“Failing to Recognize me as a Fellow Human Being”: A Matrix of Dehumanization Structures Cancer Care for Trans and Nonbinary People With Cancer

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Abstract
Background: Trans and nonbinary (TNB) people remain invisible in cancer care. Limited research indicates barriers to quality cancer treatment, including healthcare discrimination linked to poor survivorship outcomes. Aims: This study aimed to characterize cancer treatment experiences among TNB cancer patients using an intersectionality lens and exploring the structural processes underlying inequities. Methods: We recruited TNB cancer patients ( N = 42) using multiple strategies and conducted individual, semi‐structured interviews (45–90 minutes). Interviews were transcribed by professional service and de‐identified. We used reflexive thematic analysis to generate themes from interview data. Results: We developed seven interconnected themes across three, mutually constitutive domains of power that compose a matrix of dehumanization in cancer care—a structural process that confers uneven risks of harm based on patients' multiple social positions. In the institutional systems domain, The Climate We Live In describes how anti‐trans politics are embedded in legal systems, and A New Type of Consumer explains how for‐profit cancer care exploits value from patients. In the cancer care organizations domain, Made Invisible articulates practices of erasure in clinics leading to unmet care needs, and What Are You Doing Here? elaborates hyper‐visibility and a lack of safety in clinic settings. In the socio‐structural processes domain, Ingrained Racism details racialized dehumanization in provider and staff interactions, Losing Sexuality captures sexual and gendered objectification, and Continues to Hurt Me highlights the enduring traumas of dehumanizing care. Conclusions: Improving cancer treatment inequities for TNB people requires disrupting the status quo power relations that sustain dehumanization in cancer care.
Funding Information
  • National Cancer Institute (R01CA265945)
  • National Cancer Institute (R01CA265945S1)

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