Trans and non-binary people’s experiences of cancer care in Aotearoa/New Zealand

Abstract

Cancer is a severe and life-threatening disease affecting many people and their loved ones. Much is still unknown about cancer as a disease; however, it is known that the care that patients receive can play a vital role in producing better illness outcomes and improving quality of life during treatment. Understanding people’s experiences of cancer care is important for creating better care protocols, understanding barriers to care access, and ensuring patients receive care that meets their needs. This thesis explores the gap in knowledge surrounding trans and non-binary (TNB) people’s experiences of cancer care in Aotearoa/New Zealand. There is limited cancer research internationally regarding TNB communities and cancer, and little-to-no known research has been published specific to Aotearoa/New Zealand. The research question of this study was, what are the cancer care experiences of TNB people in Aotearoa/New Zealand? To understand this question, I undertook an interpretive qualitative study theoretically informed by community psychology. Semi-structured interviews were conducted with three participants who identified as trans or non-binary and had received treatment in Aotearoa/New Zealand within the last ten years. A narrative case study approach was utilised, in order for the complexity and diversity of each participant’s experiences to be recognised. It was found that TNB people experience barriers in accessing cancer care and receiving quality cancer care. These barriers are related to wider structural issues resulting from cisgenderism that are reflected within cancer care. Cisgenderism acts to constrain how TNB patients define their own narrative of illness and interrupts the ability to move forward through cancer in ways that are personally meaningful. The study also found that TNB people are not passive in the face of constraint, as the participants each found ways to maintain a sense of agency within their experience of cancer care. There was significant diversity within the participants’ experiences, which was an important finding in-itself. This diversity particularly demonstrated the benefit of a methodological approach that could account for complexity and intersectionality, when seeking to understand TNB people’s experiences of cancer care. Overall, this thesis provides new insight into an underexplored topic and has important implications for TNB cancer patients in Aotearoa/New Zealand.