Integrating Multicultural Orientation into Cancer Care for Sexual and Gender Minorities: A New Paradigm for Leadership, Practice, and Research

The American Society of Clinical Oncology’s (ASCO) 2017 position statement drew attention to the need to address cancer care disparities experienced by sexual and gender minority populations (SGM). In response to the ongoing disparities in cancer care faced by sexual and gender minorities, we adapt the Multicultural Orientation (MCO) framework as a needed paradigm to actualize affirmative cancer care. MCO has been studied in psychotherapy and supervision process and outcome research, demonstrating promise for improving treatment outcomes. The MCO framework encourages providers to convey cultural humility, recognize and respond to cultural opportunities, and self-reflect on their level of cultural comfort. Building upon the extensive body of MCO research in psychotherapy, we present how the MCO framework can be applied in oncology leadership, practice, and research with SGM communities. More specifically, we outline how cultural humility can prompt cancer care leaders, providers, and researchers to examine the structural and societal factors that contribute to disparate cancer care conditions. Cultural opportunities exist in leadership priorities, in how clinical care is structured, and in the research that is conducted. Transformational and authentic leadership styles and intersectionality can be infused into these cultural opportunities to address cancer care disparities faced by the SGM populations. Further, self-reflexivity at the level of leaders, providers, and researchers is key to creating affirmative SGM cancer care environments.