What patients want: recommendations for policy and practice in LGBTIQ+ cancer care

This chapter draws on the voices of LGBTIQ+ patients and carers to explore what inclusive, affirming, and respectful cancer care looks like from their perspective. It highlights the gaps between current healthcare practices and the needs of LGBTIQ+ people and sets out clear recommendations grounded in lived experience. Participants described the importance of being seen, heard, and respected in their identities and relationships. Many shared stories of positive healthcare marked by genuine curiosity, cultural humility, and clear efforts to create welcoming environments. Affirming practices – such as inclusive language, correct pronoun use, and acknowledgement of partners or chosen family – were often simple but deeply meaningful. However, these moments of affirming care were often the exception rather than the norm. Participants recounted instances of misgendering, erasure, inappropriate questioning, and assumptions based on cisnormative and heteronormative frameworks. These experiences caused emotional distress, reinforced mistrust in health systems, and contributed to poorer engagement with care. The chapter identifies key areas for improvement, including the need for routine collection of gender and sexuality data, targeted staff training, inclusive forms and environments, and visible signals of welcome and safety. It also calls for better recognition of the role of partners, carers, and chosen families in decision-making and support. Importantly, participants did not ask for special treatment, but for care that affirms their humanity and responds to their specific needs without bias or judgement. Their reflections point towards a model of care that is relational, respectful, and aware of structural inequalities. By centring the perspectives of LGBTIQ+ people with cancer and those who care for them, this chapter offers a blueprint for more equitable and inclusive cancer care: care that listens, adapts, and affirms.