Journal: The American journal of hospice & palliative care
Study question
- The study evaluated how comfortable adult oncology patients are answering sexual orientation and gender identity (SOGI) questions in a clinical context, and whether changing the order of more commonly used versus debated/less familiar terms alters comfort.
Methods
- Cancer patients were randomly assigned to 1 of 2 survey versions.
- Both versions contained seven identical SOGI questions but differed in the sequence of response options (e.g., placing terms like “genderqueer” earlier vs later).
- Comfort was rated on a 5‑point Likert scale (1 = very uncomfortable, 5 = very comfortable).
- Primary endpoint: proportion of patients reporting comfort (4 or 5) with the question “Do you consider yourself to be…”, which included 12 response options (such as genderqueer).
- Secondary endpoints: differences in comfort by question order and by demographic factors; qualitative analysis of free‑text comments.
Key results
- 74% of patients (95% CI 70–78%) reported being comfortable with the main SOGI identity question.
- Similar comfort levels were observed for the other SOGI questions.
- No significant differences in comfort were detected based on question sequence or patient demographics.
Qualitative themes from comments
- Emotional reactions to question structure (e.g., concerns that wording remained “essentially gender binary”).
- Emotional reactions toward SOGI content (e.g., perception of “bending over backwards to be politically correct”).
- Concerns about privacy and clinical relevance (e.g., uncertainty why SOGI data are needed for cancer care).
- Constructive feedback (e.g., unfamiliarity with terms like “cisgender” and requests for definitions).
Conclusions and implications for practice
- Most patients with cancer are comfortable answering SOGI questions in oncology settings.
- Comfort may be further improved by:
- Clarifying terminology (e.g., defining less familiar terms).
- Adjusting wording to reduce perceived binary framing.
- Briefly explaining why SOGI information is relevant to cancer care and assuring privacy.