Today in the U.S., 7.2 % of adults identify as LGBTQ+ — that’s more than 24 million people who often face stigma and discrimination that can make navigating the healthcare system difficult.
Elizabeth Cathcart-Rake, M.D., a Mayo Clinic Comprehensive Cancer Center medical oncologist specializing in breast cancer, wants to change that. She’s launched the Rainbows Breast Cancer Clinic in Rochester, Minnesota, to support the needs of lesbian, gay, bisexual, transgender, queer, gender diverse and intersex (LGBTQ+) people with or at risk for breast cancer. She is also researching how to improve their cancer care experiences and outcomes.
The Mayo Clinic Comprehensive Cancer Center Blog team spoke with Dr. Cathcart-Rake about the Rainbows Breast Cancer Clinic. Here’s what she wants people to know about the clinic and the LGBTQ+ cancer care experience:
Meeting the unique needs of LGBTQ+ people
People who identify as LGBTQ+ experience significant disparities in cancer care, including higher rates of late-stage diagnoses, poorer cancer outcomes, and side effects from therapy that go unaddressed.
“I am interviewing folks who talk about getting surgeries on their nose and having their surgical team not feel comfortable getting them dressed after surgery because of their gender identity and gender expression. These types of experiences, to me, are heartbreaking,” says Dr. Cathcart-Rake.
Dr. Cathcart-Rake says LGBTQ+ people are less likely to be offered fertility preservation before cancer treatment and often have unaddressed sexual side effects from treatment. For transgender and gender-diverse people, she says there are questions and concerns about the interaction between hormone therapy, gender-affirming and cancer-specific surgeries.
Opening the Rainbows Breast Cancer Clinic is personal for Dr. Cathcart-Rake. “I have a dear friend who came out and experienced unbelievable discrimination and stigma. That experience has fueled this — thinking through what they’ve gone through every step of the way. Our role is to care for the person in front of us, no matter what.”
Offering cancer care services in a supportive, affirming environment
The Rainbows Breast Cancer Clinic team provides specialty, multidisciplinary and person-affirming care for LGBTQ+ individuals in a safe and respectful environment while optimizing physical, emotional and social health.
“At every point on their cancer care journey, we want patients to see clinic staff who are excited and happy to see them and know the affirming, culturally appropriate language to use. To support that environment, we have posted LGBTQ–welcoming signage throughout the clinic, wear rainbow pins on our badges, and offer gender-neutral bathrooms,” says Dr. Cathcart-Rake.
The team includes Dr. Cathcart-Rake and Amye Tevaarwerk, M.D., another medical oncologist specializing in breast cancer. Jamie Carroll, a nurse practitioner; Gina Schultz, a registered nurse; and Nicole Sintler, a social worker, are also on the team. All team members are trained in providing care for LGBTQ+ people. The team also consults with a breast surgeon and a radiation oncologist with similar training.
“LGBTQ+ people experience so much discrimination and stigma — in everyday life and healthcare experiences. They deserve spaces like this where they’re welcomed and supported and receive equitable healthcare,” says Dr. Cathcart-Rake. “We hope this is just a starting point, and we can expand to other cancer types and subspecialties.”
Conducting research to improve cancer care for LGBTQ+ people
Dr. Cathcart-Rake says research is needed to help healthcare professionals understand the cancer care disparities LGBTQ+ people experience. “We know there are inequities and aspects of their cancer care we’re not addressing. But there’s little data to better understand those needs and how we can improve outcomes,” she says.
Research will be central to the Rainbow Breast Cancer Clinic’s purpose. “That’s going to be a huge part of this clinic — to better understand and identify LGBTQ+ peoples’ needs and work collaboratively with patients and advocates to address them,” says Dr. Cathcart-Rake.
Patients will be asked to complete surveys about their care experiences and symptoms to support this research. Information from these surveys will be used to continuously improve clinical care and to develop clinical trials focused on the needs of LGBTQ+ people related to breast cancer.
How to make an appointment
Housed on the 10th Floor of the Gonda Building on Mayo Clinic’s campus in Rochester, Minnesota, the Rainbows Breast Cancer Clinic is open to anyone who wishes to be seen in an LGBTQ–focused breast clinic.
To make an appointment, call the Medical Oncology Appointment Office in Rochester, Minnesota, at 507-284-8815 and mention “Rainbows.”
Virtual visits will be allowed for any patient, as laws allow.
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This article was originally published on the Mayo Clinic Comprehensive Cancer Center blog.
