Advocacy Action—Raising Awarness About Cancer in the LGBT Community

By Liz Margolies

Advocacy Action—Raising Awareness About Cancer in the LGBT Community

By Liz Margolies

My organization, the National LGBT Cancer Network, estimates that there are 1 million lesbian, gay, bisexual and transgender (LGBT) cancer survivors in the country today. While you may not know it, you likely have LGBT survivors in your community.

Compared with the general population, LGBT people have greater cancer risks and lower screening rates, resulting in more frequent late-stage diagnoses. Part of the problem is that many LGBT women and men are afraid to “come out” to their health care providers, due to past discrimination. While provider bias against LGBT patients is declining, it remains quite real. Many LGBT cancer survivors are especially concerned about alienating their oncologists—the very doctors on whom they depend for treatment.

We can help eliminate health care disparities in the LGBT cancer community by creating safe spaces and speaking up for them. Here are some tips on how you can help.

1. Educate yourself about cancer risks and realities in the LGBT community. The increased cancer risks in this population are not the result of biological differences but behavior, like tobacco and alcohol use. In the lesbian population, there are higher rates of tobacco and alcohol use and obesity, along with delayed childbirth or not having biological children. All these factors have been linked to breast cancer. This could potentially increase the likelihood that lesbian women may develop the disease.

Among gay men, those who engage in anal receptive intercourse are at increased risk for anal cancer, which is caused by the same types of human papillomavirus (HPV) that causes cervical cancer in women. Some studies have found that anal HPV is present in 65 percent of HIV-negative gay men and 95 percent of gay men who are HIV-positive. Despite these worrisome facts, many gay men don’t come out to their health care providers. What’s more, doctors frequently don’t know about the simple anal Pap smear used to detect abnormal cells.

There are many other challenges facing LGBT patients. For instance, same-sex partners are not always permitted in a consultation or exam room. And health care professionals are often unaware of the impact of cancer on the family, sexuality and fertility of an LGBT individual.

2. Dismantle the “heterosexual assumption.” Don’t assume that everyone is heterosexual. Studies show that LGBT people are willing to come out if they are invited to do so, and less likely to share their sexual identity if they have to bring up the subject themselves. Instead of assuming a breast cancer survivor has a husband, try asking about her family or her support system to open up the conversation. It is important to remember that people who aren’t married may be in committed, long-term relationships. Start using the word “partner” instead of husband or wife. In your support groups, try to remember that sex does not always involve vaginal intercourse.

3. Speak up. Cancer does not discriminate, but the health care system often does. The next time you are at a medical facility, imagine how it appears to LGBT patients and their families. Is it welcoming? Is there a non-discrimination policy posted? Are there any LGBT magazines? Under “Marital Status” on the intake form, are there options besides “single,” “married,” “widowed” and “divorced”? Pay attention to support groups, cancer websites and local survivors’ events. Do their written materials and outreach efforts include LGBT patients and their families? If you see ways to increase sensitivity to the needs of these survivors, speak up.


Liz Margolies is the executive director of the National LGBT Cancer Network.

Organization website: