Assessing Referral Patterns and Barriers to Cancer Genetic Services Among Providers of Gender-Affirming Care for Gender-Diverse Patients

Overview:
Gender-diverse patients, such as transgender and non-binary individuals, face significant disparities when accessing comprehensive healthcare, including cancer genetic services. Gender-affirming care (GAC), including gender-affirming hormone therapy (GAHT) and gender-affirming surgeries (GAS), is critical for treating gender dysphoria and largely overlaps with cancer risk management. Although consultation with a cancer genetic counselor may help patients understand how GAHT or GAS could affect hereditary or hormone-sensitive cancer risk, little is known about how often such referrals occur, leaving the intersection of GAC and cancer risk management largely unexplored. Systemic barriers, compounded by cisgender cancer risk guidelines, leave cancer screening and genetic counseling practices for gender-diverse individuals inconsistent and unclear. This study investigates how GAC providers currently approach cancer genetic testing referrals, focusing on family history collection, recognition of testing criteria, and perceptions of testing benefits for gender-diverse patients. A mixed-methods, cross-sectional survey will be distributed through professional societies and LGBTQ+ health organizations to physicians, nurse practitioners, and physician associates/assistants in the United States and Canada that provide a range of GAC. The survey includes multiple choice, select all that apply, ranking, and open-ended questions assessing GAC providers’ use of cancer genetic services, ability to conduct accurate cancer risk assessments, and perceptions of cancer genetic testing in GAC. Quantitative data will be analyzed using descriptive statistics, chi-squared tests, Fisher’s exact tests, t-tests, and ANOVA. Qualitative responses will undergo thematic analysis to identify key trends and provider perspectives. Findings will identify provider knowledge gaps and systemic barriers that contribute to disparities in cancer genetic services for this population. Results could inform provider education, institutional policies, and inclusive clinical guidelines, ultimately improving cancer risk identification and outcomes for gender-diverse individuals.

Study Type:
Mixed Methods

IRB Approved:
Yes

Target Audience:
Physicians, PAs, NPs, and APRNs in the United States and Canada that provide gender affirming care (anything from hormone therapy to surgical procedures)

Target Audience:
250

How to Apply:
Use this link

Study Contact:
Nathan Mitnick