Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers

Charles Kamen

Marilyn Smith-Stoner

Charles E. Heckler

Marie Flannery

Liz Margolies

cancer, sexual orientation, health disparities, social support
ONF 2015, 42(1), 44-51. DOI: 10.1188/15.ONF.44-51

Purpose/Objectives: To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health.

Design: Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches.

Setting: Online, Internet-based.

Sample: 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers.

Methods: Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point.

Main Research Variables: Demographics, which provider(s) delivered the patients' cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health.

Findings: 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients' support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health.

Conclusions: Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients.

Implications for Nursing: Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients' care.

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