LGBT Best and Promising Practices Throughout the Cancer Continuum

Explore the best and promising practices, understand cross-cutting issues, and filter the strategies throughout the stages of the cancer continuum.

To learn about the people involved, the methodology employed, and, of course, the more than 100 Best and Promising Practices, download the full report.

Prevention/Health Promotion

 info
Best and Promising Practices Cross-Cutting Issues

Involve culturally competent and trained community health workers to augment and/or deliver prevention and health promotion messages.

  • For example, health educators such as promotoras, navigators, popular opinion leaders, LGBT peer leaders
Cross-Cutting Issues
  • Icon for Workforce

Ensure that disclosure of SOGI and sexual behavior is safe (confidential, private, affirming, accepted without judgment) during all individual intake and clinical/community encounters.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Recognize that disclosure of layered and intersectional identities is complicated for LGBT individuals seeking health prevention services. They must negotiate whether and how to come out to multiple providers about being LGBT.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems
  • Icon for Diversity

Cultural competence to conduct LGBT health promotion activities should involve measurable competencies, including but not limited to a measure of engagement with the local LGBT communities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Provide ongoing education on LGBT cultural competence to the entire health care work force, especially those that interact with LGBT patients, their family, and their chosen support person(s).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Identify LGBT liaison(s) (point person) to provide cross-cutting subject matter expertise on LGBT issues.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Collaborate with community partners on LGBT-tailored prevention and health promotion activities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Screening

 info
Best and Promising Practices Cross-Cutting Issues

Train all staff (all levels) in providing culturally competent service to LGBT patients, their family, and their chosen support person(s) throughout the screening process.

Cross-Cutting Issues
  • Icon for Workforce

Identify, use, and refer to screening facilities known to be culturally competent in delivering health services to LGBT individuals.

Cross-Cutting Issues
  • Icon for Workforce

Develop and/or use LGBT-tailored cancer screening guidelines for LGBT communities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information
  • Icon for Diversity

Engage culturally competent patient navigators for LGBT patients from the time of screening through the cancer care continuum.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information
  • Icon for Diversity
Public Health Department Recommendation:

Provide management, leadership, and coordination for LGBT-centered screening promotions.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems
  • Icon for Information

Diagnosis

 info
Best and Promising Practices Cross-Cutting Issues

Ensure health care providers are knowledgeable of unique health care needs of LGBT individuals.

Cross-Cutting Issues
  • Icon for Workforce

Develop guidelines for culturally competent LGBT patient navigation programs including training for all patient navigators.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Train all staff who interact with patients/caregivers (including clerical, technicians, patient navigator, pharmacy, housekeeping, food service, etc.) in LGBT cultural competence.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Treatment

 info
Best and Promising Practices Cross-Cutting Issues

Maintain appropriate hormone regimens and transition-related services for transgender and gender variant patients during cancer treatment as a standard of care, in the absence of compelling data to the contrary.

Cross-Cutting Issues
  • Icon for Workforce

Ensure compliance with treatment guidelines regardless of SOGI or gender transition care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Ensure nondiscrimination on the basis of SOGI in hospital visitation, surrogate medical decision making, etc. for Centers for Medicare & Medicaid Services and Joint Commission Accrediting Standards.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Include LGBT topics in all cultural competence training across the health care treatment workforce (including clerical, technicians, patient navigator, pharmacy, housekeeping, food service, etc.).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Educate appropriate bodies about the importance of LGBT cultural competence training as part of provider licensing.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Provide LGBT-focused CME trainings for health care providers.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Establish and support incentive programs that address LGBT health care provider shortages

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Support policies that address and encourage LGBT culturally competent treatment.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Survivorship

 info
Best and Promising Practices Cross-Cutting Issues

Offer LGBT cancer survivors access to culturally competent support services either through the creation of LGBT-specific support groups, referrals to community groups, or at a minimum training support service staff to provide LGBT culturally competent care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Offer LGBT families of choice access to culturally competent support services either through the creation of LGBT-specific groups, referrals to community groups, or at a minimum training support service staff to provide LGBT culturally competent care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Avoid gendered assumptions (e.g., breast reconstruction always being desired), including battle metaphors (e.g., fighting cancer) when providing services to LGBT cancer survivors.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Train all staff who interact with LGBT patients/caregivers (including clerical, technicians, patient navigator, social work, pharmacy, housekeeping, food service, etc.) in culturally competent language and LGBT survivorship issues.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Provide cultural and age appropriate cancer services to LGBT youth survivors.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Recognize the complexity of disclosure for LGBT survivors who must negotiate whether and how to come out to multiple providers about being SOGI and to potential sexual partners about their cancer status. Respect that sometimes withholding is safer.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Palliative Care & End Of Life

 info
Best and Promising Practices Cross-Cutting Issues

Provide in-person and/ or virtual access to culturally competent and/or LGBT-specific bereavement programs for LGBT support networks (i.e., family of choice), recognizing the increased risk for disenfranchised grief.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Address the increased risk of mental health problems and unique psychosocial barriers that exist for some LGBT cancer patients, and ensure that existing quality standards for pain and symptom management are met.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Provide ongoing training to all hospice/palliative care providers and staff to ensure culturally competent care to LGBT patients and families of choice in all care settings (including hospice, long-term care, and skilled nursing facilities).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Address the complex spiritual needs of LGBT patients and families of choice with awareness of the fear and distrust of faith-based communities experienced by many LGBT communities. This includes respecting the choice of not wanting spiritual/pastoral care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Support training for palliative care and hospice providers on LGBT cultural competence.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Prevention/Health Promotion

 info
Best and Promising Practices Cross-Cutting Issues

Involve culturally competent and trained community health workers to augment and/or deliver prevention and health promotion messages.

