It takes more than rainbows: Supporting sexual and gender minority patients with trauma‐informed cancer care

Abstract

Background/PurposeThe American Society of Clinical Oncology has called for an increased priority to improve cancer care for sexual and gender minority (SGM) populations because of heightened risk of receiving disparate treatment and having suboptimal experiences, including perceived discrimination. We demonstrate how integrating trauma‐informed care (TIC) principles across the cancer continuum is a key strategy to improving care delivery and outcomes among SGM populations.MethodThis empirically informed perspective expands on the concepts generated through the American Society of Clinical Oncology position statement and uses the Substance Abuse and Mental Health Services Association’s “Four Rs” Toward Trauma Informed Care: Realize, Recognize, Response, and Resist Traumatization.ResultsRecommendations for each component of TIC include: (1) Realize: Implement SGM cultural humility training, including modules on SGM‐specific trauma, discrimination, harassment, and violence; (2) Recognize: Routinely screen for emotional distress using methods to ensure privacy, and/or normalize mental health screenings to cancer patients; (3) Respond: Create and widely disseminate policies and patients’ rights that prohibit discrimination and ensure access to gender‐neutral clinical environments; and (4) Resist Traumatization: Establish and respond to quality metrics (e.g., standardized patients, patient satisfaction surveys) that are informed by a community advisory board with the purpose of ensuring and maintaining quality care.Conclusions and ImplicationsIntegrating TIC principles into cancer care for SGM populations is crucial to address disparities in treatment and clinical outcomes. Our recommendations offer practical approaches for oncology teams to implement TIC care and ensure equitable and inclusive cancer care for patients and their families.

A Needs Assessment Approach for Adolescent and Young Adult Sexual and Gender Diverse Cancer Survivors

“…In determining where additional support is needed among SGD AYAs, it was important for Escape to apply a critical lens in reassessing their mission identifying the starting question of why it is they exist (Figure 2). In doing this, they determined that the purpose of the organization is to fill the gaps in supportive resources for SGD AYAs and deliver these resources through an intersectional, person-centered, and trauma-informed approach [35]. Escape also provides education to institutions and community organizations working to better serve SGD AYAs and acts as a partner in addressing the unique needs of this population in oncology.…”

“…It has always been the goal for Escape to train medical providers, researchers, and cancer advocates on SGD service provision. Analysis of survey responses was helpful in identifying specific skills and education, and Escape plans to create a curriculum that will help medical providers ground their communications in cultural humility and trauma-informed care, educate them on the unique support needs of SGD AYAs, and emphasize the importance of trusting a patient's experience while letting them lead [35].…”