LGBTQI+ and navigating a cancer diagnosis

Research shows that as an LGBTQI+ person diagnosed with cancer you may have to deal with a number of unique challenges, including:

• health professionals making assumptions about your sexual orientation, gender and sex characteristics, which can make you feel invisible
• anxiety about coming out as LGBTQI+ and fear of negative reactions from health professionals
• higher levels of depression and anxiety because of a history of marginalisation, violence, stigma, exclusion and discrimination (sometimes called minority stress)
• difficulty having your partner/s or other significant people recognised as your family
• less or no support from your family of origin
• little or no LGBTQI+ specific cancer information or support
• lack of knowledge among health professionals about issues specific to LGBTQI+ people.

Screening is organised testing to find cancer before any symptoms appear. Finding cancer early and when it hasn’t spread often makes it easier to treat. In  Australia, there are screening programs for breast, cervical and bowel cancer. Most people who are in a certain age group and who have a Medicare card, will receive an invitation in the mail to get screened.

LGBTQI+ people may face several barriers to screening.

Ask your doctor what screening tests are right for your body. It is now possible to collect your own sample for the cervical screening test. This needs to be done at the doctor’s office. For more information on screening, visit the Can We or Trans Hub websites.

The causes of many cancers are unknown, but some factors may increase the risk if you’re LGBTQI+. Risk factors for intersex people depend on their specific variation. Cancer risk has often been used as a reason for medical treatment of intersex people during childhood.

Delaying or avoiding cancer screening – Research shows that many LGBTQI+ people delay or avoid screening. This may be because they think mammograms or cervical screening are not for them because of who they have sex with. Trans people may find screening uncomfortable and upsetting. Trans, gender-diverse and intersex people may not receive appropriate screening reminders. Missing screening tests may mean cancer is diagnosed at a later stage when it is harder to treat.

Higher risk for smoking- and alcohol-related cancers – Studies show that there are higher rates of smoking and drinking alcohol among some LGBTQI+ people, often because of minority stress. These factors increase the risk of several cancers including breast, mouth, and bowel cancer. Smoking also increases the risk of lung and cervical cancers.

Higher risk of HPV (human papillomavirus) – This very common sexually transmitted infection causes many types of cancer, including cervical, anal, throat  (oropharyngeal), penile, vulvar and vaginal. HPV can be passed on sexually, including by fingers and oral sex, or through sharing sex toys. The HPV vaccine can  protect against the virus. For more information, visit the HPV Vaccine and The Bottom Line websites.

Living with HIV – Living with HIV/AIDS may make you more likely to develop some cancers. These are known as AIDS-defining cancers and include Kaposi sarcoma, aggressive B-cell non-Hodgkin lymphoma and cervical cancer. Some cancers are common in people living with HIV but are classified as non-AIDS-defining. They include anal, liver, oral cavity and pharynx and lung cancers, and Hodgkin lymphoma.

Lower rates of pregnancy – Pregnancy before age 30, breastfeeding and using oral contraceptives may all offer some protection from breast cancer and  gynaecological cancers. Lesbian, bisexual and trans people are statistically less likely than cisgender heterosexual women to have a child before age 30. If you  haven’t had children, you may not have breastfed or had a break in your menstrual cycle.