  • For example, health educators such as promotoras, navigators, popular opinion leaders, LGBT peer leaders
Cross-Cutting Issues
  • Icon for Workforce

Ensure that disclosure of SOGI and sexual behavior is safe (confidential, private, affirming, accepted without judgment) during all individual intake and clinical/community encounters.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Recognize that disclosure of layered and intersectional identities is complicated for LGBT individuals seeking health prevention services. They must negotiate whether and how to come out to multiple providers about being LGBT.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems
  • Icon for Diversity

Cultural competence to conduct LGBT health promotion activities should involve measurable competencies, including but not limited to a measure of engagement with the local LGBT communities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Provide ongoing education on LGBT cultural competence to the entire health care work force, especially those that interact with LGBT patients, their family, and their chosen support person(s).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Identify LGBT liaison(s) (point person) to provide cross-cutting subject matter expertise on LGBT issues.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Collaborate with community partners on LGBT-tailored prevention and health promotion activities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Screening

 info
Best and Promising Practices Cross-Cutting Issues

Train all staff (all levels) in providing culturally competent service to LGBT patients, their family, and their chosen support person(s) throughout the screening process.

Cross-Cutting Issues
  • Icon for Workforce

Identify, use, and refer to screening facilities known to be culturally competent in delivering health services to LGBT individuals.

Cross-Cutting Issues
  • Icon for Workforce

Develop and/or use LGBT-tailored cancer screening guidelines for LGBT communities.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information
  • Icon for Diversity

Engage culturally competent patient navigators for LGBT patients from the time of screening through the cancer care continuum.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information
  • Icon for Diversity
Public Health Department Recommendation:

Provide management, leadership, and coordination for LGBT-centered screening promotions.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems
  • Icon for Information

Diagnosis

 info
Best and Promising Practices Cross-Cutting Issues

Ensure health care providers are knowledgeable of unique health care needs of LGBT individuals.

Cross-Cutting Issues
  • Icon for Workforce

Develop guidelines for culturally competent LGBT patient navigation programs including training for all patient navigators.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Train all staff who interact with patients/caregivers (including clerical, technicians, patient navigator, pharmacy, housekeeping, food service, etc.) in LGBT cultural competence.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Treatment

 info
Best and Promising Practices Cross-Cutting Issues

Maintain appropriate hormone regimens and transition-related services for transgender and gender variant patients during cancer treatment as a standard of care, in the absence of compelling data to the contrary.

Cross-Cutting Issues
  • Icon for Workforce

Ensure compliance with treatment guidelines regardless of SOGI or gender transition care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Ensure nondiscrimination on the basis of SOGI in hospital visitation, surrogate medical decision making, etc. for Centers for Medicare & Medicaid Services and Joint Commission Accrediting Standards.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Include LGBT topics in all cultural competence training across the health care treatment workforce (including clerical, technicians, patient navigator, pharmacy, housekeeping, food service, etc.).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Educate appropriate bodies about the importance of LGBT cultural competence training as part of provider licensing.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Provide LGBT-focused CME trainings for health care providers.

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Establish and support incentive programs that address LGBT health care provider shortages

Cross-Cutting Issues
  • Icon for Workforce
Public Health Department Recommendation:

Support policies that address and encourage LGBT culturally competent treatment.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Survivorship

 info
Best and Promising Practices Cross-Cutting Issues

Offer LGBT cancer survivors access to culturally competent support services either through the creation of LGBT-specific support groups, referrals to community groups, or at a minimum training support service staff to provide LGBT culturally competent care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Offer LGBT families of choice access to culturally competent support services either through the creation of LGBT-specific groups, referrals to community groups, or at a minimum training support service staff to provide LGBT culturally competent care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Avoid gendered assumptions (e.g., breast reconstruction always being desired), including battle metaphors (e.g., fighting cancer) when providing services to LGBT cancer survivors.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Train all staff who interact with LGBT patients/caregivers (including clerical, technicians, patient navigator, social work, pharmacy, housekeeping, food service, etc.) in culturally competent language and LGBT survivorship issues.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Provide cultural and age appropriate cancer services to LGBT youth survivors.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Recognize the complexity of disclosure for LGBT survivors who must negotiate whether and how to come out to multiple providers about being SOGI and to potential sexual partners about their cancer status. Respect that sometimes withholding is safer.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity

Palliative Care & End Of Life

 info
Best and Promising Practices Cross-Cutting Issues

Provide in-person and/ or virtual access to culturally competent and/or LGBT-specific bereavement programs for LGBT support networks (i.e., family of choice), recognizing the increased risk for disenfranchised grief.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Address the increased risk of mental health problems and unique psychosocial barriers that exist for some LGBT cancer patients, and ensure that existing quality standards for pain and symptom management are met.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Systems

Provide ongoing training to all hospice/palliative care providers and staff to ensure culturally competent care to LGBT patients and families of choice in all care settings (including hospice, long-term care, and skilled nursing facilities).

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Information

Address the complex spiritual needs of LGBT patients and families of choice with awareness of the fear and distrust of faith-based communities experienced by many LGBT communities. This includes respecting the choice of not wanting spiritual/pastoral care.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
Public Health Department Recommendation:

Support training for palliative care and hospice providers on LGBT cultural competence.

Cross-Cutting Issues
  • Icon for Workforce
  • Icon for Diversity
;