Equity in Preventive Oncology: Practices That Respect Identity and Anatomy

As oncology care continues to evolve toward more personalized and patient-centered approaches, addressing the unique needs of LGBTQ+ individuals remains an important component of equitable care delivery. In this interview, Justin Schweitzer, DO, family physician and Medical Director of LGBT+ Health at Cooper University Health Care, discusses key considerations for clinicians caring for LGBTQ+ patients, including survivorship, cancer screening, family dynamics, and culturally competent care.

Recognizing the Chosen Family

According to Dr. Schweitzer, one of the most important differences in caring for LGBTQ+ patients is recognizing that traditional assumptions about family structure and support systems may not always apply. “What comes to mind is that for LGBT+ patients, family dynamics might be different based off of families accepting someone's sexual orientation or gender identity,” he explained.

For many LGBTQ+ individuals, support networks may extend beyond biological relatives and include a “chosen family” composed of close friends and loved ones who provide emotional, practical, and caregiving support. These relationships can play a critical role throughout cancer treatment and survivorship. “The concept of a chosen family—this close bubble of friends that you have that aren't your biological family—those connections are still strong and important,” Dr. Schweitzer said.

Recognizing and respecting these support systems is particularly important when coordinating care, discussing treatment decisions, and planning for survivorship needs.

Cancer Screening Requires an Anatomy-Based Approach

Another key consideration is ensuring that preventive care and cancer screening recommendations are based on anatomy rather than assumptions about sex or gender identity. “The organ that is present needs to be screened, if appropriate for cancer screenings,” Dr. Schweitzer emphasized.

For clinicians, this means evaluating each patient individually and ensuring that recommended screenings align with the organs and tissues present. Examples include cervical cancer screening for patients with a cervix, breast cancer screening for individuals with breast or chest tissue, and prostate cancer screening when a prostate is present.

These conversations may require additional nuance when a patient's legal gender, sex assigned at birth, and gender identity differ. Dr. Schweitzer stressed that clinicians must approach these discussions with sensitivity and cultural competence. “It’s important to have that cultural competence to make sure that you're having effective and compassionate conversations with your patients so that they're getting the care that they need.”

Addressing Healthcare Disparities Through Communication

Despite growing awareness of LGBTQ+ health issues, disparities in preventive care and cancer screening persist. Dr. Schweitzer believes one of the most effective ways to address these gaps is through clear communication and patient education.

“I try to be real with my patients,” he said. “It's just walking them through that process together and explaining to them the importance of that screening.”

Helping patients understand the rationale behind screening recommendations can improve engagement and encourage earlier detection of disease. As with many areas of oncology, timely diagnosis remains a critical factor in achieving better outcomes.

“If there is a problem, it's better to be detected earlier rather than later so that treatment is much more successful,” he noted.

The Importance of Recognizing Diverse Caregiving Relationships

Dr. Schweitzer also highlighted the importance of understanding the caregiving structures that often exist within LGBTQ+ communities. These relationships may not always be reflected in traditional medical documentation but can significantly influence patient care and decision making.

He shared the story of a patient with advanced lung cancer whose support system extended beyond biological family members to include a partner and chosen family members. “The patient wanted to be surrounded by all of their loved ones,” he recalled.

Through collaboration among healthcare providers, family members, and caregivers, the patient's wishes were respected during hospice care. For Dr. Schweitzer, the experience underscored the importance of recognizing and honoring meaningful relationships regardless of legal or biological status. “It was just making sure that the staff was trained and educated,” he said.

This example illustrates how culturally competent care extends beyond clinical management to include communication, caregiving recognition, and end-of-life planning.

Creating Inclusive Healthcare Environments

Beyond individual patient encounters, Dr. Schweitzer's work focuses on broader organizational efforts to improve LGBTQ+ healthcare experiences. These initiatives include clinician education, medical student and resident training, community outreach, and participation in programs such as the Human Rights Campaign's Healthcare Equality Index. Such efforts help ensure that healthcare organizations are welcoming environments both for patients and healthcare professionals.

For oncology teams, fostering inclusivity can improve trust, encourage engagement with preventive care, and help reduce barriers that may contribute to disparities in cancer outcomes.

Supporting Patients in Finding Affirming Care

Dr. Schweitzer encourages patients who do not feel supported by their current healthcare provider to seek care elsewhere when necessary.

“If you feel like your doctor isn't accepting you for who you are or you feel like they're missing something based off of your anatomy,” he said, resources such as the LGBT+ Healthcare Directory can help identify affirming providers and specialists.

Providing patients with access to knowledgeable and culturally competent clinicians can help ensure that preventive care, cancer screening, and survivorship needs are addressed appropriately.

Looking Ahead

As awareness of LGBTQ+ health issues continues to grow, healthcare professionals have an important opportunity to improve care through culturally informed communication, anatomy-based screening practices, and recognition of diverse support systems.

Dr. Schweitzer's insights serve as a reminder that equitable cancer care requires more than clinical expertise alone. It also requires understanding the lived experiences, relationships, and unique healthcare needs of the individuals being served.

By fostering inclusive environments and maintaining patient-centered approaches, oncology teams can help ensure that all patients receive the preventive care, treatment, and support they need throughout the cancer continuum.

Key Takeaways

• LGBTQ+ patients may have unique support systems, including chosen family members who play important caregiving roles.

• Cancer screening recommendations should be based on anatomy and organs present rather than assumptions about sex or gender identity.

• Cultural competency is essential for effective communication and equitable care delivery.

• Recognizing diverse caregiving relationships can improve care coordination and end-of-life planning.

• Inclusive healthcare environments help build trust and improve engagement in preventive care and survivorship services.

About the Dr. Schweitzer

Justin Schweitzer, DO, is a family physician at Cooper University Health Care and serves as the organization's Medical Director of LGBTQ+ Health. In addition to providing primary care services, he leads initiatives focused on LGBTQ+ patient care, clinician education, community outreach, and organizational efforts to promote healthcare equity and inclusion.