Lesbian, Gay, Bisexual Cancer Survivors Experiencing More Challenges in Survivorship Than Heterosexuals

Lesbian, gay, and bisexual cancer survivors are more likely to have poorer mental and general health, be told they are depressed, have limited or no access to health care, and have worse sleep quality than their heterosexual peers.

The data — which were published in the journal Cancer — highlighted that cancer survivors who identify as lesbian, gay and bisexual are more likely to experience challenges in their survivorship than their heterosexual peers.

Prior to this study, there had not been much data or research on this patient population. The reason, according to study author Dr. Yannan Li, is that many patients (at time of study recruitment) may not have wanted to disclose their sexual orientation.

However, Li, a data analyst at the Icahn School of Medicine at Mount Sinai in New York, said more people now accept their identity; therefore, they are more comfortable to disclose it.

“So, I think now’s a good time to study this population,” she said in an interview with CURE®.

The study included over 17 million cancer survivors from across the United States using data from the 2018 Behavioral Risk Factor Surveillance System. Lesbian and gay survivors accounted for 1.52% of the study population, and bisexual survivors accounted for 1.41%.

Bisexual participants were more likely to smoke (32.3%), and binge drink (17.1%) compared to their heterosexual peers (13.6%; 9.1%). Li said factors that influenced these higher rates include peer pressure into smoking and, stress and depression that lead to binge drinking.

In addition, 16.6% of bisexual participants and 8.5% of gay and lesbian participants reported no health care coverage compared with 4.1% of heterosexuals. And 20% of bisexuals reported having no personal doctor or missing doctor visits due to costs, which is 2 to 3 times higher than their heterosexual peers.

Li mentioned that lesbian, gay and bisexual people can often experience discrimination at work, school or in life, which can affect their socioeconomic standing, that subsequently effects their access to health care. She also highlighted that some health care providers may not know how to effectively communicate with this patient population.

“(Doctors) don’t have enough resources to target this population. So sometimes (doctors) only offer very general idea of health care, which doesn’t really fit the needs of lesbian, gay or bisexual people,” she added.

The study results showed that bisexual females were more likely to have poorer general and mental health compared with heterosexual peers and were 3.32 times more likely to be told they had depressive disorders. Moreover, bisexual males were 5.14 times more likely to be told they had depressive disorders. Despite these results, Li said this means they are seeking help from health care providers — which, she noted, is a good thing.

Li also suggested that because of depression, cancer survivors may experience a poor quality of sleep. This aligns with results of the study that demonstrated that survivors who identified as lesbian, gay and bisexual all reported experiencing a worse quality of sleep than heterosexual peers.

Notably, bisexual, and gay males reported better general health than heterosexual men. While Li explained that this outcome was not consistent with previous studies, she noted that the study authors believed it may be because bisexual and gay males are more sexually active and there is less of a strict social norm bound to them that heterosexual men may experience.

The results also demonstrated that lesbian, gay and bisexual individuals were less likely to receive support from their partners. A major part of survivorship and cancer treatment, Li highlighted, is the social support a survivor or patient receives from either a partner or spouse. But, as Li expressed, lesbian, gay and bisexual individuals are less likely to be married or in a civil union, resulting in them having a harder time in receiving stable, long-term care.

Li noted that the study was originally supposed to include cancer survivors who identified as transgender. However, there was not enough data among that patient population to assess outcomes. But, she said, the researchers are planning to conduct a separate study in the future that focuses on cancer survivors who identify as transgender.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.