Abstract
Purpose
The purpose of this study was to explore healthcare experiences of Black and White sexual and gender minority (SGM) cancer survivors across the cancer care continuum.
Methods
This was a qualitative analysis of two focus groups and eight individual interviews completed as part of a larger initiative using a community-engaged research approach to reduce cancer disparities in marginalized communities. There was a total of 16 participants in the study (9 were White, 7 were Black) and data were collected between 2019 and 2020.
Results
Three main themes emerged from the thematic analysis: strategically coming out, provider preferences, and health system challenges. Participants noted that they often came out through their support system, decided to come out based on the relevance of their SGM identity that they perceived, and expressed a desire for privacy. Lack of an accessible and competent PCP was tied to delayed cancer diagnosis and many participants voiced a preference for consistency when they found a provider they liked.
Conclusions
Providers across specialties can address barriers for SGM patients by not making assumptions about patient sexual orientation or gender identity. Institutions should systematically collect sexual orientation and gender identity information. Primary care providers should be aware that due to resistance to switching from trusted providers, they may need to take greater initiative to facilitate cancer screenings for their patients when appropriate or take special care when making referrals to ensure they are using SGM-affirming providers.
Implications for Cancer Survivors
SGM cancer survivors often benefit from a cultivating relationship with a trusted PCP or other provider.
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Funding
This work was supported by the Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington Engagement Award (6252-WSU).
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DAS: conceptualization, formal analysis, funding acquisition, investigation, methodology, project administration, supervision, validation, writing—original draft and review, and editing. LK: data curation, formal analysis, validation, visualization, writing—original draft and review, and editing. FH: data curation, formal analysis, validation, writing—original draft and review, and editing. JH: visualization, writing—original draft and review, and editing. MM: validation and writing—review and editing. PM: conceptualization and writing—review and editing. HT: conceptualization, funding acquisition, investigation, methodology, supervision, and writing—review and editing.
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Shires, D.A., Kattari, L., Hosea, F. et al. Healthcare experiences among Black and White sexual and gender minority cancer survivors: a qualitative study. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01504-z
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DOI: https://doi.org/10.1007/s11764-023-01504-z