Experience and unmet needs of transgender middle-aged and older adults in oncology care: A qualitative study


Community-dwelling persons aged 50 or older; diagnosed with any form of cancer within the past 10 years; living in Canada; and self-identify as transgender. *In this study, the term “trans” includes anyone who identifies as a sex or gender other than the one they were assigned at birth. This includes people who identify as male or female, but were assigned the opposite sex at birth. It also includes those who identify as trans men or trans women, non-binary, genderfluid, genderqueer, agender, bigender, or any gender identity other than the one they were assigned at birth


Transgender older adults are at higher risk of poor health outcomes when compared to other non-transgender sexual minority older adults. One-third (33%) of transgender persons reporting at least one negative healthcare experience by healthcare providers due to being transgender (e.g. verbal harassment, refusal of treatment due to their gender identity. Additionally, nearly one-quarter (23%) of transgender persons avoid seeking health care due to fear of discrimination and mistreatment.
Cancer is a disease of aging, with individuals >65 years accounting for 60% of all newly diagnosed cancer and 70% of all cancer deaths. Therefore, it stands to reason that a significant but underrepresented number of middle-aged and older transgender people may already have cancer, or are at increased risk of developing it. We can anticipate a continued increase of older cancer patients who are transgender and who will require quality health care and services in the foreseeable future. This is particularly important as cancer is a strong driver for functional decline and a heightened risk of depression in older adults. For persons who are lesbian, gay, bisexual, or transgender (LGBT), a cancer diagnosis may confer higher risk of adverse physical and psychological outcomes compared to those who are heterosexual and/or cisgender. Understanding the cancer care experiences and unmet needs of this marginalized, vulnerable population is a vital first step in the effort to improve care, promote positive care experiences, and decrease the risk of psychosocial distress related to cancer and cancer care. The purpose of this study is to explore the cancer care experiences and potential unmet needs of transgender middle-aged and older adults with cancer.

How will this research help LGBT people and communities?

Findings from this study will provide insights into the cancer care experiences of this vulnerable and invisible population, and add to the dearth of knowledge, thereby inform strategies to support the care experiences and address needs through clinical practice and advocacy. Moreover, this study will make a unique and original contribution to nursing research by addressing a salient gap in knowledge, and generate much-needed data regarding cancer care experiences and the needs of this largely invisible population. This study will serve as a foundation to inform further nursing research methodology and theory development, with the ultimate goal to promote positive cancer care experiences for this vulnerable population.


Participants will receive a $50 gift card as a token of appreciation for their time. If during or after the interview the participant decides to withdraw the study, they will still be given the gift card.

What mitigation measures are in place to reduce potential distress caused to participants as a result of being part of the research study?

We do not anticipate any psychological, emotional, physical, social or legal harms to occur in participants during and after their participation. However, we are sensitive to the possibility that recalling and recounting past experiences (in particular negative experiences) could potentially be unpleasant to the research participants. Therefore, at the end of each interview, the interviewer (who is a registered nurse) will take time to debrief with the participant, and will provide support and/or referral as needed. Additionally, a leaflet will be provided to each participant at the end of the interview; this leaflet contains web links and phone numbers for support resources (e.g. counselling line, crisis hotline, and information about local LGBT community resources) which participants may choose to use as they see fit.

When do you anticipate that this study's findings will be available?



Name: Schroder Sattar

Email: schroder.sattar@usask.ca

Website: N/A


Schroder Sattar

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