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Cedars-Sinai Cancer: Erasing LGBTQ+ Healthcare Disparities

By Examining the Intersection of Sexual Orientation, Gender and Cancer, Cedars-Sinai Cancer Specialists Aim to Better Prevent, Detect, Treat and Cure Cancer

B.J. Rimel, MD

A first-of-its-kind LGBTQ+ cancer symposium is part of Cedars-Sinai's effort to equalize healthcare access and treatment for allincluding patients who identify as LGBTQ+. 

Studies have shown that the way LGBTQ+ patients are screened, diagnosed and treated for cancer may put them at a significant disadvantage compared to cisgender heterosexual patients.  

To help overcome these disparities in healthcare, teams at Cedars-Sinai Cancer—and across the broader health system—are uniting to better include the science and voices of LGBTQ+ people on cancer care, community engagement and policies that influence health disparities. 

“We recognize that by examining the intersection of sexual orientation, gender and cancer, we can better prevent, detect and cure cancer,” said B.J. Rimel, MD, a gynecological oncologist and medical director of the Cedars-Sinai Cancer Clinical Trials Office. “To make meaningful change, we must continue to ask ourselves where the disparities are, then identify how best to address them. While this process can be challenging, recognizing disparities is the first step to repairing them.”

Dan Theodorescu, MD, PhDTo address these needs, Rimel and Cedars-Sinai Cancer leadership—including Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer—are hosting a first-of-its-kind LGBTQ+ cancer symposium, taking place in Los Angeles on June 2-3.

“We must build national and international awareness to the specific cancer issues that affect our LGBTQ+ patients and discuss how to overcome barriers that impede the best care,” said Theodorescu, the PHASE ONE Foundation Distinguished Chair and professor of Surgery and Pathology and Laboratory Medicine. “We aspire to transform the practice of medicine by advancing and applying science and striving for a better understanding of all aspects of diversity. In doing so, we can achieve the highest impact.”

The Cedars-Sinai Newsroom spoke to Rimel, also associate professor of Obstetrics and Gynecology in the Division of Gynecologic Oncology at Cedars-Sinai Cancer, to learn more about Cedars-Sinai’s efforts to eradicate disparities in LGBTQ+ care.  

Newsroom: What inequities, or disparities, exist in the LGBTQ+ cancer community?
Rimel: One of the clearest examples is in gendered cancer screening. We think of mammography as one of the most powerful tools we have against breast cancer. But if a person whose gender doesn’t fit that of a cisgender female walks into a mammography suite—or a community screening event—they might not be offered appropriate screening, or they might even receive suboptimal care.

Another example common in gynecological oncology is when a transmasculine patient calls the office in need of a pelvic ultrasound. The medical office staff might assume the patient, who has a male voice, called the wrong office, and direct them elsewhere without listening to their questions or concerns.  

Newsroom: How can data, advanced education and better communication solve these problems?
Rimel: If the medical office staff member who answered the phone knew this patient was transmasculine—because his patient records indicated this—they could have answered the phone saying, “Hello, sir. Can I help schedule your pelvic ultrasound?”

Capturing the data—including patient preferences and goals—and ensuring care teams have access to this data, are ways to undo inequities.

Newsroom: How is Cedars-Sinai Cancer helping lead the paradigm change across the medical center?
Rimel: Within our electronic medical records, Cedars-Sinai has an option for patients to identify as multiple gender orientations, sexual orientations and sexual partner preferences. Capturing this information is one part of the solution.

The other key element is educating providers to ask those hard questions and get comfortable using the correct language when they are asking them. Continuing education and an openness to learn is critical.

Newsroom: What are the key takeaways that you hope medical professionals will learn at the Cedars-Sinai LGBTQ+ Cancer Symposium?  
Rimel: I want medical professionals to walk away with two things. First, to understand it’s OK to ask questions and to approach conversations with LGBTQ+ patients with humility and curiosity.

The second takeaway is a call for medical professionals and care teams to understand the disparities. While enormous strides have been made, LGBTQ+ cancer patients don’t benefit from the same privileges or opportunities as other patients. As doctors, we have to be accountable for understanding what policies exist—and how they impact all of our patients, including those who identify as LGBTQ+.

To register or learn more about the upcoming LGBTQ+ Cancer Symposium, taking place in person and virtually, click here

Read more in the Cedars-Sinai Blog: Breast Cancer Has No Gender