“Surviving discrimination by pulling together”: experiences of minority stress and social support for LGBTIQ+ people with cancer and their carers

This chapter explores how minority stress shapes the cancer experiences of LGBTIQ+ people, drawing on findings from the Out with Cancer Study. Using a minority stress framework, the chapter outlines how discrimination, stigma, non-affirmation, and internalised prejudice create chronic stressors that undermine wellbeing across the cancer care continuum. LGBTIQ+ patients and carers described how fear of disclosure, prior healthcare discrimination, and societal invisibility shaped their experiences of diagnosis, treatment, and survivorship. We examine how heteronormativity and cisnormativity in cancer care settings compound stress, with participants reporting identity erasure, misgendering, and assumptions about sexuality, gender, and family. These everyday microaggressions, combined with structural exclusion, contribute to feelings of shame, anxiety, and isolation, reinforcing minority stress. Younger participants, trans and gender diverse people, and those with intersecting marginalisations were particularly vulnerable. While some participants responded to minority stress through concealment or identity management, others resisted by asserting visibility and seeking affirming spaces. We highlight the protective role of community support, chosen family, and LGBTIQ+-affirming healthcare. Participants’ narratives underscore the importance of being seen and understood in care, and the psychological toll when this is denied. Importantly, the chapter moves beyond pathology-focused understandings of minority stress, emphasising resilience, resistance, and the power of connection. It calls for healthcare providers and systems to address the structural and interpersonal drivers of minority stress through inclusive practice, education, and policy reform. By centring LGBTIQ+ voices, this chapter challenges oncology to move beyond tokenistic inclusion and instead actively create environments where LGBTIQ+ people feel safe, affirmed, and supported across the cancer journey.