Rapid Fire Presentation Cancer Survivorship Conference 2023

The cancer survivorship experiences of trans and gender diverse Australians: a qualitative study and suggestions for implementation (#21)

Karolina Lisy 1 2 3 , Lucille Kerr 4 , Michael Jefford 1 2 3 , Christopher Fisher 5
  1. Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  2. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
  3. Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  4. Department of Nursing Research, Cabrini Institute, Melbourne, VIC, Australia
  5. College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia

Background: Reducing disparities in survivorship care and striving for equitable outcomes for all cancer survivors are current priorities internationally. People who identify as sexually or gender diverse are known to be at risk of inferior cancer and survivorship outcomes, however, the post-treatment survivorship experiences of trans and gender diverse (TGD) people have not been well studied. This study explored the survivorship experiences of people who identify as TGD, focusing on the physical and psychological aspects of the post-treatment survivorship phase and their experiences of follow-up cancer care.

Methods: A qualitative study of 10 TGD cancer survivors. Semi-structured interviews were conducted to explore participants’ experiences with cancer care. Interviews were transcribed verbatim and data pertaining to survivorship and follow-up care was analysed by thematic analysis.

Results: Six themes were generated from the data. TGD people reported (1) experiences of transphobia and discrimination within oncology care settings, (2) anxiety when attending appointments and avoidance of necessary follow-up care. Themes further describe (3) significant gaps in provider knowledge of TGD health, including the potential impacts of cancer and treatment on TGD bodies, as well as (4) lack of consideration of TGD identity by providers and lack of TGD-competent care, and (5) absence of inclusive and diverse supportive care resources, such as support groups and written information. A final theme illustrates (6) positive growth following cancer, including feeling more empowered, confident and assertive, having an improved view of their bodies, and improved relationships with family.

Conclusion: Approaches to mitigate the issues identified in this study are needed. These may include training in TGD health for healthcare providers, inclusion of TGD health in medical and nursing curricula, processes to collect and use gender identity and preferred pronoun data in clinical settings, and development of TGD-inclusive information and peer-support resources.