Nurses, Create a Welcoming Environment for LGBTQ Patients

Oncology providers reported gaps in knowledge when treating LGBTQ patients with cancer, as well as a willingness to learn more about this patient population, according to recent research published in Patient Education and Counseling.

The researchers administered surveys to 149 oncologists nationwide. While many of them said that they had positive experiences, such as non-judgmental communication, compassion, and supporting patients’ identities, there was still a lack in knowledge that respondents said could be barriers to providing affirmative care. This included a fear of offending patients, as well as microaggressions, such as “don’t ask, don’t tell.”

“There was absolutely overall enthusiasm to know more about this patient [population],” Matthew B. Schabath, PhD, study author and associate member of the Moffitt Cancer Center said in an interview with Oncology Nursing News.

“They wanted education, because there was not — and there still is not – a lot of education available about the LGBTQ patients, their needs, their desires, and their disparities.”

LGBTQ Patients Face Disparities

Many providers said that they are not aware of the specific health disparities that LGBTQ patients face.

“It’s not who they are and who they love that’s the risk factor,” Schabath said. “It’s … the downstream effects of living in a society where … they [may] feel that they have to hide their identity for so long.”

Schabath said that the LGBTQ population has a higher rate of smokers than the general population, which could increase cancer risk. Additionally, LGBTQ individuals are less likely to seek out medical care, possibly because they have been met with bias or stigma in the past.

“Much like we see in racial and ethnic disparities where these populations tend to get their health care in the emergency room, we see the same phenomenon occurring in LGBT patients. Rather than seeking cancer prevention and early detection modalities — which are 100% life-saving – they tend to wait until they’re symptomatic,” Schabath said.

This can result in a later stage cancer diagnosis.

Once LGBTQ patients do seek out cancer care, they are less likely to follow-up, according to Schabath.

Providers, Establish a Welcoming Environment

To help mitigate these disparities, nurses and other oncology providers must create a welcoming and inclusive environment that is comfortable for all patients.

The “don’t ask, don’t tell” policy is not a good one, according to Schabath. Clinicians should ask patients about their identity and, “collect information in a sensitive way that’s making [patients] comfortable.” Providers should ask patients about their preferred pronouns and can even introduce themselves with their preferred pronouns.

Even having a rainbow flag — signifying LGBTQ pride – can make a difference.

“Patients are going to recognize that immediately, and they’re going to cue in one that,” Schabath said. “And they know that they’re in a welcoming environment. All of these things make up for a successful provider-patient relationship.”

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