Are symptoms overlooked in patients who have cancer and identify as transgender or nonbinary?-Hiccups as a bellwether sign/symptom: a retrospective cohort study.
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BACKGROUND: Are signs and symptoms overlooked in patients who have cancer and who identify as transgender or nonbinary? Because clinicians seem unaware of hiccups and because patients who identify as transgender or nonbinary appear at especially high risk for having their medical signs/symptoms overlooked, this study focused on hiccups as a bellwether sign/symptom. METHODS: The medical records of 126 patients who had cancer and who identified as transgender or nonbinary were reviewed in detail. A literature-based, incidence rate of hiccups of 9% served as a benchmark. RESULTS: The median age was 42 years (range, 18-78 years). Fifteen self-identified as transgender men, 41 as transgender women, and 70 as nonbinary. Seven patients, or 6%, had hiccups (this observation was below the benchmark). The incidence of hiccups was 0% (0/15), 12% (5/41), and 3% (2/70) among transgender men, transgender women, and nonbinary individuals, respectively. In 3 patients, the hiccups appeared to go unaddressed. CONCLUSIONS: These findings suggest signs/symptoms might be overlooked in gender diverse patients with cancer. Additionally, these findings should prompt efforts to identify and palliate signs/symptoms-including hiccups but, of course, others as well-in patients who have cancer and who identify as transgender or nonbinary.