Challenges in Cancer Control Confronting the LGBT Population in China: Health Risks, Unique Barriers, and Unmet Needs

Cancer is a leading cause of death in China, which is also home to the world’s largest LGBT population. Yet, the Chinese LGBT community along with their health problems, especially regarding cancer, remain largely invisible. This chapter highlights the health disparities of sexual and gender minorities in China with respect to cancer. Using the conceptual framework of minority stress, it explicates the key issues with respect to risks, barriers, and needs in the cancer control continuum vis-à-vis the LGBT population in China. A major source of minority stress identified is the lack of full acceptance for LGBT persons stemming from prevailing Confucian familial values. This minority stress, in turn, contributes to the greater prevalence of unhealthy behaviors among the Chinese LGBT population, which increases their risk for certain types of cancer. Furthermore, actual or perceived discrimination—for instance, among lesbian women with more masculine appearances—in health care settings hinder their access to cancer screening and care. The recent rise of LGBT-specific spaces and service providers in China, hitherto focused on sexual health, should be expanded to cancer control. There is also a need to formulate screening guidelines and culturally competent interventions that address the LGBT population in China.