Disparities in Breast Cancer Risk and Care for Lesbian, Gay and Bisexual People
As a lesbian, gay or bisexual person, you have a greater risk of developing breast cancer. This is not because of your sexual orientation. There are no biological differences between you as an LGB person and someone who is straight.
You are more likely to get breast cancer because of health disparities, or differences between groups of people that affect how a disease affects certain groups. Disparities for LGB people affected by breast cancer include lifestyle factors, such as obesity and alcohol use. They also include your socioeconomic status, a measure of your work experience, education level and yearly income. Your socioeconomic status may also be impacted by where you live and how much your family makes as a whole.
Your socioeconomic status may affect how easy it is for you to access to and ability to pay for health care. If you are unemployed or work a part-time job, you may not have the access to or resources to pay for breast cancer care. Lifestyle factors like obesity and drinking a lot of alcohol can raise your risk of developing breast cancer, your risk of recurrence, or the disease returning, or developing a new primary breast cancer. These disparities, as well as other lifestyle factors, greatly increase your risk of developing breast cancer.
Studies suggest that these disparities are due to the stress you may encounter as an LGB person. You are more likely to be uninsured than your straight peers, because of legal barriers to health care. LGB people are also more likely to drink more alcohol than recommended, become an unhealthy weight and have other certain behaviors that raise the risk of breast cancer. Some experts say that LGB people have an increase in these risk factors because of social factors like cultural norms, the expected behaviors of specific groups. Others believe these risk factors for LGB people are due to the stress of discrimination.
Understanding LGB-specific breast cancer risk issues and how your breast cancer experience may be unique may help empower you to ask your healthcare team questions and make medical decisions that are right for you.
There aren’t many large-scale studies that explore how cancer in general affects lesbian, gay, bisexual and transgender people. Research that is available suggests that LGBT people are more likely to develop cancer because of lifestyle factors that increase risk.
Studies show that lesbian and bisexual women are more likely to smoke, drink too much alcohol, have children after age 30 or not have them at all, and become an unhealthy weight. These are all risk factors that can increase your chance of having breast cancer.
These disparities go beyond lifestyle factors. Some LGB people are likely to avoid or delay medical care and health screening, because of a fear of discrimination or past negative experiences with doctors. Waiting to go to appointments to detect breast cancer earlier may mean finding out about breast cancer at a later stage.
Some research shows that these health disparities are also true of gay and bisexual men, but there is not much data available on gay and bisexual men and breast cancer.
Your sexual orientation is likely to impact your breast cancer care experience. Unlike your straight peers, you have the added task of deciding whether you feel comfortable coming out, or sharing your sexual identity with your breast cancer care team. You are also more likely to have a different support system, like a same-sex partner, or close friends instead of your immediate family.
Some LGB people do not share their sexual orientation with their care team because they fear it will affect the quality of their care.
For some, coming out may not be an option because they aren’t ready to share their orientation, they feel their hospital is not LGB-friendly or lacks LGB training and resources, or because they have limited LGB-friendly healthcare options in the area or region in which they live. Others may feel sharing their orientation is not necessary for their breast cancer treatment, or prefer to focus on their immediate medical needs.
Some hospitals are trying to be more welcoming for LGB people by creating friendlier policies that address you as an LGB person, offering LGBT health education programs. They may also offer LGBT liaisons, or key staff members who serve as advocates for complaints from LGBT people in or working for the hospital.
Some breast cancer providers still may not be aware of your specific medical needs or concerns. Reports suggest this is due to gaps in education and awareness of LGB health overall.
Depending on your relationship with your immediate family, the people you turn to for support may be close friends, colleagues and, if you are in a relationship, your partner.
Some personal information forms don’t have options for you to describe your identified family. That often leaves it to you to tell your breast cancer care team who you want to bring with you for appointments and when you receive treatment.
In-person and online breast cancer support groups for LGB people exist. Read more to find out how to join them.
As an LGB person, you are more likely to be uninsured or have problems paying for health care. Low rates of health insurance among LGB people may exist because insurance policies do not provide coverage to partners who are not married. Though more states are recognizing same-sex marriage and domestic partnerships, if you live in a state that does not, you may have more trouble getting insurance through your partner.
Breast Cancer inFocus: Getting the Care You Need as a Lesbian, Gay or Bisexual Person contains information and tips to help you find providers who may be LGB-friendly, decide if you want to or are ready to come out and ways you can communicate with your breast cancer care team. The publication also lists resources that can further help you get the care and support you want.
With information and a little research, it’s possible that you’ll build a breast cancer healthcare team as aware of your needs as an LGB individual as you are yourself.
Discover more in-depth information in our sections Coming Out, the Unique Needs of LGB People Affected by Breast Cancer and Emotional Support.