Department of Medicine, Division of Hematology and Medical Oncology, University of Rochester Medical Center, Rochester, NY, USA.
Department of Medicine, Massachusetts General Hospital, Cambridge, MA, USA.
Patient Educ Couns. 2021 Oct;104(10):2552-2558. doi: 10.1016/j.pec.2021.03.007. Epub 2021 Mar 10.
Understanding barriers to care for transgender people with cancer is necessary to increase oncologic care access. Little has been published regarding the experiences of transgender people with cancer. We sought to explore these experiences, assess barriers to oncologic care, and elucidate potential solutions.
Using an interpretive descriptive approach, we conducted two group interviews with transgender people who had been diagnosed with cancer and one with physicians who treat patients with cancer. Two investigators independently analyzed verbatim transcripts and, together, refined themes, resolving disagreements with consensus. Member checking and peer debriefing were used to confirm and elaborate on findings.
Seven people who had been diagnosed with cancer and five physicians who treat people with cancer participated in group interviews. Themes included: (a) experiences with cancer may uniquely impact transgender people; (b) enforcement of clinician and systemic gender expectations creates barriers to cancer care; and (c) resistance to gender expectations may facilitate care.
Gender expectations create barriers to oncologic care, which can be resisted by patients, clinicians, and institutions.
Clinicians and institutions should create gender-inclusive oncologic spaces, demonstrate allyship, and support patient autonomy to decrease barriers to care for transgender people with cancer.
了解跨性别癌症患者的护理障碍对于增加肿瘤护理的可及性至关重要。关于跨性别癌症患者的经历，相关研究还很少。我们旨在探讨这些经历，评估肿瘤护理的障碍，并阐明潜在的解决方案。
采用解释性描述方法，我们对已被诊断患有癌症的跨性别者进行了两次小组访谈，对治疗癌症患者的医生进行了一次小组访谈。两位研究人员独立分析了逐字记录，并共同完善了主题，通过共识解决了分歧。采用成员检查和同行讨论来确认和阐述研究结果。
共有 7 名被诊断患有癌症的人和 5 名治疗癌症患者的医生参加了小组访谈。主题包括：（a）癌症经历可能会对跨性别者产生独特的影响；（b）临床医生和系统的性别期望的执行会给癌症护理带来障碍；（c）对性别期望的抵制可能有助于护理。
性别期望会给肿瘤护理带来障碍，而患者、临床医生和医疗机构都可以抵制这些障碍。
临床医生和医疗机构应为跨性别癌症患者创造包容的肿瘤护理环境，展示盟友关系，并支持患者自主权，以减少护理障碍。
