Survey Identifies Gap in Culturally Competent Cancer Care for LGBTQI+ Latinx Population

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Most Latinx people who are LGBTQI+ (lesbian, gay, bisexual, transgender, queer, and intersex) reported being reluctant to share their gender identity and/or sexual orientation with a health-care provider, and a majority have never received cancer information tailored for their community, according to City of Hope–led survey results that were presented recently at a meeting on the Science of Health Care Disparities in Racial/Ethnic Minorities and the Medically Underserved, held by the American Association for Cancer Research (AACR) in association with the AACR Minorities in Cancer Research Council.

Mayra Serrano, MPH, CHES

Mayra Serrano, MPH, CHES

LGBTQI+ individuals are at higher risk of developing cervical and oral cancers, and Latinx people have a higher risk of developing virus-associated cancers. Yet substantial cancer health disparities exist for both LGBTQI+ individuals and Latinx people, said Mayra Serrano, MPH, CHES, Manager of the Center of Community Alliance for Research and Education at City of Hope, Duarte, California.

Health Disparities Among Double-Minority Population

In conjunction with the Latinx Task Force, a volunteer coalition of individuals in the Greater Los Angeles area working to promote community-wide health and wellness, Ms. Serrano and her colleagues conducted a survey in an effort to understand cancer-related knowledge and behavior within the LGBTQI+ Latinx community.

“Together, this group is a double minority whose increased risk for certain cancers, unfortunately, is not currently being addressed,” said Ms. Serrano. In a statement issued by City of Hope, she added, “We hope that our survey results add to a conversation that needs to be had about how people—regardless of their gender, sexuality, race, or ethnicity—should receive equal and appropriate health treatment and disease prevention education.”

Survey Findings

A total of 176 people completed the survey as of June 2019. Most (74%) identified as Latinx, 82% identified as cisgender, 40% identified as gay, and 28% identified as queer. Some respondents shared their gender identity or sexual orientation with providers (44%), but those who identified as bisexual were less likely to share that information, according to the study findings.

Most respondents (73%) said they were afraid to share their gender identity and/or sexual orientation with health-care providers. People who identified as queer were more likely to be reticent about sharing their sexual orientation.

The investigators reported the following findings from their survey:

  • A total of 91% of respondents said they have never received LGBTQI-tailored cancer information
  • Of respondents between the ages of 21 and 29 who were eligible for Pap testing, 60% had not been tested in the past 3 years, compared with 22% of all eligible individuals in the United States
  • Of those eligible for a mammogram, 50% had not had one in the past 2 years, compared with 29% of all eligible individuals in the United States.

Cultural Incompetency

Examples of a lack of cultural competency occur when, for example, a health-care provider uses inappropriate gender pronouns in conversation or in written materials, or when a physician and support staff assume a patient is cisgender and heterosexual during discussions about sex.

“Results [from the survey] will guide future outreach to and education efforts for the LGBTQI+ Latinx community and their health-care providers,” Ms. Serrano said. “The early data suggest that there is an urgent need to train health-care providers how to make their practice more culturally competent, safe, and welcoming for LGBTQI+ Latinx communities.”