Dr Louise Soanes

Wednesday 22nd July 2020

At Teenage Cancer Trust, we’ve always believed it’s important that young people feel able to be themselves, no matter what they’re going through.

We’re here to support every young person with cancer, and that includes LGBTQ+ young people and their families.

These young people might face extra challenges as they go through cancer, so our support for them needs to be the best it possibly can be.

Special thanks to Rob Sefton, one of our Youth Support Coordinators, whose extensive experience of supporting LGBTQ+ young people was a huge help in creating this information, and Brad Gudger, a young person supported by Teenage Cancer Trust who helped us review the content.

What challenges might you face if you’re an LGBTQ+ young person with cancer?

Finding your identity

Your teenage and young adult years are naturally a time for exploring and developing your identity, including your sexual orientation and gender identity. Facing cancer on top of this is a massive challenge in itself.

Cancer can really make you re-examine your identity. It can feel like it takes away the things that make you, you. And that’s especially tough on your mental and emotional wellbeing if you’re still exploring who you are and what’s important to you.

Feeling isolated

Teenagers and young adults only make up 1% of the cancer population. If you already feel different from your peers because of your sexual orientation or gender identity, cancer can make feelings of isolation more intense.

And while peer support among young people with cancer is really important, the lower likelihood of meeting someone who’s also going through it, and who also identifies the same way as you in terms of sexuality or gender identity, could make things tougher still.

Worrying about disclosure

You meet a lot of different health professionals when you go through cancer treatment, and it can be stressful weighing up whether to ‘come out’ and disclose your sexual orientation or gender identity to each of them.

You might wonder if it’s relevant, worry about how they’ll react, whether it’ll impact on your care, or whether it’ll be kept confidential – at a time when you’re already likely to feel more vulnerable.

Other people’s assumptions

You might find that other people incorrectly assume you’re in a heterosexual relationship, or that you’re cisgender (meaning your gender identity matches your biological sex).

This could mean they use the wrong pronoun (he/she/they) when referring to you, which can be hurtful and undermine your identity. Or they might assume your same-sex partner is your friend.

Prejudice and lack of understanding

Prejudice against the LGBTQ+ community unfortunately exists in society. Young people who are trans, non-binary or questioning their gender identity often face a particular lack of understanding.

If you decide to pursue treatment to help you live the way you want to, in your preferred gender identity, the waiting times for referral and treatment can be long, and navigating the health service can be very challenging – especially if you’re going through something like cancer at the same time.

If you’re an LGBTQ+ young person with cancer, what can you expect from your care team?

We work hard to make our units and services a safe and inclusive space for LGBTQ+ young people. You can expect your care team to treat you with dignity, empathy and respect, no matter how you identify.

  • Visibility is vital. Teenage Cancer Trust spaces in hospitals should clearly display things like posters, leaflets and rainbow badges that show we’re LGBTQ+ allies, and nothing that promotes prejudice or exclusion.
  • You shouldn’t have to fill in forms where ‘male’ and ‘female’ are the only gender options.
  • Your care team shouldn’t make assumptions about your sexuality or your relationship. They shouldn’t ask if you have a ‘boyfriend or girlfriend’ – they might use the word ‘partner’ if it’s relevant to ask. And they shouldn’t assume your same-sex partner is your friend.
  • Your care team shouldn’t make assumptions about your gender identity either. They should ask you before using a particular pronoun (he/she/they) to refer to you. It’s good for members of your care team to share their own pronouns with you too, to help you feel more comfortable.
  • Confidentiality: if you disclose your sexuality or gender identity to someone in your care team, it’s not for them to ‘out’ you to anyone else. They should only ever share that information with other members of your care team if it’s relevant to your care, and if they’ve discussed it with you first.
  • If you have a choice between a male or female ward, that choice is for you to make based on how you identify – your care team shouldn’t make the choice for you.
  • As part of your treatment you should always get the chance to discuss sex, sexual health and fertility with your care team in a way that’s honest, open and relevant to your sexuality and gender identity.
  • Your Teenage Cancer Trust nurse or Youth Support Coordinator (YSC) will always listen and make the time to talk with you about anything that’s on your mind, including your sexual orientation or gender identity.
  • Our nurses and YSCs might not always be experts in the issues that affect you as an LGBTQ+ young person – but we’ll always take the time to educate ourselves, signpost you to additional support where it’s available, and advocate in the healthcare system on your behalf.
  • If your care ever falls short of these standards, we’ll listen and support you in raising concerns. The NHS Youth Forum has more information and resources about young people’s rights in healthcare.

What else can Teenage Cancer Trust (and others) do to support you?

  • Share stories from young people in the LGBTQ+ community who’ve been through or are going through cancer. Your voice is important and we’d love to hear from you, whether it’s a blog, film or just a quote – get in touch and create with us.
  • Make sure we’re aware of the right terminology to use when talking with LGBTQ+ young people.
  • Learn about LGBT history and key dates for lesbian, gay, bi and trans equality.
  • Educate ourselves on the issues that LGBTQ+ people face, and areas of inequality such as mental health and wellbeing.
  • Respect other people’s experiences and be aware of how these might differ from our own.
  • Always be mindful of our actions and their impact on others.
  • Challenge prejudice when we see or hear it.
  • Share the message and fly the flag. In 2020 we were planning to take part in the Pride in London parade for the first time, along with other charities including CLIC Sargent and Trekstock, and young people we’ve supported. We’re sad that coronavirus put paid to those plans, but we’ll be back in force as soon as we can!
  • Keep listening, and use what we learn to improve our services – we can always do more to support LGBTQ+ young people.

Further support and recommended reading