The importance of disclosure: Lesbian, gay, bisexual, transgender/transsexual, queer/questioning, and intersex individuals and the cancer continuum

Quinn, Gwendolyn P.; Schabath, Matthew B.; Sánchez, Julián; Sutton, Steven K.; Green, B. Lee

doi:10.1002/cncr.29203

Cited by 64 publications

(40 citation statements)

References 24 publications

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“…First, 61.2% of rural lesbians and 55% of urban lesbians had not been asked about their sexual orientation by their WHCP. These rates are disturbingly high given that knowledge of one's unique sexual identity and behavior on the part of women's healthcare providers is particularly crucial for the provision of appropriate and affirming care [68][69][70] . Given these low rates, it is not surprising that only 21.4% of rural lesbians and 25.4% of urban lesbians indicated that they had been provided with appropriate safe-sex education by their WHCP, with less than 20% of both samples reporting that their last HIV/STI screening was instigated by their provider.…”

mentioning

confidence: 99%

Women’s health care: the experiences and behaviors of rural and urban lesbians in the USA

Barefoot

Warren

Smalley

2017

Rural Remote Health

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Introduction:Previous research has consistently demonstrated that, in comparison to their cisgender heterosexual counterparts, lesbians face a multitude of women's healthcare-related disparities. However, very little research has been conducted that takes an intersectionality approach to examining the potential influences of rural-urban location on the health-related needs and experiences of lesbians. The purpose of this study was to quantitatively compare rural and urban lesbians' access to women's health care, experiences with women's healthcare providers (WHCPs), and preventive behavior using a large, diverse sample of lesbians from across the USA. Methods: A total of 895 (31.1% rural and 68.9% urban) lesbian-identified cisgender women (ie not transgender) from the USA participated in the current online study. As part of a larger parent study, participants were recruited from across the USA through email communication to lesbian, gay, bisexual, and transgender (LGBT)-focused organizations and online advertisements. Participants were asked to complete a series of questions related to their women's healthcare-related experiences and behaviors (ie access to care, experiences with WHCPs, and preventive behavior). A series of χ 2 analyses were utilized in order to examine rural-urban differences across dependent variables. Results: An examination of sexual risks revealed that relatively more rural lesbians reported at least one previous male sexual partner in comparison to the urban sample of lesbians (78.1% vs 69.1%, χ 2 (1, N=890)=7.56, p=0.006). A similarly low percentage of rural (42.4%) and urban (42.9%) lesbians reported that they have a WHCP that they see on a regular basis for preventive care. In terms of experiences with WHCP providers, relatively fewer rural lesbians indicated that their current WHCP had discussed/recommended the human papillomavirus (HPV) vaccination in comparison to urban lesbians (27.5% vs. 37.2%; (1, N=163)=8.36, p=0.004) when compared to their urban counterparts. No other significant rural-urban differences in preventive behaviors emerged. A similarly low percentage of rural and urban lesbians indicated that they have received the HPV vaccination (22.8% and 29.0%, respectively) and/or have had a HIV/STI screening (43.0% and 47.8%), Pap test (62.0% and 64.5%) or breast exam (59.2% and 62.8%), in the past 3 years. Conclusions: The current findings highlight that rural lesbians in the USA, in comparison to urban lesbians, may experience elevated health risks related to being more likely to have at least one previous male sexual partner, less likely to be recommended the HPV vaccination by a WHCP, and, for those 40 or older, less likely to receive routine mammogram screenings. Furthermore, rural lesbians appear to engage in similarly low rates of HPV vaccination and regular HIV/STI screenings, Pap tests, and clinical breast exams as their urban counterparts. Given the increased cervical and breast cancer risks associated with rural living, the current findings underscore the dire need f...

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confidence: 99%

Women’s health care: the experiences and behaviors of rural and urban lesbians in the USA

Barefoot

Warren

Smalley

2017

Rural Remote Health

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“…[6][7][8] Stigmatizing encounters or fears of expected bias and mistreatment have resulted in a certain unwillingness to disclose sexual orientation in healthcare settings. [9][10][11][12] Non-disclosure for LGB adults may, consequently, have significant health and mental health risks. 6 A study conducted in the United States, for instance, demonstrated that non-disclosure among LGBs with cancer increased distress and negatively affected health outcomes and subsequent referrals to suitable care settings.…”

Section: Disclosure Of Sexual Orientation For Lgb Ayas In Healthcarementioning

confidence: 99%

“…Conversely, when providers reflect upon sexual diversity and LGB specific issues and concerns in their practice, LGB AYAs are often more forthcoming, leading to positive health and mental health outcomes, and promoting health-seeking behaviours. 10 Practices that acknowledge LGB AYAs can increase access to care and foster equitable and informative service provision.…”

