An NCI-designated Comprehensive Cancer Center
By City of Hope | March 18, 2016
Breakthroughs - David Rice David Rice, Ph.D., R.N., N.P.

Lesbian, gay, bisexual and transgender (LGBT) persons are still experiencing stigma and discrimination, despite growing social acceptance universally, including exclusion within the health care system. It’s a scenario that is compromising the care and treatment they receive, and have access to.

These are the findings of a manuscript, “The National LGBT Action Cancer Plan,” recently published in LGBT Health, and co-authored by City of Hope’s David Rice, Ph.D., R.N., N.P., the director of clinical practice and education in the Department of Professional Practice and Education.

The paper concludes that increased sexual orientation and gender identity data collection, improved clinical care, and broader education and training among health care providers is essential to better understanding and addressing the cancer risks and incidences within the LGBT communities.

“Acceptance into a welcoming practice, along with coordinated care, has a positive effect on the patient and how they respond to treatment,” Rice said. “If people don’t feel that they have an inclusive environment, they’re going to withhold information, lie to their providers, or they are going to leave and may not seek treatment elsewhere.”

LGBT cancer patients face unique challenges that can adversely affect early cancer screening and care, including:

  • Discrimination, prejudice and stigma

  • Higher rates of alcohol abuse, tobacco use, depression/suicide, eating disorders, obesity and sexually transmitted disease

  • Lower rates of disclosure

  • Diminished access to health care


According to Rice, the paper is the result of insights that emerged from the 2014 LGBT Leaders’ Summit, where experts weighed in on how the challenges LGBT cancer patients face when seeking medical care can adversely affect cancer treatment.  

While these challenges remain widespread, Rice sees progress. And City of Hope, he says, is ahead of the curve in many ways. “We are a leader in improving cancer screening and care for the LGBT community. We are a welcoming environment, we have expanded LGBT training into nursing programs, and we have an active diversity resource group, ‘Pride in the City.’” 

Pride in the City, which is part of City of Hope’s diversity and inclusion initiative, brings senior leadership together to implement changes that promote a safe and welcoming environment for all patients, families and employees, regardless of gender identity and/or sexual orientation. This year, City of Hope expects to submit its application for recognition in the Human Rights Campaign’s Healthcare Equality Index, which ranks health care facilities on LGBT patient care quality.

LGBT Health is a peer-reviewed journal that promotes greater awareness of the health concerns of sexual and gender minority populations and improving the availability and delivery of culturally appropriate health care services.  Editor-in-chief William Byrne, M.D., Ph.D., has praised the action plan as “a landmark for the health of sexual and gender minority populations.” 


If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

Sign up to receive the latest updates on City of Hope news, medical breakthroughs, and prevention tips straight to your email inbox!

*Required Fields