Health of Sexual and Gender Minorities

Background

The National Cancer Institute (NCI) maintains a strong commitment to health disparities research, which includes DCCPS efforts to support research aimed at addressing the mechanisms contributing to disparities across the cancer control continuum. This includes understanding the extent and causes of cancer health inequities experienced by sexual and gender minority (SGM) populations. For the purposes of research, NIH defines SGM as including, but not being limited to:

individuals who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex. Individuals with same-sex or -gender attractions or behaviors and those with a difference in sex development are also included. These populations also encompass those who do not self-identify with one of these terms but whose sexual orientation, gender identity or expression, or reproductive development is characterized by non-binary constructs of sexual orientation, gender, and/or sex.

The lack of systematic collection of sexual orientation and gender identity (SOGI) data makes it difficult to fully assess cancer incidence, morbidity, and mortality in SGM populations. A growing body of evidence suggests that members of SGM populations experience higher rates of certain cancers and worse physical and mental health after diagnosis than do non-SGM populations. Additionally, research suggests that outcomes may vary across sub-populations (e.g., bisexual and transgender). There is increasing recognition that prevention, screening, treatment, and survivorship care all too often fails to acknowledge or address the unique needs of SGM population. These include the fear of stigmatization and discrimination, inadequate recognition of SGM-specific risk factors and medical care considerations, and the role of individuals who are recognized as family members absent a biological or legal relationship. DCCPS efforts to understand and address disparate outcomes experienced by SGM populations include funding opportunities and other activities described below.

Notice of Funding Opportunities

• Featured Funding Opportunity
  • PAR-23-292: Improving Care and Outcomes for Cancer Survivors from Sexual and Gender Minority (SGM) Populations (R01 Clinical Trial Optional)
• Notice(s) of Special Interest
  • NOT-MD-22-012: Research on the Health of Sexual and Gender Minority (SGM) Populations
  • NOT-OD-23-166: Family Support and Rejection in the Health and Well-Being of SGM Populations
  • NOT-OD-22-166: Research on the Health of Bisexual and Bisexual+ People
• The Sexual and Gender Minorities Research Office (SGMRO) maintains a list of active funding opportunities across NIH.

Events

• The Rainbow Connection: Building a Career as an LGBTQ+ Scientist
• Disparities Among Sexual and Gender Minority Cancer Survivors: Studies on Prostate Cancer in Gay and Bisexual Men
• NIH Sexual and Gender Minority Research Office Scientific Webinar Series

Related Reports and Publications

• Editorial - Addressing Sexual and Gender Minorities in Cancer Research
• Workshop Summary - Expanding the Evidence Base in Gender-Affirming Care for Transgender and Gender Diverse Populations (NIH Sexual and Gender Minority Research Office)
• Position Statement - Strategies for Reducing Cancer Health Disparities Among Sexual and Gender Minority Populations (American Society of Clinical Oncology)
• Reports
  • FY 2022 Annual Report (NIH Sexual and Gender Minority Research Office) (PDF)
  • FY 2021 Portfolio Analysis (NIH Sexual and Gender Minority Research Office) (PDF)
  • Strategic Plan to Advance Research on the Health and Well-Being of Sexual and Gender Minorities (NIH Sexual and Gender Minority Research Office) (PDF)
  • Understanding the Well-Being of LBGTQI+ Populations (National Academies of Sciences, Engineering, and Medicine)
  • Cancer Disparities Progress Report (American Association for Cancer Research)

Resources

SOGI Data Collection

A major barrier to advancing SGM cancer research is the lack of systematic and standardized SOGI data collection in surveillance, research, and clinical settings. The NIH-commissioned report titled “Measuring Sex, Gender Identity, and Sexual Orientation” from the National Academies of Sciences, Engineering, and Medicine provides a model for measuring SOGI in research settings.

The implementation of the National Academies-identified measures at NCI-designated Cancer Centers is being explored in an NCI-sponsored and DCCPS-coordinated initiative.

Contact

David Dean Jr, PhD, MS (HDRP secondary appointment)
(he/him/his)
chipper.dean@nih.gov Behavioral Research Program (BRP)

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