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Ben Thomas: Challenging health inequalities for gay and bisexual men and transgender women with prostate cancer

Figures from Prostate Cancer UK show the number of men dying from prostate cancer has overtaken female deaths from breast cancer in the UK for the first time. Mental health expert Ben Thomas says health professionals must ensure that gay and bisexual men and transgender women with prostate cancer receive the help and support they need

Figures from Prostate Cancer UK show the number of men dying from prostate cancer has overtaken female deaths from breast cancer in the UK for the first time. Mental health expert Ben Thomas says health professionals must ensure that gay and bisexual men and transgender women with prostate cancer receive the help and support they need


Picture: iStock

Prostate cancer is the most common cancer found in men in the UK, with more than 40,000 new cases diagnosed every year. Inevitably included in these figures are gay and bisexual men, and some male to female transgender women.

As healthcare professionals, we need to understand the needs of all individuals affected by prostate cancer, including the challenges faced by what has often been described as an ‘invisible group.’

After recognising the patchy provision of support networks nationally for gay and bisexual men and transgender women, Prostate Cancer UK teamed up with Opening Doors London for a six-month pilot of a national virtual discussion group.

Chance to talk

This gives people the opportunity to talk to others in an open forum about their cancer-related experiences and its effects on them and their lifestyles. As the group facilitator, it is my job to make sure the conversations flow smoothly and that all participants have the opportunity to take an active part in the discussion.

We know that a cancer diagnosis can leave people feeling isolated and vulnerable. The peer support and help from gay and bisexual men in the group with similar experiences is effective in reducing this stress.

The group functions on the principles of mutual respect and shared understanding. Some of the men are dealing with a current diagnosis while others have received medical or surgical interventions and are getting on with their lives following treatment.

Honest answers

The group provides an opportunity to meet others who may be going through similar challenges or who have had a different healthcare experience. There is no shortage of encouragement and optimism, and the men can ask questions and receive honest answers.

The biggest and most worrying problem faced by some of these men is stigma and discrimination. Some of the men in the group said they did not tell their doctors about their sexual orientation for fear of homophobia, and because they did not want discrimination to affect the quality of their care.

The men are encouraged to raise topics they want to discuss with the group, with many of the discussions focusing on erectile dysfunction and urinary incontinence.

Effect of inequalities

Some said healthcare professionals assumed that because they were over 60 they would not be sexually active, so having erectile dysfunction should not be a problem for them.

One group member who asked his consultant what treatment was available for erectile dysfunction was told he was unlikely to be offered treatment as he did not have a regular partner.

We know it is illegal to discriminate against people based on sexual orientation and gender identity, and that the NHS has a legal duty to treat people fairly. But we also know that health inequalities still exist and can have a profound effect not only on men’s quality of life but on their survival rates.

Early detection

The National Prostate Cancer Audit of England and Wales shows there are still large numbers of men being diagnosed at an advanced stage of the disease, reducing their chances of survival.

Fear of a negative experience and the expectation of poorer treatment means some men avoid early detection tests. This results in their prostate cancer being diagnosed at a later stage, when it is harder to treat.

Healthcare professionals must work together to tackle health inequalities and uphold the rights of gay and bisexual men and transgender women to have the same standard of care and treatment for prostate cancer as heterosexual men.


Ben Thomas is professor of mental health and learning disabilities at London South Bank University and an ambassador for Opening Doors London 

More information: 

  • For information on training about equality issues and the needs of older LGBT people contact Opening Doors London. 
  • Prostate Cancer UK offers free training and support for healthcare professionals. Click here to find out more.

 

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