Health disparities for LGBTQ+ people affected by breast cancer

Research shows that lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people are disproportionately impacted by several types of cancer, including breast cancer. Like other underrepresented people, members of the LGBTQ+ community are affected by health disparities, which may be related to increased risk, poor access to screening, and lack of quality care.

What is a health disparity?

A health disparity is a type of health difference that is closely linked to being part of disadvantaged populations, or groups of people who have experienced greater obstacles to health due to such things as ethnicity or religion, socioeconomic status, disability, gender, sexual orientation, or gender identity. Some people belong to more than one of these groups, and may experience greater challenges to health care, as a result.

LGBTQ+ health disparities: Increased risk and delayed screening

There aren’t many large-scale studies that explore how cancer in general affects people who are part of a sexual orientation or gender identity (SOGI) minority group. Research that is available suggests that LGBTQ+ people are more likely to develop cancer and more likely to be diagnosed at a later stage than people who are heterosexual and cisgender (non-transgender people whose gender identity matches their sex assigned at birth).

Breast cancer risk and detection

We know that people assigned female at birth have a higher risk for breast cancer than people assigned male at birth. Studies show that lesbian and bisexual women have higher rates of some breast cancer risk factors such as increased alcohol use, smoking, and obesity. Lesbian and bisexual women are also more likely than heterosexual women to have never given birth, which is associated with increased breast cancer risk.

Health disparities affect screening, too. LGBTQ+ people are more likely to avoid or delay screening mammograms because of a fear of discrimination because of their sexual orientation or gender identity or because of past negative experiences with healthcare providers. Transgender people are less likely to get screened than their cisgender peers. Delaying breast cancer screening may mean learning about a breast cancer diagnosis when the cancer is at a later stage, and in some cases, harder to treat.

Learn more about health disparities in risk and detection for transgender people.

LGBTQ+ health disparities and living with cancer

SOGI is likely to impact a person’s cancer care experience. Health disparities often affect health care and quality of life.

Research shows that compared with heterosexual and cisgender people, LGBTQ+ people living with cancer are more likely to report stress and relationship difficulties, engage in substance use, have poorer overall health, and feel less satisfied with their cancer care and treatment.

At the same time, research also shows that people in the LGBTQ+ community may, in some cases, have a more adaptive coping ability than heterosexual women when it comes to a cancer diagnosis. For instance, in one study, sexual minority women reported that they had participated in cancer support groups and counseling before diagnosis, potentially leading to a higher ability to cope after a cancer diagnosis.

Unlike heterosexual and cisgender people, LGBTQ+ people are often tasked with deciding whether they feel comfortable coming out to, or sharing their sexual and/or gender identity with, their cancer care team. They may have experienced discrimination as an LGBTQ+ person in a healthcare setting in the past and feel that it impacted their care—especially LGBTQ+ people who are Black, Hispanic, or live in the South.

Meanwhile, doctors and scientists have difficulty collecting data and conducting research about breast cancer and sexual minority groups if this information is not collected by doctors or shared with them.

Gay and bisexual men and breast cancer

While health disparities exist for gay and bisexual men, there is not much data available on gay and bisexual men and breast cancer. This is likely because men, in general, are not at high risk for breast cancer, and are less likely to be diagnosed with the disease.

However, men with inherited BRCA1 or BRCA2 genetic mutations have a higher likelihood of developing breast cancer than men who do not have these mutations. Other risk factors, such as alcohol use and smoking, that disproportionately affect all LGBTQ+ people could also increase risk for gay or bisexual men. This means that gay and bisexual men who do not feel comfortable disclosing their sexual orientation to their doctors may not get the most accurate risk assessment. Without a complete picture of a person’s risk, a breast cancer diagnosis could be delayed.

Challenging LGBTQ+ health disparities

Many medical organizations are working to educate and train healthcare professionals to create more informed and welcoming environments for members of the LGBTQ+ community.

However, if you are an LGBTQ+ person who is at high risk for breast cancer, or who has recently been diagnosed, some breast cancer care teams still may not be aware of your specific medical and healthcare needs or concerns. Understanding your breast cancer risk—and if you’ve been diagnosed, how your breast cancer experience may be different from those of your heterosexual and cisgender peers—can make it easier to identify questions to ask your healthcare team, advocate for yourself, and make medical decisions that are right for you.

The National LGBT Cancer Network offers a directory by state of cancer treatment centers in the U.S. that are welcoming to LGBTQ+ individuals. Cancer.net also offers LGBTQ+ resources.

Emotional and social support

The experience of diagnosis of breast cancer and treatment can feel overwhelming, regardless of a person’s age, other health or healthcare-related issues, financial situation, and relationship status, as well as SOGI.

If you identify as LGBTQ+ and your life is impacted by breast cancer, your experience may be different than that of your heterosexual peers. It may be harder to find resources that are not heteronormative, that do not assume and promote heterosexuality as “normal” or preferred, which can be alienating. However, in-person and online breast cancer support groups for LGBTQ+ do people exist. You can learn more about these support groups on the Emotional support for LGBTQ+ people affected by breast cancer page.

If you would like to learn more about issues facing the LGBTQ+ breast cancer community, a two-part webinar series is available at LBBC.org. This webinar series was created for healthcare professionals, but may be of interest to all members of the LGBTQ+ community.