data collection, enforce non-discrimination protections, and fund research to reduce LGBTQ+ cancer disparities.