Shine includes many people in the LGBTQI+ community. We have a growing LGBTQI+ community and you can learn more about this element of our work here.
We know how important it is for our member’s whole selves to be welcomed and supported, especially after a cancer diagnosis. We believe that health care should always be patient-centred but we also know that’s not always what happens and that many in the LGBTQI+ community face significant barriers when accessing healthcare and support.
Research has found that LGBTQI+ people with cancer are less likely than heterosexual people to believe that they have been treated with dignity and respect by hospital staff, and are also more likely to report high levels of isolation within the healthcare system. Many health systems still focus on male-female binaries and some healthcare professionals are unaware of differences in healthcare needs for an LBGTQI+ person or may have assumptions or about you, your lifestyle, how or who you have sex with, or your feelings. They may not understand how the needs of a transgender person differ to that of a cisgender individual, or that a gay person may be interested in preserving their fertility. There can be a lack of understanding of the priority a transgender person may place on continuing hormones during treatment regardless of how this may interact, or how some treatments may interact with PrEP.
The effect of all of this can be anything from annoying and draining, to devastating. Bias or ignorance on the part of health care providers can mean being denied access to services or treatment options others would have been given, for example preservation of symmetry in surgery or fertility preservation.
Going through cancer treatment is a daunting time so it helps to feel comfortable with your healthcare providers. If it feels safe to do so, you may want to tell them about your sexuality, correct pronouns, relationship status and your previous medical experience. However, you should only do this if you feel safe; you may wish to speak to a support group or network first. Remember that it is illegal to discriminate against you because of your sexual orientation or gender identity, and being able to speak openly could help your team to provide you with care that is tailored to you. Remember that if you feel your needs are not being met or you do not feel comfortable discussing your needs with a member of your team that you are able to ask for a different doctor, nurse or team to support you.
NHS Rainbow Badges are one way the NHS is trying to enable better healthcare for the LGBTQI+ community; they helps you to spot an ally within a team. The badge shows that the healthcare member has pledged to reduce inequalities and to provide support and signposting to LGBTQI+ people. This is the beginning and more does need to be done to truly make healthcare inclusive.
If you are in a relationship or sexually active, some of the treatments may impact on your sexual experience. Some treatments can cause sexual side effects such as erectile dysfunction, vaginal dryness, not being able to orgasm, impact on your anal canal or your ability to have children. Dealing with cancer and side effects of treatment may also change the way you have or think about sex or how you feel about yourself. Some treatments can also affect your fertility. If you are interested in having children and want to discuss your options around preserving your fertility, speak with your consultant. You can also look at Shine’s resources on sex and fertility.
