Discrimination in the medical setting among LGBTQ+ adults and associations with cancer screening

Ashley E. Stenzel, G. Nic Rider, Olivia S. Wicker, Allison C. Dona, Deanna Teoh, B. R.Simon Rosser, Rachel I. Vogel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) individuals experience disparities in cancer screening. We examined whether experience of LGBTQ+ -related discrimination in medical settings was associated with cancer screening disparities. Methods: Participants were recruited via social media for a cross-sectional survey study. Those who self-reported as LGBTQ+, being 40+ years of age, and residing in the US were eligible. Participants reported their clinical and demographic characteristics, cancer screening history, and experiences of discrimination in a medical setting. We examined the odds (OR) of ever undergoing cancer screening by experienced discrimination, stratified by sex assigned at birth. Results: Participants (n = 310) were on average 54.4 ± 9.0 years old and primarily White (92.9%). Most identified as lesbian (38.1%) or gay (40.0%) while 17.1% were transgender or gender diverse. Nearly half (45.5%) reported experiencing LGBTQ+ -related discrimination in the medical setting. Participants assigned female at birth with discriminatory experiences had significantly lower odds of ever undergoing colonoscopy/sigmoidoscopy compared to those without discriminatory experiences (OR: 0.37; 95% Confidence Interval (CI) 0.15–0.90). No significant differences in colonoscopy/sigmoidoscopy uptake were observed in those assigned male at birth by discriminatory experiences (OR: 2.02; 95% CI 0.59–6.91). Pap tests, mammogram, and stool colorectal cancer screening did not differ by discriminatory experience. Conclusion: Discrimination in medical settings was commonly reported by LGBTQ+ individuals in this study. When treating LGBTQ+ patients, clinicians should ask about prior experiences and continue to promote cancer screening. Future studies should examine discrimination as a key driver of LGBTQ+ disparities in cancer screening.

Original languageEnglish (US)
Pages (from-to)147-156
Number of pages10
JournalCancer Causes and Control
Volume36
Issue number2
DOIs
StatePublished - Feb 2025

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.

Keywords

  • Cancer screening
  • Discrimination
  • Disparities
  • Gender identity
  • LGBTQ
  • Sexual orientation

PubMed: MeSH publication types

  • Journal Article

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