LGBTQI+ and cancer - Unique health needs and common concerns

Diversity and Inclusion

We are guided by our values and commitments to ensure that everyone at Canteen feels respected, included and safe. We welcome the LGBTQI+ community and people from all cultures, backgrounds and abilities.

When you’re LGBTQ+

Lesbian, gay, bisexual, transgender, queer (LGBTQ+) and other young people with diverse sexualities and genders have unique health needs and concerns when diagnosed with cancer. 

If you’re a member of the LGBTQ+ communities, you might have experienced bullying and discrimination in the past for being different. This is even more likely if you’re trans or gender diverse. Facing bullying and discrimination can be stressful and upsetting, and may make it harder for you to ask for help in healthcare settings. You have the right to receive care in a culturally safe and inclusive health setting.

If you have a variation of sex characteristics and also identify with the LGBT communities, visit our page on Dealing with cancer when you’re born with intersex variations

For trans and gender-diverse people dealing with a cancer diagnosis, we have a helpful guide at canteen.org.au/trans-and-gender-diverse.
 

Common concerns you may have

Exploring your identity – It’s common for young people to question and explore their identity, including their sexual orientation and gender identity. Having to also deal with cancer can feel overwhelming. You might feel like you’ve always known that you LGBTQ+, or recently started to question or explore your identity. In either case, having treatment can make figuring out your sexual orientation and gender identity more complicated. 

Cancer can make you re-examine your identity. Some treatment side effects, such as hair loss and loss of a body part, can be upsetting because they change the things that make you, you. Or the changes may help affirm your identity. Whatever you’re feeling, it’s okay. Adjusting to the diagnosis is a process that you can take at your own pace.
 

I came out as gay when I was nearly 15, so just before I was diagnosed. I was still sort of very uncomfortable with myself, and still trying to figure everything out. And then I was diagnosed with cancer, and that sort of took precedence. Going, ‘Okay, I actually have to acutely survive this now. Not even think about that.’ (Carter, gay cis man, 20)


Feeling isolated – If you already feel different from your friends because of your sexual orientation and/or gender identity, cancer can make you feel even more isolated. And while cancer support groups are a way of connecting with people who understand what you’re going through on your cancer care journey, you might worry about feeling isolated or excluded when trying to discuss issues around relationships, sexuality, gender and fertility.

There are other organisations you can connect with that understand your LGBTQ+ experience. Canteen offers counselling in person, via phone, email or direct messaging. Minus18 provides support for LGBTQIA+ young people across Australia. You can also chat with a volunteer LGBTIQA+ counsellor at QLife on 1800 184 527, or via webchat: Chat.
 

Growing up with cancer as an adolescent, I already felt so different to my peers and so excluded from the "normal" experiences of sexual development, that I couldn't bear to have something else that made me different again. It felt so unfair to me that I had another thing that I had to face at the same time. (queer cis woman, 25)


Worrying about coming out – Going through cancer treatment means seeing a lot of different health professionals. And some you’ll see for a long time. You might need to decide whether to ‘come out’ and disclose your sexual orientation and/or gender identity over and over again, and this can feel stressful and exhausting. 

You might wonder if your sexual orientation and/or gender identity are relevant to your care, worry about how health professionals will react, whether it will affect your care, or whether they will keep any information you tell them private, especially if you’re not out with your own parent or carer. Your sexual orientation and/or gender identity are an important part of who you are, and knowing more about you helps health care professionals explain how treatments and side effects may affect you. Sharing your sexual orientation and gender identity is also a good way for your health care team to consider issues they may not have thought were relevant. For example, how your cancer treatment may affect your gender expression, who do you want to help make decisions.

For most young people, coming out is a gradual process. You can choose to just tell the health care professionals you see all the time or feel comfortable with. If you experience negative reactions or feel distressed, you can seek support (see below).
 

I don’t like how it was assumed that I was straight. The conversation never opened up about my sexuality which really pisses me off. (bisexual cis woman, 23)

 

I'm completely out because I choose to be. I will only not disclose it if I don't feel comfortable. (genderqueer/trans man attracted to men/masc nonbinary people, 23)


Sharing your name and pronouns – You might find that health professionals assume that you identify with the gender you were assigned at birth (cisgender). This is more likely when hospital and health records show the gender assigned at birth and/or dead name. Having to deal with misgendering can be distressing and make you feel invisible. You might want to introduce yourself with your pronouns and preferred name. Wearing a pronoun badge is another way to remind people of your pronouns. If the misgendering continues, you may want to find a different doctor who might be more respectful.
 

I also tend to add it [the fact that I am trans] on my intake forms because it helps the practitioner understand what to expect. I never used to do this but after I had an ECG with a nurse who looked at my bare chest horrified and asked me what was wrong, I decided that it hurt too much not to disclose. People seem to be very easily shocked by physical differences. (genderqueer/trans man attracted to men/masc nonbinary people, 23)


Introducing your partner/s and family – If you have a partner/partners, encourage them to come to your appointments. This lets your doctors know who’s important to you. If you feel comfortable, you may want to say, “This is Angie. She’s my girlfriend”. If your family includes members of your biological family or family of origin, and others who you think of as your chosen family, ask them to come to your appointments for support.

Keeping your identity private – If you disclose your sexual orientation and/or gender identity to your doctor, they should keep this information private. If the doctor discloses your sexual orientation and/or gender identity to others without your consent, this can be hurtful and upsetting. If you can, let your doctor know that their action has created a difficult situation for you. You have the right to feel safe and respected. 

Avoid teaching others about your needs – Even though it can feel that there is growing acceptance of LGBTQ+ people, you may feel that you have to teach others about your sexual orientation and/or gender identity. And if you’re trans or non-binary, you might find people don’t understand what this means. Having to constantly explain yourself can be exhausting. And if you’re still learning yourself, don’t feel you have to take on the work of educating others. You could point health professionals to websites such as minus18.org.au or transhub.org.au for more information.
 

I'm aware that I look quite different to what they might expect a typical man's chest to look like. It's just that that curiosity should be satiated with professional training and development. I'm very happy to answer people in good faith but it does take an emotional toll on me. (genderqueer/trans man attracted to men/masc nonbinary people, 23


Where to find support

Getting support may be helpful for dealing with feelings of distress. You may wish to reach out to friends and family members. There are also organisations that provide information and support:

  • Canteen Connect - an online community where young people with cancer can share stories, get support from peers, attend events, and access free counselling.
  • QLife – an anonymous and free LGBTIQ+ peer support and referral for people in Australia wanting to talk about sexuality, identity, gender, bodies, feelings or relationships. Call 1800 184 527 (3pm to midnight daily) or visit qlife.org.au to chat online.
  • TransHub – an online information source for trans and gender diverse people, their loved ones, allies and health providers. 
  • DocDir website – This website lists doctors who are welcoming and safe for LGBTQI+ communities, and know about health needs and concerns. Visit docdir.org.au.
  • Genders, Bodies and Relationships passport – You can use this booklet to tell your healthcare team about your gender, body and relationships. 

For more information on your rights at the doctor as a LGBTQI+ person, please see our guide at canteen.org.au/lgbtqi-rights.
 


Peter MacCallum Cancer Centre has a great booklet specifically for young people who identify as LGBTQI+ have cancer called Being OK…Being You. You can download a copy from petermac.org. Cancer Council’s booklet LGBTQI+ People and Cancer also includes information about how cancer and treatment may affect LGBTQI+ people. Visit cancercouncil.com.au


 

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