Gender and sexually diverse people (GSD) experience disproportionate cancer burden in comparison to mainstream populations. Risk factors, social determinants of health, engagement with healthcare services, real and anticipated discrimination, maltreatment, assumptions and poorer health and wellbeing outcomes mean that while inclusion of GSD people is growing in some parts of the world, true equity is far from achieved.
Every health professional has or will treat someone who is lesbian, gay, bisexual, transgender, intersex, queer, asexual, questioning, or has sex or other intimate relationships with a person or people of the same sex. There is growing awareness of the importance of sexual issues for people affected by cancer, but how cancer impacts GSD people and how sexuality and gender relates to experiences of cancer and healthcare are less understood.
Every person should receive the best possible care and treatment delivered in a way that meets their personal, individual needs. It is the health professional’s responsibility to ensure that each person is informed and able to participate and make decisions that are right for them in relation to that care. Underpinning effective, safe, appropriate, and meaningful healthcare is communication between staff within healthcare contexts and the people who they engage with including patients and their significant others. Communication does not occur in a vacuum however; society and history shapes beliefs and the way that people behave and think, so communicating with GSD people in the context of cancer care and survivorship must be based upon an understanding and appreciation of these factors as well as of each person as an individual.
GSD people are themselves a diverse group with special, unique needs in relation to healthcare. Understanding some key principles for communicating with GSD people is vital for all health staff to ensure that every person experiences equitable care and health outcomes.