Coping With Cancer as a Gay or Bisexual Man

Gay and bisexual men face additional health care challenges compared to their heterosexual peers, including health care disparities, increased risk for specific cancers and negative medical experiences. Awareness, self-advocacy and adequate support can help promote the healthiest outcomes possible.

Health Care Disparities for Gay and Bisexual Men

Gay and bisexual men may face covert or overt discrimination and harassment in medical care settings. These may come from individuals or from the health care systems themselves. When appropriate medical care and treatment are difficult to obtain, negative results become more likely. Some of the issues that impact care include:

• Lower rates of coverage. Health insurance policies do not always cover unmarried partners. This affects everything from access to care, costs and legal rights like visitation.

• Discrimination. Health care providers may exhibit bias against gay and bisexual men. Whether direct or accidental, these interactions can make care unpleasant or even dangerous.

• Negative experiences with health care providers. Fear of unpleasant interactions can lead some men to avoid or delay medical care.

These barriers may cause some men to delay or avoid routine check-ups, screenings and other early detection exams. Missing these can lead to cancer being diagnosed at later stages, making the cancer harder to treat.

Many gay and bisexual men are not partnered, married or living with a significant other. Depending on age, they may have also lost members of their community due to HIV/AIDS and other diseases related to aging.

In addition, many gay and bisexual men have been rejected by or have limited contact with their biological families.

Gay and bisexual men face additional health care challenges compared to their heterosexual peers, including health care disparities, increased risk for specific cancers and negative medical experiences. Awareness, self-advocacy and adequate support can help promote the healthiest outcomes possible.

These situations can result in having to cope with cancer and treatment alone or with support mainly from friends or others in their general community.

Increased Cancer Risks

Gay and bisexual men face a greater risk of certain cancers compared to their heterosexual counterparts. Some of these are based on stress levels, while others are related to lifestyle activities and practices. For example, cigarette smoking is nearly double the rate of the general population. Alcohol and drug consumption are also more prevalent and contribute to increases in lung, colon, head and neck, esophageal and anal cancers.

High-risk strains of the human papillomavirus (HPV) are responsible for most cervical cancers in women. Research shows it also increases the risk of anal cancer through receptive anal intercourse as well as an increase in head and neck cancers as a result of oral sex. Few physicians perform the necessary anal screening exams that could detect these incidences at early stages.

Gay sexual activity is different than straight sexual activity. The impact of cancer treatment raises different concerns that are not always addressed by providers. Fears related to erectile dysfunction following treatment can also affect a man’s sense of well-being, his sense of social self and any relationships with long-standing partners.

Whether you have a cancer diagnosis or have other concerns, keep these heightened risks in mind. Proactive screening can detect cancers at earlier and more easily treatable stages. Openness with your health care team, where possible, can lead to better outcomes.

Coming Out to Your Healthcare Provider

Disclosing your sexual orientation to your healthcare team is a highly personal choice. Gay and bisexual men have historically faced a great deal of prejudice, discrimination and violence. Despite gradual acceptance of various lifestyles, it can be a tremendous step to disclose one’s identity. Above all, your sense of safety should take priority.

Communicating your identity along with partner status can lead to a sense of comfort. This communication may help you address additional health concerns related to your sexual identity. You may be able to focus your energies on your treatment rather than the stress of concealing who you are.

Do not be afraid to seek a second opinion in order to find a better fit, especially if you feel uncomfortable, fearful or discriminated against.

Edited by William Goeren, LCSW-R, ACSW, OSW-C, SEP