Don Dizon, MD on Overcoming Barriers to LGBTQ+ Inclusivity in Clinical Cancer Research

In an interview with CancerNetwork®, Don Dizon, MD, FACP, FASCO, director of women’s cancers at the Lifespan Cancer Institute, director of medical oncology at Rhode Island Hospital, and professor of medicine at the Warren Alpert Medical School of Brown University in Providence, discussed how cancer institutions are working to overcome barriers to clinical cancer trial inclusivity within the Lesbian, Gay, Bisexual, Transgender, and Questioning plus (LGBTQ+) population. Although several institutions have published mission statements advocating for the inclusion of LGBTQ+ patients in clinical research, implementation is needed in order to achieve equity.

Transcript:

It has been a great push for the better that societies such as the American Society of Clinical Oncology, for example, has come out and stated that their agenda requires us to talk about equity and diversity, as well as inclusion. The fact that they have a leader in the organization who holds that position is important. Of course, putting their message out there that we need to strive for equity and inclusion when it comes to the LGBTQ community is so important. Everyone [who] works in a National Cancer Institute–designated cancer center has an inclusion statement that essentially strives for equality in care regardless of sexual orientation or gender [identity]. Still, that message has to lead to implementation.

It requires us talking to our community to gather all our stakeholders. That includes the folks who are working registration. It includes the people who are putting people in rooms. It includes our research coordinators and research assistants to ask the questions. We need to ask them their preferred pronouns; ask them if they were born male or female; ask them what their gender is today; and ask them what parts they have had removed if they’re [post-operative] transgender.

These are sensitive questions. Not only to the person being asked, but for the person asking them. Everyone is going to want to know how they are supposed to do this and what happens if they get a question back [such as], ‘Why are you asking about my pronouns? I don't understand. What are you getting at? Why do you need to know this information?’

It’s like the other role I play in life as a sexual health provider for people treated for cancer. It’s the same thing. You open that box and you don’t know what’s going to come out. Someone has to toss that hot potato in the air. It is going to be someone’s job to catch it. Whoever is catching that hot potato, we need to make sure that they understand why it’s important. We need to give them the skillset to ask these questions sensitively, then we need to back them up. But it’s important, because we need [to support] people who have felt misaligned in medicine—people who have been the subjects of discrimination. Honestly, you hear the anecdotes of people who are treated unkindly, not to put it mildly. We need to do better for those individuals, so that they’re not delaying access to care [and] that they are participating in our screening programs. At the end of the day, we as oncologists all want to do the right thing. This is part of doing the right thing.