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William J. Gradishar, MD, FACP, FASCO


Addressing the Health-Care Struggles of Transgender and Gender-Diverse Patients With Cancer

By: Chris Schimpf, BS
Posted: Thursday, September 21, 2023

Through the presentation of an illustrative case of the journey of a person with breast cancer, published in JNCCN–Journal of the National Comprehensive Cancer Network, Elizabeth J. Cathcart-Rake, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues discuss ways to improve the poorer outcomes among transgender and gender-diverse patients with cancer—versus those of cisgender patients. Citing barriers to the self-disclosure of noncisgender identities in many health-care settings, the authors pointed out that the cancer-specific needs of this patient population are likely underestimated as a result of incomplete and inconsistent data across registries and databases. Therefore, their recommendations center on breaking down the barriers that have hindered these patients’ from receiving appropriate care.

First, they suggested that even when health-care records do not contain explicit information regarding gender identity, records may be assessed for codes and information to indicate transgender and gender-diverse identities. The authors noted that such methodologies have been validated in prior studies and could serve as an effective starting point to better understand cancer outcomes and patient needs in this population.

Second, they recommended social media as a valuable and underexploited source of both quantitative and qualitative data. However, they stressed the importance of well-meaning intent and the building of trust when accessing online communities.

Third, they emphasized the importance of gender-affirming clinics, where trust between patients and clinicians is high, as vital sources of data. In addition, they called for integrating research into these spaces.

And finally, the authors stressed the critical need for health-care systems and practitioners to examine and eliminate their own biases to create and maintain truly welcoming and nonjudgmental spaces. In such an environment, transgender and gender-diverse patients will feel comfortable disclosing their gender identities from the outset.

Disclosure: The study authors reported no conflicts of interest.

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