Investigators have uncovered how current and historical experiences—including discrimination, violence, family rejection, and exclusion—have created a legacy of distress and fear, adversely impacted trust in health-care professionals, and resulted in unmet needs in cancer survivorship and care for patients in the lesbian, gay, bisexual, transgender, queer and/or intersex (LGBTQI) community, according to a study published by Power et al in Frontiers in Oncology. The findings also revealed that social support often provided by partners and other chosen family—including intimate partners and other individuals in the LGBTQI community—may buffer the negative impacts of stress and help LGBTQI patients cope with cancer.
Study Methods and Results
The study drew on qualitative findings from the Out with Cancer study—which involved online surveys completed by 430 LGBTQI patients with a range of tumor types, age ranges, sexual and gender identities, and intersex status, as well as 132 partners and caregivers. The investigators explained that the study highlighted the complexities of caring for LGBTQI patients with cancer and the impact of both a legacy of mistrust and the power of peer support.
“We know that LGBTQI [patients] with cancer and their [caregivers] report poorer psychological outcomes than patients in the general cancer population,” noted first study coauthor Jane M. Ussher, PhD, Professor of Women’s Health Psychology at the Translational Health Research Institute and the School of Medicine at Western Sydney University. “It’s not unexpected that LGBTQI [patients’] experiences of historical and present-day discrimination are contributing to stress they felt receiving care as a member of a minority group—but that this was able to be buffered by social support is a positive way forward,” she added.
The investigators found that LGBTQI patients and their caregivers were not passive when facing discrimination and exclusion in cancer care, demonstrating agency and resistance through collective action and advocacy—despite the chronic, cumulative impacts of minority stress. The study further demonstrated that having supporters resulted in a positive impact on the patients; however, some patients lacked support because they did not have a partner, were rejected by their family of origin, and had no backing from peers within the LGBTQI community. The investigators found that this gap in caregiver and peer assistance increased the patients’ vulnerability to poor psychological well-being.
Conclusions
“There is a need for cancer health-care professionals and support services to be aware of and responsive to these potential vulnerabilities, including the intersectional differences in experiences of minority stress and social support. There is also a need for recognition and facilitation of social support among LGBTQI [patients] with cancer and their [caregivers],” concluded Dr. Ussher.
Disclosure: The research from the Out with Cancer study was funded by an Australian Research Council linkage grant. For full disclosures of the study authors, visit frontiersin.org.
