Allyship in Action: Supporting LGBTQIA+ Patients in the MBC Community

The month of June is set aside and known as Pride Month, commemorating the 1969 Stonewall Uprising in Manhattan, which was a tipping point for the Gay Liberation Movement in the United States.

To me, as an ally, this month is a chance to celebrate further advancements to address the inequities in the LGBTQIA+ community when it comes to healthcare. FYI, that acronym stands for lesbian, gay, bisexual, transgender, queer/questioning (one's sexual or gender identity), intersex, and asexual/aromantic/agender. I didn't know that and had to look it up.

Intersectionality in the breast cancer community

How inequities impact the metastatic breast cancer community

As with anyone who presents as "different," we know that systems like the healthcare system don't often account for and address those differences well. Those individuals who identify as a gender different from the one assigned to them at birth present a conundrum for many healthcare workers, who have no idea how to handle someone different from what they expect.

For many, filling out healthcare forms is a minefield of triggers since the categories don't often apply, or inappropriate questions are asked. Additionally, the actual experiences of many people in this community affect their risk for different types of cancer.

Understanding unique risk factors

For example, a friend of mine who identifies as a lesbian woman shared with me recently that the fact that many lesbian women don't have children, and therefore never breastfeed, affects their risk significantly for developing breast cancer. While I know that having children and breastfeeding can be a protective factor longitudinally for developing breast cancer, I hadn't connected those dots for others.

Navigating triggers and obstacles in care

I encounter triggers when accessing care, and I'm a white woman who identifies as my assigned gender at birth, so hearing about those things that are harder for those in our community when accessing care that is already a minefield just breaks my heart.

How to put allyship into action

Over the years that I've been married to my dark-skinned husband and parenting mixed-race boys, I've learned a few things about how we can all use our privilege to help others. Here are some thoughts:

• Ask questions. Many people who have different experiences don't have an outlet to talk about them or are ignored. When you meet someone who has had a challenging experience, ask them about it.
• Speak up. If there is a situation happening within your earshot, speak up. If you learn about how people in our community are treated differently, ask questions of the leadership of your cancer center, support group, or otherwise.
• Show up. If there is an educational opportunity, march, or discussion about people who are different from you, show up to learn more. If there is someone you know who is being treated differently, offer to accompany them to their appointments.
• Hold space. While it is good to learn and ask questions when there is an unfamiliar situation, sometimes the person who is experiencing bigotry or marginalization just needs you to be there, to be present with them. I find it hard to always know when to do this, but I have never experienced holding space as the wrong choice.
• Be open. The experiences of people different from us can often be baffling, and it's easy to assume that the person themselves might be at fault rather than the system as a whole. I remind myself daily to be open to the possibility that I don't always know everything.

One of the best things about the metastatic breast cancer (MBC) community is that we do show up for each other, and I see others in the community all the time speaking up. There are always opportunities to learn more about how to do this better and more often.