Once diagnosed with cancer, LGBT people face some unique challenges. First, they have to decide whether it is safe to come out to their oncologist and treatment team. Even those people who are generally comfortable revealing their sexual orientation or gender identity may be more guarded and fearful of alienating a provider when they have a life-threatening illness such as cancer. This is regrettable, as the latest research supports the idea that an empathic oncologist can help survivors understand their diagnosis, endure difficult treatments and perhaps even fare better medically.
Family support is critical for cancer survivors. LGBT people create families in ways that are often invisible or unwelcome in a health care setting. Intake forms ask only about legal marital status, obscuring or rejecting same-sex non-legal partnerships. Providers may not then know who to invite into their office for important meetings about diagnosis and treatment decisions. Many LGBT cancer survivors report that their partners were not permitted in the emergency room with them, leaving them alone and frightened.
Almost all cancer treatments affect sexual functioning. However, oncologists and social workers rarely address the impact on LGBT sexuality adequately. For example, after treatment for prostate cancer, the most common cancer diagnosed in men, the experts say that most men can still have an erection “good enough for intercourse”. This is not a meaningful measure for a gay man who requires a stronger erection for anal sex or needs to know if he can safely have receptive anal sex. Even when the patient is brave enough to ask, the oncologist is often ill equipped to answer.
Support groups for cancer survivors and caregivers also pose extra challenges for LGBT people. The partner of the lesbian breast cancer survivor will probably be the only woman in her caregiver group. Similarly, the gay male partner of the prostate cancer survivor will, most likely, be the sole man in his caregiver group. This greatly diminishes the likelihood of receiving knowledgeable support for the some of the stresses and sexual difficulties they have.