Including a Partner in the Process
LGBT individuals who are married in states that recognize ‘gay marriage’ have an easier time dealing with either a hospitalization or outpatient healthcare in that the spouse can be present at the bedside and at physician appointments—just like any heterosexual married couple. In states without same-sex marriage rights, the life-partner can be barred from the room at a time when the LGBT cancer patient most needs that person’s support and input. (Likewise, the non-biological children can also be barred from visiting the bedside on the same basis.) Thirteen states currently ban ‘gay marriage’—12 by constitutional amendment and state law, and one by state law only (as of 5/20/15). For those LGBT cancer patients living in the 13 states where same-sex marriages are not allowed, it can only be hoped that the Supreme Court will quickly render these bans unconstitutional.
Informing Others about Diagnosis/Treatment and Dealing with the Response
Similar to the heroine (Hester Prynne) in Hawthorne’s The Scarlett Letter—who was forced to wear a scarlet letter to stigmatize her in the wider community— many cancer survivors feel that they invisibly wear a similar scarlet letter in their interpersonal relationships. Especially in the workplace, telling others about a cancer diagnosis—and the need to take periodic time off for treatment and recuperation—can affect relationships with supervisors and co-workers. For LGBT cancer survivors, informing others at work can generate conversation about personal issues that may feel uncomfortable. Especially for an LGBT employee who is not ‘out’ on his/her job, it can be difficult to navigate the minefield of questions.
Cancer survivors all too often feel that they have to prove their well-being to supervisors by not taking accrued “sick-time” or expressing any complaint of illness as compared to colleagues who have never had such a diagnosis. This is due to the reality that employers are more likely to “lay-off” an employee perceived to be potentially unproductive in future in comparison to a co-worker who has not had cancer. Despite anti-discrimination laws protecting LGBT employees and the American with Disabilities Act, it can be hard to prove that the job loss occurred as a result of prejudice. The enormous fatigue experienced by cancer survivors may make legally fighting an unfair dismissal even harder—especially during prolonged treatment.
Psychological counseling can be extremely important for cancer survivors to deal with changed interpersonal relationships (and to be able to set limits in terms of personal boundaries), whether with a partner, family members, friends, or colleagues. Since cancer can happen to anyone, curiosity may be the motivating factor for questions about health changes. Engaging with a mental health therapist may provide the support needed to handle the reactions (and unsolicited advice) of others to a cancer disclosure.