UBC Theses and Dissertations
Cancer's margins : sexual and gender marginality and the biopolitics of knowledge Taylor, Evan
Research in Canada and the United States indicates consistent health inequities among sexual and gender minority populations, including cancer health disparities. The Cancer's Margins project (www.lgbtcancer.ca) is likely the first nationally-funded project to investigate the complex intersections of sexual and gender marginality and experiences of cancer-related health, treatment, support networks, and decision-making. The Cancer's Margins database includes 121 interviews with sexual and/or gender minority breast and/or gynecologic cancer patients and members of their support networks across Canada, including pilot interviews in the San Francisco Bay area. As part of Cancer's Margins, this dissertation research examines sexual and/or gender minority breast and/or gynecologic cancer patients’ experiences, access to knowledge, knowledge mobilization, and the organization of cancer care. Where approaches to “LGBT health”/“SGM health” have subsumed transgender and other gender diverse people into a general LGBT umbrella or less helpfully, as an aspect of minority sexuality, this dissertation—by contrast—examines sexual marginality and gender marginality intersectionally. The analysis takes into account the biopolitical production of identity, knowledge regimes, and sexuality and gender. The qualitative analysis in this dissertation documents and analyzes how different bodies of knowledge shape complex relationships between marginalization, gender and sexuality, and experiences of cancer health and decision-making. The findings reported here provide evidence that assemblages of cancer care systems are informed by and reinforce heteronormative, cisnormative, homonormative, and repronormative modes of sexuality, gender, and embodiment. Findings also point to the importance of population-specific cancer knowledge for minority cancer patients and the key role of communitarian and experiential knowledge in treatment decision-making by marginalized patients. Additionally, these findings suggest that understanding illness narratives of sexual and/or gender minority cancer patients requires an analysis that takes into account distinct generational cohorts of knowledge related to sexuality, gender, and the production of identity and marginalization. To ameliorate population health disparities, cancer care environments need to account for diverse intersectional models of identity and embodiment. By analyzing the systems of biomedical and biographical knowledge informing cancer patients, providers, and regimes, this dissertation contributes new evidence to undergird culturally-specific and culturally-effective cancer care and practice with sexual and/or gender minority cancer patients.
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