Awkward Choreographies from Cancer's Margins: Incommensurabilities of Biographical and Biomedical Knowledge in Sexual and/or Gender Minority Cancer Patients\u2019 Treatment

Mary K Bryson,Genevieve Rail,Tae L Hart,Janice Ristock,Lorna Boschman,Evan T Taylor,Jacqueline Gahagan

doi:10.1007/s10912-018-9542-0

Abstract

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were conducted with a diverse group (n=81) of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge.

Highlights

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides
Our analysis focuses on patient narratives as autobiographical artifacts makes use of the concept of “choreography” as providing both a lens and a method with which to appreciate intense local modes of epistemic and ontological dissonance and alignment that arise in the cancer clinic, between multiple actors, and multiple modes of biographical and biomedical cancer knowledge, across the trajectory of cancer health decision-making
In the fraught mix of LGBQ//T2 cancer patients and the cancer clinic is an assemblage of multiple systems of knowledge, actors and practices that co-exist in health settings that are characterized by robust and persistent differences in power, and yet, that provide anecdotal evidence of the multiple forms of agency that exist in encounters between bodies located in state systems

Summary

Introduction

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge He said a single mastectomy with reconstruction would be best. North American population-based surveys among sexual and/or gender minority populations provide evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides (Cathcart-Rake 2018; Gibson et al 2017; Peitzmeier et al 2014; Sinding, Grassau and Barnoff 2006)

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