Transgender patients face barriers in cancer care: Study

Transgender and gender-diverse individuals aren’t getting the best cancer care, from screening to treatment, researchers say.

The researchers note a paucity of data involving care care and said much more work needs to be done. But in a study published Feb. 9 in Jama Oncology, the researchers identified some disparities in care among transgender and gender-diverse individuals.

“Health care practitioners and relevant stakeholders have the ethical and professional obligation to offer the best care to every patient regardless of gender identity and, therefore, to eliminate existing disparities and shape an ultimate gender-diversity–inclusive health care setting,” the authors wrote.

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In the analysis of other studies and data, researchers found transgender and gender-diverse people had high rates of infection with human papillomavirus (HPV) and HIV. Transgender and gender diverse individuals also had “a high prevalence” of tobacco consumption and alcohol use.

Researchers noted transgender and gender-diverse patients had a higher incidence of cancers associated with HIV and HPV, and they were less likely to follow cancer screening programs. Most anal cancers and cervical cancers are tied to HIV infection, the study notes.

Social and economic disparities in health are likely exacerbating both risk factors and health outcomes, the researchers suggest.

The authors also note that practitioners aren’t knowledgeable about transgender health, and that’s a significant obstacle to closing disparities in care.

“A lack of knowledge about gender minorities’ health needs among health care practitioners was evidenced, and it represented a major hurdle to cancer prevention, care, and survivorship for transgender and gender-diverse individuals,” the authors wrote.

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Some transgender patients cite discrimination and a lack of sensitivity from clinicians in oncology, according to the study. Transgender patients commonly report “misgendering” by practitioners in oncology, while some patients said their concerns weren’t taken seriously. Some patients also note they had trouble changing their name and gender in medical charts.

“With respect to the oncologist-patient relationship, it is paramount to counteract the tendency to paternalize. Shared decision-making is crucial,” the authors wrote.

Most oncologists said they want to gain more knowledge in treating transgender patients, and the authors suggested that this should be incorporated in medical training programs and continuing education programs.

The study notes that 0.3% to 0.5% of adults globally identify as transgender, while it is estimated that 0.5% to 4.5% of adults are described as gender diverse.

However, as more people are willing to come forward in public and disclose being transgender, healthcare organizations need to work harder to address their needs and close disparities.