Improving Cancer Care for Trans+ Individuals

We are coming to the end of phase one of Trans Aware Cancer Care, a community-based project exploring the experiences of trans+ people with cancer services and healthcare more widely.

Throughout this project, trans+ people, and our allies, were asked to create a square to depict their feelings and experiences.

Some of these squares were very ornate and painstakingly created, while others were made quicker and featured more writing. All were made of emotions and memories. These were lovingly attached together to create a large trans flag.

We hope to take the flag (pictured) on a tour of several local hospitals and trusts before embarking on a UK-wide journey.

Earlier this week the core research team unravelled the flag to theme the squares however stories created by trans and queer people can’t and shouldn’t fit neatly into a theme. The very act of theming felt wrong. Participants have not smashed out of cisgender and heterosexual boxes for us to cram them into others.

What we can give voice to is what we witness, fear, joy, tears, laughter, distrust, violence, belonging, and thriving. What of these experiences can we improve, and how? How can we make good experiences more consistent across cancer services?

The answer is not simple, it relies on an ongoing growth mindset of practitioners and system creators. These changes in attitude need to be grounded in active anti-transphobia, and there is no quick fix for this. However, some things can be put into practice instantly…

Share your pronouns and ask them of patients. “Hi, my names Marianne, I use she / her pronouns and I’ll be your physician today.”
Pronouns can also be worn on name badges and lanyards and shared in email signatures. These all normalise asking and sharing pronouns. Practitioners shouldn’t press people to share that information but it can be made space for.
Check names. Trans+ people may have chosen a different name to their given one, even cisgender people have nicknames and preferred names! Make a note of these in the patient’s paperwork.
Avoid gendered language (we do it more often than we think!)… ladies and gentlemen; young lady; between us girlies; young man; women’s trouble; female cancer; women; men. Most of these words can be exchanged for something more specific: a person’s name, cervical screening, prostate screening, people, people with a prostate.
If you get something wrong, or are corrected apologise, correct and move on, we appreciate you didn’t intend to cause offense.

These things are simple enough to change in practice across all areas of healthcare and they cost nothing. They will take time for you to get used to, but it also took you time to achieve your medical degree. These seemingly small things can make a big difference to trans+ patients and many more besides.

Anecdotally speaking trans+ people are nice and just want to be treated with dignity, there is no need to fear our reactions. Do not be scared of getting it wrong, be excited about getting it right.