Gay Men and the Stigma of a Cancer Diagnosis

Culturally Sensitive Care

The Gay and Lesbian Medical Association (GLMA) identified 10 areas essential for gay men to review in concert with their medical care team. Oncology nurses should be aware of these areas and encourage gay male patients to discuss them with their health care team:

• Sexual orientation in regard to overall health and health care
• HIV/AIDS, safe sex practices, and risk factors specific to the patient;
• Hepatitis, including history of vaccination, exposure, infection, and treatment;
• Diet and exercise, overall fitness, and potential body image concerns;
• Substance and alcohol use/abuse;
• Depression/anxiety, particularly with patients at higher risk for suicide (eg, adolescents, young adults) and those who remain in the closet;
• Sexually transmitted diseases (STDs);
• Screening for prostate, testicular, anal, and colon cancers;
• Tobacco use and risk for tobacco-related health problems;
• HPV infection and risky behaviors.⁸

The oncology medical team, including physicians, oncology nurses, social workers, and support staff, can take the following steps to help gay men feel more confident in their health care, improve patient-provider communications, and build a strong relationship with these patients:

• Place legal and institutional nondiscriminatory policies in public view;
• Ensure intake materials, records, and assessments use gender-neutral and sexual-orientation friendly language;
• Provide health care publications and patient materials that are LGBT sensitive;
• Attend cultural competency training and formal education on working with LGBT patients;
• Use resources and referrals that are LGBT inclusive;
• Provide access to channels for registering concerns and complaints of homophobia, discrimination, or poor care;
• Ongoing participation in HIV/AIDS awareness and training, especially as it relates to cancer.

References

1. The history of psychiatry and homosexuality. LGBT Mental Health Syllabus website. http://www.aglp.org/gap/1_history/. Accessed June 19, 2017.

2. Quinn GP, Sanchez JA, Sutton SK, et al. Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations. CA Cancer J Clin. 2015;65(5):384-400.

3. Healthy People 2020. Washington DC: US Dept of Health and Human Services, Office of Disease Prevention and Health Promotion; November 2010. ODPHP Publication No. B0132.

4. Boehmer U, Elk R, eds. Cancer and the LGBT Community. New York, NY: Springer; 2015:37-62.

5. Kamen C, Palesh O, Gerry AA, et al. Disparities in health risk behavior and psychological distress among gay versus heterosexual male cancer survivors. LGBT Health. 2014;1(2):86-94.

6. The effect of cancer on the LGBT community. New York, NY: The LGBT Cancer Project; 2007. 

7. Lee TK, Handy AB, Kwan W, et al. Impact of prostate cancer treatment on the sexual quality of life of men-who-have-sex-with-men. J Sex Med. 2015;12(2):2378-2386.

8. Winn RJ. Ten things gay men should discuss with their healthcare provider. GLMA website. http://www.glma.org/index.cfm
?fuseaction=Page.viewPage&pageId=947&grandparent
ID=534&parentID=938&nodeID=1. Revised May 2012. Accessed June 19, 2017.