Abstract B168: A qualitative examination of how state policy and sociopolitical environmental influence experiences of cancer care for minoritized sexual and gender populations who have experienced breast cancer

Abstract Introduction: A growing body of literature is investigating how structural barriers, including policies, impact cancer outcomes among marginalized populations, including the 2SLGBTQ+ (two spirit, lesbian, gay, bisexual, transgender, queer, asexual, intersex, and gender non- conforming or gender non-binary)(sexual and gender minoritized (SGM)) communities. An underresearched area is how the state-level policy and sociopolitical environment shape the experiences and outcomes of SGM people who have experienced breast cancer. Using data from the Elsie Study, this research examines how SGM people who have experienced breast cancer are impacted by their state’s policies and sociopolitical context. To the authors' knowledge, this study is the first of its kind to examine these experiences of breast cancer care for SGM people. Methods: The Elsie Study is the largest qualitative survey of SGM people who have experienced cancer conducted within the U.S. To date the Elsie Study at the University of Minnesota has conducted 60-90 minute semi-structured interviews with thirteen sexally and gender minoritized people who have experienced breast cancer. Our participants were recruited from advertising campaigns on social dating applications, including HER, and community organizations. Interviews were conducted nationwide over Zoom and phone beginning in June 2023 and continuing through June 2024. Summary of data: Our participants who have experienced breast cancer have diverse sexual orientations, gender identities, and racial and ethnic backgrounds. Among the thirteen sexually and gender minoritized participants who experienced breast cancer, their sexual orientations encompass those who identify as lesbian, gay, bisexual, queer, or some of these interchangeably. Participants’ gender identities include identifying as cisgender woman, genderqueer, non-binary, transgender man, and transgender woman. Participants’ racial and ethnic backgrounds are white, Black or African American, Latino/a/x, and Asian. Participants at the intersections of marginalized identities noted substantial difficulties in receiving culturally competent care during breast cancer treatment. A majority of SM and GM women and non-binary participants mentioned the importance of living in a “queer and trans friendly state,” liberal cities, or states with marriage equality for aspects such as accessing culturally competent cancer care and participating in cancer research. Conclusions: Narratives such as those expressed by our SGM participants who experienced cancer are important for understanding how state policy and sociopolitical contexts shape access to healthcare and even cancer research. Our study has wide implications for how affirming state policy and sociopolitical climates may afford more equity in cancer care for SGM people. Citation Format: Courtney Sarkin, Alexandra M. Ecklund, Ben Weideman, Rhea Alley, B.R. Simon Rosser, G. Nic Rider. A qualitative examination of how state policy and sociopolitical environmental influence experiences of cancer care for minoritized sexual and gender populations who have experienced breast cancer abstract. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B168.