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Talking About Your Sexual Orientation and Gender Identity With Your Cancer Care Team

Chasity Burrows Walters, PhD, RN, is the senior director of patient education and engagement and the founder and sponsor of the LGBTQ Clinical Advisory Committee at Memorial Sloan Kettering Cancer Center in New York, New York. Dr. Burrows Walters is also a member of the Leadership Council of the LGBTQ+ Employee Resource Network at her institution.

The chatter of feminine voices drifts into the hallway where Jamie stands frozen, too afraid to enter the room. He listens to their emotional stories about getting their loved ones through prostate cancer treatment, swapping tips and encouraging words. No wonder the cancer doctor had raved about this local cancer support group for the spouses of people with cancer.

Jamie takes a deep breath and walks through the door. The room falls silent. The social worker warmly thanks Jamie for coming before telling him that this support group was for caregivers. Tomorrow night’s group was for people with cancer.

Jamie’s husband never told his care team he was gay. No one told the support group leader to expect a man as one of the spouses. No one suggested an alternative support group.

Sharing your sexual orientation and gender identity with your provider can improve your care

Cancer treatment is a long journey, and most people find their relationships with their providers to be very important during their cancer experience. Sharing information about yourself lets you build better relationships with your providers and makes your visits feel more comfortable. It also lets you be fully present and feel free to talk about what’s important to you.

Sharing your sexual orientation and gender identity with your cancer care team opens the door to raising questions that may otherwise go unanswered. For example, how will treatment impact your gender expression? Who do you want to help make decisions about your care? Who do you want at your bedside?

When you’re open and honest with your care team, they know more about your needs. Only then can they recommend appropriate screenings, better explain how treatments and side effects may affect you, and make recommendations for support groups and other follow-up care. No one should face cancer alone. And when your providers see you for who you really are, they can take better care of you.

Discussing your identity with your health care team can be scary and difficult

Gender identity and sexual orientation are important parts of who we are. Yet many people go through their cancer treatment without telling their care team about these key pieces of their identity, often due to the barriers to care that exist for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people with cancer.

Cancer care has special challenges that may require sharing deeply personal information about who you are. For many people, it means leaving the comfort of your primary care network, completing new forms, and navigating unfamiliar processes.

There are also many members of the health care team involved in a person’s cancer care, which can mean navigating coming out over and over again. It’s a process that, for many, will improve in time, particularly as more health care groups are asking about sexual orientation and gender identity along with other personal information they collect and share through electronic health systems. But these conversations are not always easy, especially as many LGBTQ+ people have experienced discrimination in health care settings. The fear of sharing your sexual orientation or gender identity does not go away after a cancer diagnosis. But considering opening up to your health care team about these aspects of yourself can make a huge difference in your cancer care.

How to bring up your sexual orientation and gender identity with your cancer care team

A person who has cancer shouldn’t also have to worry if they’re in a safe space to talk about who they are. It’s important to feel connected with your cancer care team during your treatment. You should feel comfortable with them and where they practice, and the environment around you should feel friendly. When you’re at your visit, pay attention to things like: Do the images you see look like you? Do the forms you complete have the options that describe you?

Cancer gives people a lot to talk about. It’s common for people to feel overwhelmed with information during treatment, especially if they feel like they’re always asking questions or giving answers. Because of this, it can be hard to find time to bring up your sexual orientation and gender identity. This is why it’s a good idea to plan ahead.

Some tips for having this discussion with your cancer care team include:

  • Bringing it up before your exam, while you’re still in your own clothes. When you introduce yourself, this is a natural time to share information about yourself.
  • Building your pronouns into your introduction.
  • If you’re at an appointment with a spouse or partner, describe that relationship when you introduce them. The way you self-identify or describe your loved one tells your care team they should use those words, too.

Your cancer care team should listen to your questions and concerns. They should work hard to understand what’s important to you. If you feel nervous talking with them about your sexual orientation and gender, bring a friend or family member for support.

Please keep in mind that most hospitals are accredited by The Joint Commission, which means they have to meet specific standards and pass an on-site survey evaluating their patient care, and they cannot discriminate based on your gender or sexual orientation. If you don’t feel safe and respected, contact the hospital’s patient relations department immediately for help.

Finding a cancer care provider who is knowledgeable and respectful

Many people find health care providers by asking friends for a recommendation. You can also ask your local LGBTQ+ center, or search the GLMA Provider Directory. Or, find organizations committed to LGBTQ+ health by visiting the Human Rights Campaign’s Healthcare Equality Index.

Read more about finding an oncologist who’s an LGBTQ+ ally.

The author has no relationships to disclose relevant to this content.

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