Inequities in cancer care among transgender people: Recommendations for change

Samantha Scime

Abstract


Owing to a shift in social attitudes and human rights standards, health inequities experienced by gender minorities are gaining an increasing spotlight globally. Transgender (trans) is an umbrella term used to describe individuals who have a dissimilar sex, gender identity and/or gender expression than what was designated at birth. Recently, studies have sought to identify health disparities and barriers to care among this population. While oncology-focused research remains limited, the social determinants of trans health elicits a significant impact on transgender people across the cancer continuum and, thus, requires further examination. The purpose of this paper is to explore the issue of trans health inequity in the context of Canadian cancer care highlighting current clinical practice, as well as gaps in research, provider education and health care policy. The paper will conclude with recommendations for policy development and a reflection on the oncology nurse’s role in advocating for change.  


Full Text:

PDF

References


Banerjee, S.C., Walters, C.B., Staley, J.M., Alexander, K., & Parker, P.A. (2018). Knowledge, beliefs, and communication behavior of oncology health-care providers (HCPs) regarding lesbian, gay, bisexual and transgender (LGBT) patient health care. J Health Commun, 23(4), 329–339. doi:10.1080/10810730.2018.1443527

Braun, H., Nash, R., Tangpricha, V., Brockman, J., Ward, K., & Goodman, M. (2017). Cancer in transgender people: Evidence and methodological considerations. Epidemiologic Reviews, 39(1), 93–107. doi:10.1093/epirev/mxw003

Canadian Cancer Society (2018). Cancer screening information and considerations for LGBTQ clients. Retrieved from http://convio.cancer.ca/site/PageServer?pagename=SSL_ON_HCP_HCPGen_LGBTQClients#.XCv-RM9KjjA

Ceres, M., Quinn, G.P., Loscalzo, M., & Rice, D. (2018). Cancer screening considerations and cancer screening uptake for lesbian, gay, bisexual, and transgender persons. Seminars in Oncology Nursing, 34(1), 37–51. doi:10.1016/j.soncn.2017.12.001

Gonzales, G., & Henning-Smith, C. (2017). Barriers to care among transgender and gender nonconforming adults. The Milbank Quarterly, 95(4), 726–748.

Government of Ontario. (2012). Toby’s Act: Right to be free from discrimination and harassment because of gender identity or gender expression. S. O. 2012, c. 7-Bill 33.

Griggs, J., Maingi, S., Blinder, V., Denduluri, N., Khorana, A.A., Norton, L., … Rowland, J.H. (2017). American Society of Clinical Oncology Position Statement: Strategies for reducing cancer health disparities among sexual and gender minority populations. Journal of Clinical Oncology, 35(19), 2203–2208. doi:10.1200/jco.2016.72.0441

James, S., Herman, S., Rankin S., Keisling M., Mottet, L., & Anaf, M. (2016). The report of the 2015 transgender survey. Retrieved from https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

Kamen, C., Mustian, K.M., Dozier, A., Bowen, D.J., & Li, Y. (2015). Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors. Psycho-Oncology, 24(11), 1384–1391. doi:10.1002/pon.3746

Levitt, N. (2015). Clinical nursing care for transgender patients with cancer. Clinical Journal of Oncology Nursing, 19(3), 362–366. doi:10.1188/15.cjon.362-366

Lombardi, E., & Banik, S. (2015). Cancer care needs of transgender, transsexual, and other gender nonconforming populations. In Cancer and the LGBT community: Unique perspectives from risk to survivorship (pp. 245–259). Cham: Springer. doi:10.1007/978-3-319-15057-4

McDowell, A., & Bower, K.M. (2016). Transgender health care for nurses: An innovative approach to diversifying nursing curricula to address health inequities. Journal of Nursing Education, 55(8), 476–479. doi:10.3928/01484834-20160715-11

Mount Sinai Hospital. (2012). Gender identity policy. Toronto, ON: Mount Sinai Hospital.

Mule, N.J., & Smith, M. (2014). Invisible populations: LGBTQ people and federal health policy in Canada. Canadian Public Administration, 57(2), 234–255. doi:10.1111/capa.12066

Ontario NDP (2017). Ontario Trans patients struggle to access care. Retrieved from https://www.ontariondp.ca/news/ontario_trans_patients_struggle_to_access_care

Quinn, G.P., Sanchez, J.A., Sutton, S.K., Vadaparampil, S.T., Nguyen, G.T., Green, B.L., … Schabath, M.B. (2015). Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA: A Cancer Journal for Clinicians, 65(5), 384–400. doi:10.3322/caac.21288

Rice, D., & Schabath, M.B. (2018). The future of LGBT cancer care: Practice and research implications. Seminars in Oncology Nursing, 34(1), 99–115. doi:10.1016/j.soncn.2017.12.007

Shetty, G., Sanchez, J.A., Lancaster, J.M., Wilson, L.E., Quinn, G.P., & Schabath, M.B. (2016). Oncology health care providers’ knowledge, attitudes, and practice behaviors regarding LGBT health. Patient Education and Counseling, 99(10), 1676–1684. doi:10.1016/j.pec.2016.05.004

St. Michael’s Hospital. (2017). Gender identity and gender expression policy. Toronto, ON: St. Michael’s Hospital.

Thomas, R., Pega, F., Khosla, R., Verster, A., Hana, T., & Say, L. (2017). Ensuring an inclusive global health agenda for transgender people. Bulletin of the World Health Organization, 95(2), 154–156. doi:10.2471/blt.16.183913

University Health Network. (2016). Policy and procedure manual: Human Resources: Gender Identity. Toronto, ON: University Health Network.

Varcoe, C., Browne, A., & Cender, L. (2014). Promoting social justice and equity by practicing nursing to address structural inequities and structural violence. In P. Kagan, M. Smith, & P. Chinn (Eds.), Philosophies and Practices of Emancipatory Nursing: Social Justice as Praxis (pp. 266–284). New York: Routledge.

Watters, Y., Harsh, J., & Corbett, C. (2015). Cancer care for transgender patients: Systematic literature review. International Journal of Transgenderism, 15(3–4), 136–145. doi:10.1080/15532739.2014.960638


Refbacks

  • There are currently no refbacks.