Friday 21st April 2017
Mac Voice, the magazine for Macmillan professionals: Spring 2017
Patient experience is influenced by social factors, as well as clinical ones. This includes sexual orientation and gender identity
These articles are intended to support you in personalising care for Lesbian, Gay, Bisexual and Transgender (LGBT) people with cancer. They aim to promote a greater understanding of the needs of LGBT patients, and provide practical advice where you may feel unsure or embarrassed about what to say without fear of causing offence.
But first, a word on language, definitions and identities...
As professionals, definitions can seem numerous and daunting, especially if a definition we’re not familiar with comes up in conversation with a patient. However, we should see definitions as a gateway to finding out more information about the patient. After all, they are being used to describe part of a person’s identity, which may be useful to know when supporting them in making decisions about treatment.
‘LGBT’ refers to the terms lesbian, gay, bisexual and transgender. These terms are understood in a range of ways and not all LGBT people openly identify with them, so they are therefore not definitive. However, it is important that the language, definitions, and categories used to describe LGBT people are broadly understood by health professionals, and considered in terms of how they impact on the person themselves. Definitions can provide a common language for talking about oneself, and often bring communities together around a shared identity or common cause. Definitions are not always completely fixed, and can mean different things to different individuals.
If a definition or term comes up which you are not sure about – just ask the person to explain what it means to them.
Sexual orientation: terms and descriptions
Sexual orientation: A person’s sexual, romantic and/or emotional attraction to another person.
Bisexual: Someone who is sexually, romantically or emotionally attracted to people of more than one gender.
Gay: Someone who is sexually, romantically or emotionally attracted to people of the same gender.
Heterosexual/Straight: Someone who is sexually, romantically or emotionally attracted to people of the opposite gender.
Lesbian: A woman who is sexually, romantically or emotionally attracted to other women.
Sexual orientation monitoring: Asking someone who they are romantically, emotionally and sexually attracted to. This should be similar to asking someone if they are married or their age; it is not a question about a patient’s sex life. The only reason sexual orientation seems different is the potential embarrassment, unfamiliarity or hostility towards LGB people that exists.
Gender identity: terms and descriptions
Assigned Gender: The gender a person is given at birth and what gets written on their birth certificate when they are a baby.
Gender identity: A personal concept of oneself as either male, female, both or neither. It can be the same or different to the gender they were assigned at birth. It also may not fit with a binary (male/female) gender system.
Trans (or transgender): An umbrella term to refer to all people who do not identify with their assigned gender at birth and/or the binary (male and female) gender system.
Trans women: Those who were assigned male at birth, but who identify as women.
Trans men: Those who were assigned female at birth, but who identify as men.
Non-binary people: Those with a gender identity that is not exclusively masculine or feminine and may be comprised of elements of either, both or neither.
Transsexual: This term typically refers to the subset of transgender people who have hormone therapies or gender reassignment surgeries to change their gender from that they were assigned at birth.
Cisgender: A term used by some to describe someone who is not trans. ‘Cis’ is a Latin prefix meaning ‘on the same side’ and is used to describe someone who identifies with the gender they were assigned at birth.
Gender identity monitoring: Asking someone about what gender term or terms most suit them. People often see gender as binary, yet an increasing number of people do not feel these terms fit with their identity and they may identify as non-binary or in a variety of other ways.
Trans status monitoring: Asking someone if they feel their gender identify differs from that which they were assigned at birth. This should only be collected at present where there is no direct link back to respondents’ names or personal identifiable information, due to the additional confidentiality included in the Gender Recognition Act 2004.
Senior Engagement Officer
Macmillan Cancer Support
Inclusion Programme Development & Engagement Officer
Macmillan Cancer Support
LGBT Foundation. Sexual orientation and monitoring. 2011.