Experiences and challenges of sexual and gender minority patients undergoing breast cancer treatment

BACKGROUND: This survey study sought to characterize the experiences and treatments of sexual and gender minority (SGM) patients with breast cancer. METHODS: The WhySurg survey was modified to focus on SGM patients and distributed via social media, support groups, and clinic flyers between 2023 and 2024. SGM individuals, age ≥18, and a history of breast cancer were eligible. Descriptive and reflexive thematic analyses were performed. RESULTS: 50 individuals responded, with 31 (62%) completing it. Most (77%) were cisgender women, 16% nonbinary, and 3% transgender man. Most (58%) were lesbian/gay/homosexual, while 23% were bisexual, 13% pansexual, 13% queer, 3% asexual, 1 heterosexual, and 1 other. 29% experienced discrimination related to their SGM identity during treatment. Three themes emerged: 1) SGM identity influenced surgical choice, 2) respondents were reluctant to share SGM identity, and 3) appropriate surgical expectations are key to optimize gender-affirming patient-centered outcomes. CONCLUSION: SGM data is essential to ensure patient-centered surgical decision-making.