Openness about identity as lesbian, gay, bisexual, transgender, queer, and other sexual orientations and gender identities (LGBTQ+) may cause strain on relationships between family members, which could lead to limited knowledge of cancer family history and reduced communication with family members. As a result, members of the LGBTQ+ community may have more difficulty accessing genetic counseling services for inherited cancer risk. We applied a mixed-methods approach to explore potential barriers to knowledge of cancer family history and family communication among participants of the Cancer Health Assessments Reaching Many (CHARM) study who self-identified as LGBTQ+. We assessed perceptions of family functioning and communication of genetic test results to family members using survey tools and supplemented these data with 20 in-depth interviews to further assess participant perspectives and experiences. LGBTQ+ participants were more likely to report unhealthy family functioning on the survey tool, and some interviewees endorsed that openness about their LGBTQ+ identity led to strained family relationships and reduced communication about their family history of cancer. Overall, this study identified barriers that may be faced by members of the LGBTQ+ community which could limit their ability to access genetic counseling services for inherited cancer risk.

中文翻译：

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遗传性癌症风险评估背景下 LGBTQ+ 个体家族史知识和家庭交流的障碍

对女同性恋、男同性恋、双性恋、跨性别、酷儿和其他性取向和性别认同 (LGBTQ+) 身份的开放可能会导致家庭成员之间的关系紧张，这可能导致对癌症家族史的了解有限，并减少与家庭成员的沟通。因此，LGBTQ+ 社区的成员可能更难以获得遗传咨询服务以应对遗传性癌症风险。我们应用了一种混合方法来探索癌症家族史知识的潜在障碍以及癌症健康评估触及许多 (CHARM) 研究的参与者之间自我认定为 LGBTQ+ 的潜在障碍。我们使用调查工具评估了对家庭功能的看法和向家庭成员传达基因检测结果的看法，并通过 20 次深入访谈补充了这些数据，以进一步评估参与者的观点和经历。LGBTQ+ 参与者更有可能在调查工具上报告不健康的家庭功能，一些受访者认为，对 LGBTQ+ 身份的开放性导致家庭关系紧张，并减少了对其家族癌症史的沟通。总体而言，这项研究确定了 LGBTQ+ 社区成员可能面临的障碍，这些障碍可能会限制他们获得遗传咨询服务以应对遗传性癌症风险的能力。一些受访者表示，对他们的 LGBTQ+ 身份持开放态度会导致家庭关系紧张，并减少有关他们癌症家族史的沟通。总体而言，这项研究确定了 LGBTQ+ 社区成员可能面临的障碍，这些障碍可能会限制他们获得遗传咨询服务以应对遗传性癌症风险的能力。一些受访者表示，对他们的 LGBTQ+ 身份持开放态度会导致家庭关系紧张，并减少有关他们癌症家族史的沟通。总体而言，这项研究确定了 LGBTQ+ 社区成员可能面临的障碍，这些障碍可能会限制他们获得遗传咨询服务以应对遗传性癌症风险的能力。