Clinical Characteristics and Care Trajectories of Transgender and Gender Diverse Patients With Cancer Seen in a Pediatric Gender Clinic.

IF 3.3 2区 医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2024-11-01 DOI:10.1002/pon.70017
Madeline H Bono, Hannah L Smith, Coleen R Williams, Kerry McGregor, Ariel K Berman, Elizabeth R Boskey
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Abstract

Background: There is very little information on the experiences of transgender and gender diverse (TGD) youth with cancer.

Aims: To examine clinical characteristics and care trajectories of TGD youth a history of cancer.

Methods: This case series reviewed records of 2790 pediatric gender clinic patients seen between 2007 and 2022 to identify 14 with a history of cancer diagnosis. Demographics, clinical characteristics, disclosure of gender identity to oncology teams, oncology teams' use of correct names and pronouns, documented interprofessional communication between gender health and oncology teams, and course of medical gender affirmation were reviewed.

Results: Of 14 TGD youth with a history of cancer, 11 (78.6%) were diagnosed prior to presenting to the gender clinic (mean [SD] = 8.2 [4.7] years), three following initial gender care (mean [SD] = 1.1 [0.2] years). Six (42.9%) patients were engaged in annual survivorship care when presenting, and 8 (57.1%) were seen concurrently by both clinics. Nine (64.3%) patients had documented communication between teams. Three-quarters of patients who were seen concurrently by both clinics had documented interprofessional communication. Eight (57.1%) patients received gender affirming hormones, after cancer treatment concluded.

Conclusion: TGD youth with cancer experiences present for gender affirming care and merit clinical attention. There was variability in (1) patients' and families' disclosure of TGD identities to oncology teams, (2) whether oncology documentation consistently used patients' correct name and pronouns, and (3) whether there was documented interprofessional consultation between teams. There is need for ongoing improvement in research and clinical protocols for TGD youth with cancer.

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在儿科性别诊所就诊的跨性别和性别多元化癌症患者的临床特征和护理轨迹。
背景有关变性和性别多元化(TGD)青年癌症患者经历的信息很少。目的:研究有癌症病史的变性和性别多元化青年的临床特征和护理轨迹:本病例系列回顾了 2007 年至 2022 年间 2790 名儿科性别门诊患者的就诊记录,从中发现了 14 名有癌症诊断史的患者。研究人员审查了患者的人口统计学特征、临床特征、向肿瘤团队披露性别身份、肿瘤团队使用正确的姓名和代词、性别健康团队与肿瘤团队之间有记录的跨专业沟通,以及医学性别确认的过程:在 14 名有癌症病史的 TGD 青少年中,有 11 人(78.6%)是在来到性别诊所之前(平均值 [SD] = 8.2 [4.7] 年)被确诊的,有 3 人是在接受初次性别护理之后(平均值 [SD] = 1.1 [0.2] 年)被确诊的。六名患者(42.9%)在就诊时正在接受年度幸存者护理,八名患者(57.1%)同时在两个诊所就诊。9名患者(64.3%)的团队之间有沟通记录。四分之三同时在两个诊所就诊的患者都有跨专业沟通的记录。八名(57.1%)患者在癌症治疗结束后接受了性别平权激素治疗:结论:患有癌症的 TGD 青少年需要性别平权护理,值得临床关注。在以下方面存在差异:(1)患者和家属向肿瘤科团队披露 TGD 身份;(2)肿瘤科文件是否始终使用患者的正确姓名和代词;(3)团队之间是否有跨专业咨询的文件记录。针对 TGD 青少年癌症患者的研究和临床方案需要不断改进。
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来源期刊
Psycho‐Oncology
Psycho‐Oncology 医学-心理学
CiteScore
6.30
自引率
8.30%
发文量
220
审稿时长
3-8 weeks
期刊介绍: Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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