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The Importance of Disclosure for Sexual Minorities in Oncofertility Cases

Abstract

The lesbian, gay, bisexual, transsexual/transgender, and queer/questioning (LGBTQ) population is an understudied and underserved population often referred to as sexual minorities [1]. The labels “lesbian, gay, and bisexual” refer to sexual orientation [2, 3]. The terms “transsexual” and “transgender” refer to gender identities where an individual does not identify with the sex assigned to him or her at birth (i.e., biological sex) [2, 3]. The labels “queer” and “questioning” may be used to refer to either sexual orientation or gender identity [4, 5]. There are several other terms associated with this community (e.g., “gender fluid, genderqueer, two-spirit”) as well as nomenclature used within these groups that is typically not acceptable to be used by nonmembers (e.g., dyke) [6, 7]. It is estimated that 3–12 % of the United States population identifies as gay, lesbian, or bisexual and 1–3 % are transgender [8].

Keywords

  • LGBTQ
  • Cancer
  • Disclosure
  • Sexual orientation
  • Infertility
  • Fertility preservation

Laura 33 years old, is seeing oncologist Dr. Smith to discuss results of her recent biopsy. Dr. Smith has reviewed Laura’s social and medical history, which includes a previous benign biopsy for testicular cancer and says, “Your name is Laura? That’s an unusual name for guy?” The patient responds, “I identify as female and chose the name Laura.” Dr. Smith, uncertain of how to respond, proceeds to explain the cancer diagnosis. “You have colorectal cancer and your treatment will include both alkylating agents and radiation. This type of treatment can render you sterile but that is probably not a concern with folks like you. “Laura responds, “Why would you say that? I’ve always wanted to have children.” Dr. Smith, still uncertain how to address his patient says “I’m going to call my nurse in here to talk to you, her son is gay and she knows more about this stuff than I do.” Laura, reeling from the cancer diagnosis is crying and says with anger “I’m not gay, I’m transgender, and I am still a human being.”

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Fig. 13.1

Abbreviations

AAP:

American Academy of Pediatrics

ACOG:

American College of Obstetricians and Gynecologists

ART:

Assisted Reproductive technology

ASCO:

American Society of Clinical Oncology

AYA:

Adolescent and young adult

CDC:

Centers for disease control and prevention

ESHRE:

European Society of Human Reproduction and Embryology

FP:

Fertility preservation

IOM:

Institute of Medicine

LGBTQ:

Lesbian, gay, bisexual, transsexual/transgender, queer/questioning

NCCN:

National Comprehensive Cancer Network

QoL:

Quality of life

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Tamargo, C., Quinn, G., Schabath, M.B., Vadaparampil, S.T. (2017). The Importance of Disclosure for Sexual Minorities in Oncofertility Cases. In: Woodruff, T., Gosiengfiao, Y. (eds) Pediatric and Adolescent Oncofertility. Springer, Cham. https://doi.org/10.1007/978-3-319-32973-4_13

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