How the Rainbow Project Is helping to change cancer care for LGBTQIA+ people

LGBTQIA+ people affected by cancer often face unique barriers when accessing care. In this conversation, Ros speaks with Joe Henson, Manager of the Rainbow Project’s Cancer Champions programme in Northern Ireland, about why inclusive support matters, how misinformation and inequity affect health outcomes, and how the project is helping change conversations.

How do you support LGBTQIA+ people affected by cancer?

The project is here to help challenge myths and provide inclusive support throughout someone’s cancer journey. We focus on emotional, mental and physical wellbeing and try to make sure people feel safe, seen and supported.

For example, our deputy director shared with us as part of our digital screening campaign that her GP notes wrongly stated that she didn’t need a smear test because she’s a lesbian. That led to her having her first screening eight years later than she should have.

Stories like that show why this work is essential to give people up to date reliable information not based on word of mouth. We also support healthcare professionals to feel more confident having certain conversations. Sometimes, it’s not a lack of care, it’s fear of getting it wrong.

The challenges are wide-ranging. Screening uptake is much lower. Around 18% of lesbian and bisexual women miss screenings, compared to 7% of the general population. Trans and non-binary people may be excluded entirely due to gender marker issues.

There are emotional barriers too. If someone’s had a negative healthcare experience, and many LGBTQIA+ people have, that stays with you. Healthcare spaces are often gendered, and if you're non-binary or trans, you may worry about how you're perceived.

On top of that, in Northern Ireland, our cancer outcomes are already the worst in the UK. Without the Equality Act or hate crime legislation LGBTQIA+ people are facing discrimination without the same legal protections. With all this combined, you can see the real necessity for a service like ours.

It sounds like the issues go beyond cancer care itself. Can you say more about that?

It’s not just about cancer, but everything that surrounds it.

LGBTQIA+ people are at a higher risk for 7 different cancers due to a variety of barriers in the system and social factors. Sometimes people require 3 or more additional appointments to receive the same diagnosis compared to cisgender, heterosexual peers according ot NHS reports.

Read more about Overcoming barriers: equitable cancer care for the LGBTQIA+ community.

If you’ve lived through rejection or trauma, those things affect your health long before cancer comes into the picture.

It can be as specific as things like if you're transitioning and you are accessing gender affirming care and you don’t know how your chemotherapy or radiotherapy is going to impact that treatment. We want to make sure everyone has the best resources they can.

The Rainbow Project provides:

• 1-to-1 support and listening-ear services,
• Peer groups and inclusive screening materials
• Events and resources, including a trans and non-binary chest screening video we developed with Antrim Area Hospital and the Public Health Agency. It walks people through the process in a really affirming, practical way.

We also create space for conversations about palliative care and end-of-life planning. For LGBTQIA+ people, there can be added layers. Someone might be out to only parts of their family, which can complicate funeral decisions. Others may not know where to find an LGBTQIA+ friendly funeral director, or how to think about things like their digital legacy and how they want to be remembered.

Our LGBTQIA+ Death Cafés have been powerful. These are spaces where people can talk openly about grief, dying, and legacy in ways that reflect their identity. It’s deeply personal, and for many, it’s the first time they’ve felt able to have those conversations without judgment. It helps people realise they’re not alone.

You mentioned managing cancer myths, is that a big part of the project?

Cancer myths are a big focus. One of our Cancer Champion officers, Samantha, has designed this lovely true-or-false resource. It has 9 statements about LGBTQIA+ people and cancer, and you have to review which you think are true and which you think are false. It takes five minutes but even if someone remembers just one fact, it might change how they approach their health.

How has working with Macmillan helped the project grow?

We wouldn’t be here without Macmillan. This is a three-year pilot with Macmillan and all our staff are trained as Macmillan Professionals. Their support, networks and guidance have been incredible. It’s helped us embed LGBTQIA+ inclusion across more cancer services and work directly with health professionals who want to improve.

People often say they wish this had existed earlier, that they would have felt less alone. We’ve had people tell us they opened up to us before telling family or friends. That trust means a lot. In our Death Cafés, we've had people who have wanted to stay in touch outside of the group.

We've had some great training feedback from professionals, saying this has been useful.

For someone newly diagnosed, living with cancer or supporting a loved one, what would you want them to hear first?

That it’s okay to feel nervous. You don’t have to go through this alone. You can call us, email us, drop by a stall, or even message us on social media, whatever feels easier.

We've tried to put our faces on things. So, if you're worried about who you're talking to, you can go on the web.

You can bring someone with you. Our team is made up of people I’d trust to talk to if I were feeling vulnerable. We’re here to listen, not judge. And if we’re not the right service for you, we’ll help you find one that is.

That's the ethos we have in the Rainbow Project, as we support each other as well as the people coming to our services.

And finally, how can people get involved?

We love volunteers, so please get in touch if you are interested in getting involved.

The Rainbow Project

• Hate crime advocacy
• Co-cultural counselling Gay Ethnic Group (GEG)
• Supporting minority ethnic communities
• Asylum seekers and refugees
• Rainbow Youth
• Sexual health services and testing.

• LGBTQ+ people and cancer treatment
• Transgender and non-binary people and cancer

This information has been written, revised and edited by Macmillan's Digital Content Editor team and checked by Macmillan's Cancer Information Development team.

Learn more about our Digital Content Editors and how we produce our cancer information.