It takes more than rainbows: Supporting sexual and gender minority patients with trauma‐informed cancer care

• Published in: Cancer 2024-02, Vol.130 (4), p.507-516
• Main Authors: Sinko, Laura, Ghazal, Lauren V., Fauer, Alex, Wheldon, Christopher W.
• Format: Article
• Language: English
• Subjects: Cancer; cancer survivors; Discrimination; Drug abuse; Gender; Health services; Mental health; Oncology; Patient satisfaction; Patients; Populations; sexual and gender minority; Trauma; trauma informed care
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.35120

Background/Purpose The American Society of Clinical Oncology has called for an increased priority to improve cancer care for sexual and gender minority (SGM) populations because of heightened risk of receiving disparate treatment and having suboptimal experiences, including perceived discrimination. We demonstrate how integrating trauma‐informed care (TIC) principles across the cancer continuum is a key strategy to improving care delivery and outcomes among SGM populations. Method This empirically informed perspective expands on the concepts generated through the American Society of Clinical Oncology position statement and uses the Substance Abuse and Mental Health Services Association’s “Four Rs” Toward Trauma Informed Care: Realize, Recognize, Response, and Resist Traumatization. Results Recommendations for each component of TIC include: (1) Realize: Implement SGM cultural humility training, including modules on SGM‐specific trauma, discrimination, harassment, and violence; (2) Recognize: Routinely screen for emotional distress using methods to ensure privacy, and/or normalize mental health screenings to cancer patients; (3) Respond: Create and widely disseminate policies and patients’ rights that prohibit discrimination and ensure access to gender‐neutral clinical environments; and (4) Resist Traumatization: Establish and respond to quality metrics (e.g., standardized patients, patient satisfaction surveys) that are informed by a community advisory board with the purpose of ensuring and maintaining quality care. Conclusions and Implications Integrating TIC principles into cancer care for SGM populations is crucial to address disparities in treatment and clinical outcomes. Our recommendations offer practical approaches for oncology teams to implement TIC care and ensure equitable and inclusive cancer care for patients and their families. This perspective highlights the urgent need to integrate trauma‐informed care principles into cancer care for sexual and gender minority populations. By implementing the proposed recommendations, oncology care teams can address disparities and enhance outcomes, ensuring equitable and inclusive cancer care for all patients and their families.