Ash B Alpert1, Vikas Gampa2, Megan C Lytle3, Charlie Manzano4, Roman Ruddick4, Tonia Poteat5, Gwendolyn P Quinn6, Charles S Kamen7. 1. Department of Medicine, Division of Hematology and Medical Oncology, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: ash_alpert@urmc.rochester.edu. 2. Department of Medicine, Massachusetts General Hospital, Cambridge, MA, USA. 3. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. 4. Transgender Cancer Patient Project, Martinez, CA USA. 5. Department of Social Medicine, University of North Carolina, Durham, NC, USA. 6. Department of Obstetrics and Gynecology, Perlmutter Cancer Center New York University Langone Health, New York, NY, USA. 7. Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Abstract
OBJECTIVES: Understanding barriers to care for transgender people with cancer is necessary to increase oncologic care access. Little has been published regarding the experiences of transgender people with cancer. We sought to explore these experiences, assess barriers to oncologic care, and elucidate potential solutions. METHODS: Using an interpretive descriptive approach, we conducted two group interviews with transgender people who had been diagnosed with cancer and one with physicians who treat patients with cancer. Two investigators independently analyzed verbatim transcripts and, together, refined themes, resolving disagreements with consensus. Member checking and peer debriefing were used to confirm and elaborate on findings. RESULTS: Seven people who had been diagnosed with cancer and five physicians who treat people with cancer participated in group interviews. Themes included: (a) experiences with cancer may uniquely impact transgender people; (b) enforcement of clinician and systemic gender expectations creates barriers to cancer care; and (c) resistance to gender expectations may facilitate care. CONCLUSIONS: Gender expectations create barriers to oncologic care, which can be resisted by patients, clinicians, and institutions. IMPLICATIONS FOR PRACTICE: Clinicians and institutions should create gender-inclusive oncologic spaces, demonstrate allyship, and support patient autonomy to decrease barriers to care for transgender people with cancer.
OBJECTIVES: Understanding barriers to care for transgender people with cancer is necessary to increase oncologic care access. Little has been published regarding the experiences of transgender people with cancer. We sought to explore these experiences, assess barriers to oncologic care, and elucidate potential solutions. METHODS: Using an interpretive descriptive approach, we conducted two group interviews with transgender people who had been diagnosed with cancer and one with physicians who treat patients with cancer. Two investigators independently analyzed verbatim transcripts and, together, refined themes, resolving disagreements with consensus. Member checking and peer debriefing were used to confirm and elaborate on findings. RESULTS: Seven people who had been diagnosed with cancer and five physicians who treat people with cancer participated in group interviews. Themes included: (a) experiences with cancer may uniquely impact transgender people; (b) enforcement of clinician and systemic gender expectations creates barriers to cancer care; and (c) resistance to gender expectations may facilitate care. CONCLUSIONS: Gender expectations create barriers to oncologic care, which can be resisted by patients, clinicians, and institutions. IMPLICATIONS FOR PRACTICE: Clinicians and institutions should create gender-inclusive oncologic spaces, demonstrate allyship, and support patient autonomy to decrease barriers to care for transgender people with cancer.
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Authors: Ash Alpert; Charles Kamen; Matthew B Schabath; Lauren Hamel; Julia Seay; Gwendolyn P Quinn Journal: J Clin Oncol Date: 2020-06-18 Impact factor: 44.544
Authors: Matthew B Schabath; Catherine A Blackburn; Megan E Sutter; Peter A Kanetsky; Susan T Vadaparampil; Vani N Simmons; Julian A Sanchez; Steven K Sutton; Gwendolyn P Quinn Journal: J Clin Oncol Date: 2019-01-16 Impact factor: 44.544
Authors: Charles S Kamen; Mandi L Pratt-Chapman; Stephen C Meersman; Gwendolyn P Quinn; Matthew B Schabath; Shail Maingi; Janette K Merrill; Elizabeth Garrett-Mayer; Melinda Kaltenbaugh; Caroline Schenkel; Shine Chang Journal: JCO Oncol Pract Date: 2022-05-23