How To Find LGBTQ-Friendly Cancer Care Providers

Accessing healthcare — including cancer screening, cancer treatment, and follow-up care — can be difficult for LGBTQ+ people. Health care providers often don’t receive sufficient education or training on caring for LGBTQ+ people. And discrimination can make queer and transgender people less likely to go to the doctor, or make their experiences much more stressful when they do. That’s why it’s important for LGBTQ+ people to look for providers who are knowledgeable, sensitive, and welcoming to the LGBTQ+ community.

“It is more likely than not people who come from [LGBTQ+] communities have experienced some degree of hostility in healthcare,” says Don Dizon, M.D. Dizon, an openly gay man and service line chief of hematology and oncology at Tufts Medical Center and professor chair at Tufts University School of Medicine.  “The diagnosis of cancer is already psychologically challenging, and I think most [LGBTQ+] people would prefer not to go back into a closet or hide who they are for fear of being rejected by their clinician.”

The risks can extend to treatment outcomes, too. One study found that it took people from sex and gender minority groups almost twice as long to get their cancer diagnosis as cisgender heterosexual people. They were also more likely to decline an oncologist-recommended treatment, and the rate of cancer recurrence (the cancer coming back) in the sex and gender minority group was three times higher.  

Many LGBTQ+ people face discrimination when they see providers. More than one in three LGBTQ+ people has had a negative experience with a healthcare provider within the past two years, such as a provider dismissing their concerns, according to health policy organization KFF.

Six to nine percent of queer people have faced medical discrimination in the past year — such as a provider refusing to see them because of their sexual orientation, refusing to recognize family members like a same-sex partner, or verbally or sexually abusing them — according to the public policy organization Center for American Progress (CAP).

Transgender people face even more discrimination, CAP found, with 12 to 29 percent having experienced these types of harm, in addition to experiences like being refused gender-affirming care or intentionally being misgendered.

That discrimination has only gotten worse under the Trump administration, which has mounted significant attacks on LGBTQ+ healthcare and research, with transgender Americans especially targeted. Scout, MA, PhD, executive director of the National LGBT Cancer Network, says it’s a hostile environment for LGBTQ+ people in healthcare right now: “We have hospitals … hiding any evidence they’re welcoming, and not able to do outreach without risking all their federal funding.” Scout says that non-inclusive providers may feel more emboldened under the current administration to express their discrimination more boldly. “The guardrails are off and that’s only going to hurt all populations experiencing discrimination.” 

Medical mistreatment makes queer and transgender people less likely to seek healthcare independent of health insurance status. For example, 35 percent of LGBTQ+ women aged 40 to 64 have had a mammogram in the past two years compared to 64 percent of non-LGBTQ+ women.

There are additional challenges for transgender people in cancer care. Experts like Dizon recommend organ-based care for cancer screening: If you have a cervix, for example, you need to get screened for cervical cancer even if you’re a transgender man. But currently, in most cases, if a trans man has legally changed his gender, his medical care team may not remind him to get screened because their computer system can only give automatic cervical cancer screening reminders to women. A provider who is competent in caring for LGBTQ+ people, on the other hand, would be able to remind the trans man to get screened anyway.

Additionally, getting screened, such as with a mammogram, can be uncomfortable for transgender people and increase feelings of gender dysphoria. (Gender dysphoria is a feeling of distress that people feel when their gender conflicts with their sex assigned at birth.) A trans-friendly provider can make the people in their care feel more comfortable, increasing the chances that they’ll get screened.

Because queer and transgender people are at a higher risk of having negative experiences with healthcare, it’s important to take the time to find a care team who is LGBTQ-competent. Several organizations, such as the National LGBT Cancer Network and the GLMA, provide searchable directories for finding welcoming providers. It's important to note, though, that these databases are incomplete and often out of date, so they’re a good place to start but shouldn't be treated as a complete list.

If the directories don’t include any specialists in your area that are covered by your insurance, or if you’re choosing between multiple options, there are a few strategies you can use to find the most welcoming provider in your area.

First, word of mouth is extremely useful. Ask local LGBTQ+ friends which providers they see. You can also ask local or national LGBTQ+ organizations for recommendations. Social media can be useful too, such as Facebook groups for LGBTQ+ folks in your area, or Reddit threads for your town or county.

Once you find potential providers, do your own research on them. Search their provider page or the web page of the medical group they work for for any mention of caring for LGBTQ+ people. Check whether the provider is a member of a group dedicated to LGBTQ-inclusive healthcare, such as the GLMA. Read reviews to see if any patients mention being LGBTQ+ and how they were treated. Familiarize yourself, if you can, with Google Scholar or PubMed, which are databases of peer-reviewed scientific research. There you can check whether providers have done research that is inclusive of LGBTQ+ people. You can also find the provider’s social media to see if they have posted about being a member or ally of the LGBTQ+ community.

