# Assessing the Conceptualizations of Coping and Resilience in LGBTQ2S+ People with Cancer: Working towards Greater Awareness in Cancer Care

## TL;DR

This study explores how LGBTQ2S+ people with cancer cope and build resilience, identifying a 'Second Coming-Out' phenomenon that highlights the need for inclusive cancer care.

## Contribution

The study introduces the 'Second Coming-Out' phenomenon and proposes the LGBTQ2S+ Cancer Care Model to improve inclusive cancer care.

## Key findings

- Most participants experienced a 'Second Coming-Out' phenomenon during their cancer journey.
- Four key narratives emerged: support networks, regaining control, conflicting identities, and traditional coping methods.
- The study highlights the need for LGBTQ2S+-specific resources and inclusive care practices.

## Abstract

The cancer journey is often characterized by significant physical and mental health challenges for people with cancer during and after treatment; LGBTQ2S+-identifying people with cancer may face additional issues surrounding their identity and discrimination in health care settings. However, there is limited research that explores the unique experiences of LGBTQ2S+ people with cancer. This study investigates the resilience of LGBTQ2S+-identifying people with cancer to understand how they experienced and coped with cancer. Most participants’ cancer journeys were characterized by a ‘Second Coming-Out’ phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. Identifying this phenomenon is critical to providing comprehensive care for LGBTQ2S+ people with cancer that draws on their unique strengths. We propose the LGBTQ2S+ Cancer Care Model where the individual is centered and the influences of personal support, professional support, and queer representation are integrated in an accessible and clinically relevant way.

People with cancer may suffer negative psychosocial outcomes due to the challenges of cancer. LGBTQ2S+ people routinely experience negative psychosocial outcomes in health care settings, but have showcased resilience in the face of discrimination; however, this has never been studied in a cancer context. Thus, this study aims to assess coping and resilience in LGBTQ2S+-identifying people diagnosed with cancer using a strengths-based approach. A qualitative exploratory design was used. Ten self-identified LGBTQ2S+ people who have completed their cancer treatment were recruited. Participants completed clinical, health, and demographic questionnaires and, subsequently, semi-structured qualitative interviews. Conceptualizations of coping and resilience in the semi-structured interviews were analyzed using interpretative phenomenological analysis (IPA). Participants were members of various gender identities and sexual orientations. In addition to identifying needed LGBTQ2S+-specific resources, four narratives emerged: support networks, regaining control in life, conflicting identities, and traditional coping methods. Most participants’ cancer journeys were characterized by a ‘Second Coming-Out’ phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. This work provides exploratory insight into LGBTQ2S+ people with cancer, but more research is required with a larger sample.