Cancer screening rates are lower for many in the 2SLGBTQ+ community, which can lead to cancer being caught at a later stage, when there are less treatment options available.
Dr. Ed Kucharski, Chief Medical Officer for Casey House and Assistant Professor at the Temerty Faculty of Medicine, University of Toronto, says there are many barriers that may prevent 2SLGBTQ+ people from accessing cancer screening programs as well as healthcare in general.
Fear or experience of homophobia or transphobia, having a health-card gender marker that is different from how one looks, or bad past experiences all create barriers, he says. In addition, being focused on other healthcare concerns might prevent cancer screening conversations from happening.
Dr. Kucharski has 5 Tips for Healthcare Providers when it comes to discussing cancer screening with 2SLGBTQ+ patients:
Start the conversation:
We know that cancer screening can help catch cancer early and save lives. Anyone who is eligible for screening should be screened.
That said, remember it’s not one-size-fits-all and that you should consider a patient’s individual situation and needs when talking about screening.
Dr. Kucharski suggests healthcare providers discuss cancer screening using the words and pronouns the patient prefers.
“Speaking about a Pap test with a trans man, for example, you might instead refer to this as ‘cell collection from the front’,” he says. “But again, there’s no blanket approach – talk to your patient about what words they prefer.”
Help ease the way:
As a healthcare provider, do what you can to help make the screening process easier for your patient. If you are recommending a trans man undergo mammography screening, you could call ahead and let the clinic know that this person will be presenting as male, Dr. Kucharski said. That way, the provider can assess if this clinic can provide culturally competent care to the patient and also allows the clinic to get it right when the patient arrives. For example, using the correct name and pronouns if they don’t match the health card.
Cancer screening tests are unsettling to anyone. It can be even more unsettling for members of the 2SLGBTQ+ community who may have been met with homophobia or transphobia at other medical appointments, or even thinking about having a cervix or breasts when that is not in keeping with their gender identity.
“Please keep this in mind when discussing screening with your patients,” Dr. Kucharski said. “And remember, it’s not one-size-fits-all and it’s important to consider other options, like vaccination, if someone doesn’t feel comfortable participating in screening.”
There are good resources available for healthcare providers and patients. Here are some sites with good information:
Dr. Kucharski and Amy Bourns, with Allan D. Peterkin and Cathy Risdon edited Caring for LGBTQ2S People, published by University of Toronto Press in April 2022.