If you’re able to, interview staff at your provider’s office to see if it will be safe for you. You can call the office and ask about the provider’s experience caring for patients with your identity, or any education they’ve had about the LGBTQ+ community. At an appointment, you can test the waters before coming out, for example, by referring to your partner with gender neutral pronouns. You can also look for signs of support for the LGBTQ+ community in the office, like posters, pronoun badges, or rainbow pins.

LGBTQ-Welcoming Cancer Screening Providers: This searchable database is provided by the National LGBT Cancer Network. You can search by state to find facilities that the organization has vetted for being affordable, safe, and welcoming for all LGBTQ+ people. Facilities that are highlighted have trained all staff on transgender issues. The results specify which types of cancer screening the facilities provide and a contact that you can reach out to.

LGBTQ-Welcoming Treatment Providers: This searchable database is also from the National LGBT Cancer Network, but it lists cancer treatment facilities. It’s just as strictly vetted and is also searchable by state. Facilities that are highlighted are also NCI Designated Cancer Centers, which means that they’re national leaders in cancer treatment and research. Unfortunately, nine states do not have any facilities that meet the criteria needed to be a part of this database.

LGBTQ+ Healthcare Directory: A project of the GLMA and Tegan and Sara Foundation, this large directory can help you find knowledgeable and sensitive providers in the U.S. and Canada. You can search by type of provider and many other factors, including patient approach (such as if they use a trauma-informed or weight-inclusive approach), specialty, distance from your zip code, languages spoken, and more.

The OutList LGBTQ+ Affirming Healthcare Directory: This international list allows you to search for LGBTQ-friendly providers by specialty, location, and keywords.

CenterLink LGBTQ Community Center Member Directory: This searchable directory maps out LGBTQ+ community centers in the U.S. (and some outside the U.S., too). Not all centers listed offer health services, but even those that don't may be able to refer you to local LGBTQ-friendly providers.

Not all areas will have good options for LGBTQ-affirming cancer care providers. Ultimately, staying safe is the most important thing. You do not have to disclose your trans identity or sexual orientation to your provider if you don’t feel safe.

If you can’t find an LGBTQ-competent provider near you and you can’t travel for care, learn your rights. 

"There are many different ways in which policy affects the care that you receive. And it might differ from one hospital to another, one town to another, and definitely from one state to another,” says Alex Sheldon, executive director of the GLMA. For example, some states and cities ban healthcare providers from discriminating on the basis of sexual orientation or gender identity. In those places, you could sue if they refuse to provide adequate care.

Still, many providers aren’t knowledgeable about caring for LGBTQ+ people but are willing to learn, Dizon says. “Oftentimes, learning by taking care of someone is probably the most important way we do change our own behaviors,” he adds. You can set up your care team for success by asking them if they have any questions about caring for you as a queer or trans person that would allow them to better care for you.

You can also bring a patient advocate, such as a friend or family member, to your appointments. Or you can reach out to a patient navigator, social worker, or local LGBTQ+ center to see if they have advocates available. Having a patient advocate with you at appointments allows you to focus on your medical care while the advocate focuses on making sure that you’re treated appropriately, such as by correcting staff if they misgender you or speaking up if the provider is hostile. They can also help support you if you start feeling stressed.

Cancer care teams are often large. And if you’re hospitalized, you may meet multiple providers in one day with little time to prepare. In this situation, it can be helpful to ask your main care provider to consult with LGBTQ-friendly specialists and to let incoming providers know about your LGBTQ+ identity and how they can respect it.

Finally, the most important thing to remember when faced with a bad experience as an LGBTQ+ person with cancer is to continue to advocate for yourself within the healthcare system, rather than disengaging from it. Dropping out of the healthcare system is a common response among LGBTQ+ people who have had bad experiences, and this disengagement is a major driver of worse healthcare outcomes for people in the LGBTQ+ community with cancer. 

To best advocate for yourself, gain a basic understanding of your cancer and the treatment options recommended by the National Comprehensive Cancer Network. There are many reasons why your oncologist may choose other treatments to provide care that’s better tailored to you. But by familiarizing yourself with the standard of care for your type and stage of cancer, you’ll be able to have a more informed discussion about the risks, benefits, and alternatives of your doctor’s plan. 

If you’ve had a bad experience with your provider, try your best to not give up. It’s important to get informed, seek a second opinion, and most importantly, stay engaged in your healthcare.