Section: Disclosure Of Sexual Orientation For Lgb Ayas In Healthcarementioning

confidence: 99%

Addressing Fertility Preservation for Lesbian, Gay, and Bisexual Adolescents and Young Adults with Cancer

Fantus

Gupta

Lorenzo

et al. 2015

Journal of Adolescent and Young Adult Oncology

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A dolescents and young adults (AYAs) with cancer are informed of their risk of sub-fertility and options for fertility preservation (FP) with the intention that, if possible, they are able to consider having biologically related children after treatment. Previous research indicates that assumptions of heterosexuality are a prevalent experience in healthcare among lesbian, gay, bisexual, and transgender (LGBT) populations. 1,2 Accordingly, pervasive heterosexual bias among providers may frame conversations on reproduction with AYAs with cancer, implying that fertility is only possible within a heteronormative cisgender (a person who identifies with their sex assigned at birth) opposite-sex relationship. 3 The purpose of this paper is to address the subpopulation of lesbian, gay, and bisexual (LGB) AYAs with cancer. The authors have intentionally chosen to focus on cisgender LGBs. Access to healthcare can be more stigmatizing and discriminatory for transgender populations than it is for cisgender sexual minorities 4 ; including transgender AYAs may indirectly promote comparisons to a cisgender norm. Thus, the unique experiences of the transgender community should be recognized independently. This paper will address issues of disclosure among LGB AYAs in healthcare and consider how providers can deliver informative FP options that are inclusive and respectful of LGB AYAs with cancer. The authors will draw on implications for healthcare practice and policy, and recommend strategies to enhance the applicability of educational materials and promote open and comprehensive practice.

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“…Although, the abbreviation suggests a homogeneous group, it includes a wide range of people 1 in part because it combines sexual orientation with gender identity. 2 Sexual orientation is the "enduring emotional, romantic, sexual or affectional attraction to another person". 3 For gay men, this attraction is primarily to men, and for lesbians, this attraction is primarily to women.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 This makes sexual minorities one of the most understudied and consequently underserved groups in health disparities research. 2 A history of perceived and endured social stigma attached to being a sexual minority ties into a reluctance of some, particularly older adults, to self-identify as LGBT, resulting in their absence from research and its findings.…”

Section: Introductionmentioning

confidence: 99%

Hospice and Palliative Care for Older Lesbian, Gay, Bisexual and Transgender Adults: The Effect of History, Discrimination, Health Disparities and Legal Issues on Addressing Service Needs

Farmer¹,

Yancu²,

King³

2015

Palliat Med Hosp Care Open J

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CitationFarmer DF, Yancu CN. Hospice and palliative care for older lesbian, gay, bisexual and transgender adults: The effect of history, discrimination, health disparities and legal issues on addressing service needs. ReviewPage 36 ABSTRACTThe acronym LGBT refers to groups of people who are lesbian, gay, bisexual and transgender, groups historically marginalized, mistreated, ignored by society and the health care delivery systems, including hospice and palliative care services. The purpose of this literature review was to explore the characteristics, history, health and health care disparities, social support systems and legal issues of LGBT persons with a particular focus on older adults, endof-life care, and ways in which hospice and palliative care organizations can better meet their needs. Despite the fact that sound enquiry is needed to improve health-related outcomes, what little research has been done with LGBT adults in general and, specifically, with older LGBT adults, has focused mainly on HIV/AIDS and other sexually transmitted diseases. As a social minority, LGBT persons are more likely to experience economic insecurity, lack health insurance, experience invisibility, and be victimized and mistreated. This is especially true of olderLGBT adults who grew up in a less tolerant era when sexual minorities were criminalized and stigmatized as pathological, sinful, and immoral. Their minority status has led to health issues and health care disparities, and requires health professionals to consider systems in a way that redefines family, addresses legal concerns, and responds with options of care unlike those of their heterosexual counterparts. With recent changes in societal attitudes and some progress in addressing legal concerns, hospice and palliative care organizations now have a unique opportunity to lead the health care community by pioneering culturally sensitive and appropriate methods to better serve this population.

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The importance of disclosure: Lesbian, gay, bisexual, transgender/transsexual, queer/questioning, and intersex individuals and the cancer continuum

Cited by 64 publications

References 24 publications

Women’s health care: the experiences and behaviors of rural and urban lesbians in the USA

Women’s health care: the experiences and behaviors of rural and urban lesbians in the USA

Addressing Fertility Preservation for Lesbian, Gay, and Bisexual Adolescents and Young Adults with Cancer

Hospice and Palliative Care for Older Lesbian, Gay, Bisexual and Transgender Adults: The Effect of History, Discrimination, Health Disparities and Legal Issues on Addressing Service Needs

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