Cancer screening information and considerations for LGBTQ clients

Like everybody else, lesbian, gay, bisexual, transgender (trans) and queer (LGBTQ) people in Ontario need to be screened for colon, breast and cervical cancer according to provincial guidelines.

However LGBTQ clients also have specific concerns when it comes to cancer screening. For example:

• They are less likely to have a primary healthcare practitioner and more likely to delay seeking medical care or screening because of actual or perceived discrimination.
• They may face barriers to screening related to sexual orientation, gender identity and gender dysphoria. For example, trans men may find intimate procedures like Pap tests and mammograms particularly challenging. Lesbian women may have been told or may believe that they do not need cervical screening.
• LGBTQ communities tend to be more vulnerable to social stresses that lead to increased alcohol, tobacco and substance use, which can increase cancer risk.
• LGBTQ clients — in particular trans clients — may take gender-affirming hormones or have had gender-affirming surgeries and other medical procedures that can affect screening guidelines, tests or results. For example, testosterone use can cause cervical cell changes. More research and evidence is needed about how gender-affirming hormones, surgeries and other factors that affect cancer screening guidelines.
• Healthcare providers may not be aware of these issues, or may not have access to research and guidelines — where they exist — for addressing them effectively.