Lesbian, Gay, Bisexual, and Transgender Issues

Lisy, Karolina; Hulbert-Williams, Nick; Ussher, Jane M.; Alpert, Alison; Kamen, Charles; Jefford, Michael

doi:10.1093/med/9780190934033.003.0003

Cited by 3 publications

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“…At the same time, inclusive and reflective HCP provision of tailored information in response to individual needs, access to LGBTQI specific support groups if available, and acknowledgment of the need for visible signs of LGBTQI inclusion, serves to address gaps in generic cancer information and support for LGBTQI people and their carers ( 4 , 6 , 28 ). It also ensures that treatment decision-making is informed by LGBTQI patient needs and the potential impact of cancer treatment on identities and relationships ( 15 , 75 ).…”

Section: Discussionmentioning

confidence: 99%

“…The materiality of the clinical context needs to be improved in order to facilitate SOGI disclosure and address LGBTQI patient needs. This includes visible indicators of LGBTQI inclusivity in clinics, health service websites, and patient support information; acknowledgement of SOGI status on intake forms, and provision of LGBTQI-specific information on issues such as sexual health, bodily changes, and the concerns of transgender and intersex people ( 22 , 75 , 104 ). Onward referral services are needed to provide support for HCPs when patients require LGBTQI-specific expert interventions ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

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LGBTQI Inclusive Cancer Care: A Discourse Analytic Study of Health Care Professional, Patient and Carer Perspectives

et al. 2022

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BackgroundAwareness of the specific needs of LGBTQI cancer patients has led to calls for inclusivity, cultural competence, cultural safety and cultural humility in cancer care. Examination of oncology healthcare professionals’ (HCP) perspectives is central to identifying barriers and facilitators to inclusive LGBTQI cancer care.Study AimThis study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers.Method357 oncology HCPs in nursing (40%), medical (24%), allied health (19%) and leadership (11%) positions took part in a survey; 48 HCPs completed an interview. 430 LGBTQI patients, representing a range of tumor types, sexual and gender identities, age and intersex status, and 132 carers completed a survey, and 104 LGBTQI patients and 31 carers undertook an interview. Data were analysed using thematic discourse analysis.ResultsThree HCP subject positions – ways of thinking and behaving in relation to the self and LGBTQI patients – were identified:’Inclusive and reflective’ practitioners characterized LGBTQI patients as potentially vulnerable and offered inclusive care, drawing on an affirmative construction of LGBTQI health. This resulted in LGBTQI patients and their carers feeling safe and respected, willing to disclose sexual orientation and gender identity (SOGI) status, and satisfied with cancer care. ‘Egalitarian practitioners’ drew on discourses of ethical responsibility, positioning themselves as treating all patients the same, not seeing the relevance of SOGI information. This was associated with absence of LGBTQI-specific information, patient and carer anxiety about disclosure of SOGI, feelings of invisibility, and dissatisfaction with healthcare. ‘Anti-inclusive’ practitioners’ expressed open hostility and prejudice towards LGBTQI patients, reflecting a cultural discourse of homophobia and transphobia. This was associated with patient and carer distress, feelings of negative judgement, and exclusion of same-gender partners.ConclusionDerogatory views and descriptions of LGBTQI patients, and cis-normative practices need to be challenged, to ensure that HCPs offer inclusive and affirmative care. Building HCP’s communicative competence to work with LGBTQI patients needs to become an essential part of basic training and ongoing professional development. Visible indicators of LGBTQI inclusivity are essential, alongside targeted resources and information for LGBTQI people.

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