By: Lauren Walleser/ TRT Assistant Editor—
BOSTON, Mass.— October is recognized annually as Breast Cancer Awareness month, a time for sharing information on prevention, treatment and resources for those who have suffered or may encounter the disease. According to Catherine Basham, Women’s Health Outreach Coordinator at Fenway Health, sexual orientation or gender identity do not increase the risk of breast cancer, but there are health issues that may affect lesbian, bisexual or transgender women more often due to health disparities for these populations.
“LBT women are less likely to receive preventive care because of real or feared discrimination in the health care system,” said Basham. “This, combined with certain behavioral risk factors, can make sexual minority women more at risk. For example, we know that many cancers can be prevented through smoking cessation, better diet and more physical activity, but research shows that lesbian and bisexual women are more likely to be overweight, smoke, and consume alcohol more frequently than heterosexual women. Transgender women face many of the same barriers to care faced by lesbian and bisexual women, often at higher rates and compounded with housing, employment and other kinds of discrimination that can affect access to care.”
According to Basham, breast cancer prevention and treatment messages, such as various pink ribbon campaigns, often target heterosexual, stereotypically feminine women, which don’t always resonate with the LGBTQ community. [pullquote]According to Basham, breast cancer prevention and treatment messages, such as various pink ribbon campaigns, often target heterosexual, stereotypically feminine women, which don’t always resonate with the LGBTQ community.[/pullquote]
“Assumptions about wanting to look stereotypically feminine or have breast reconstruction aren’t appropriate for everyone, and can make us feel isolated,” Basham said. “Sending more inclusive messages about respecting our unique needs, asking about our relationships and including our partners and other supporters in our care is important.”
Basham said LBT people are less likely to have insurance and even when they do have insurance may have difficulty finding appropriate and sensitive care.
“Assuring a positive experience begins in primary care, but extends to all of the other places that LBT women receive their breast care,” said Dr. Jennifer Potter, Fenway’s Director of Women’s Health. “This means that not only primary care providers and their staff, but also all of the other health caregivers LBT women will encounter in centers providing breast imaging, breast surgery, chemotherapy, radiation therapy, and counseling support need to be trained in providing sensitive and culturally appropriate care.”
Transgender people have the highest rates of being uninsured and according to Basham, may experience difficulty in getting the appropriate services.
“A transgender man may need a mammogram if breast tissue has not been removed, but his insurance might not cover this service for a male,” Basham offered as an example. “Societal stress poses additional challenges. Some trans (and other) people turn to smoking or alcohol use to cope with societal stress. This can increase the risk of some kinds of cancers, including cervical and breast cancers. We know that transgender women who have been on hormone therapy for five or more years should receive regular screening mammograms, but if these women don’t have a trusted health-care provider, they may not access these screenings.”
Research on transgender people’s unique cancer risks is lacking, along with research on LBT women of color and their risks for cancer. Basham said that collecting gender identity and sexual orientation information in health care settings will help lead to greater understanding.
This year, Fenway Health will present the 15th Annual Audre Lorde Cancer Awareness Brunch, a celebration for women affected by cancer and their supporters, on October 26. The brunch was established in 1999 and is named in memory of Audre Lorde, a self-described “Black, lesbian, mother, warrior, poet” who battled breast cancer for 14 years.
“She struggled against a medical establishment frequently indifferent to cultural differences and insensitive to women’s health issues and defied societal rules that said she should hide the fact that she had breast cancer,” Basham said. [pullquote]Transgender people have the highest rates of being uninsured and according to Basham, may experience difficulty in getting the appropriate services.[/pullquote]
The theme for this year’s event is “Finding Strength Within Oneself and Community” and is an opportunity to share and network. It will be emceed by Dr. Yvonne Gomez-Carrion of Beth Israel Deaconess Medical Center and feature a panel on self-care for cancer survivors, musical performances, a spiritual dedication to loved ones lost to cancer, and more.
“Here in Massachusetts, many organizations support the LGBT community,” said Basham. “Fenway Health collaborates with Facing Cancer Together to offer a free LGBT cancer support group.”
According to Basham, there are many decisions one can make on a day-to-day basis to support a healthy lifestyle and reduce the risk of breast cancer, such as maintaining a healthy weight, exercising moderately and avoiding alcohol.
“Women with a family history of breast cancer are at increased risk for developing breast cancer, and individualized screening strategies, such as starting imaging at a younger age or alternating mammograms with breast MRI, may be beneficial for some of these women,” said Potter. “Because of this, it is very important for all LBT women to be sure to discuss any family history of breast cancer they are aware of with their health provider.”
The Audre Lorde Cancer Awareness Brunch is free, but space is limited. To RSVP, email Basham at [email protected] or call 617.927.6134.
For more info or to register for the Facing Cancer Together support group, call 617-332-5777.