A Novel Poetic Dignity Therapy Adaptation for Sexual and Gender Minority Patients With Cancer

Sexual and gender minority (SGM) patients experience disproportionately poor psychosocial cancer outcomes when compared to non-SGM patients. Psychosocial interventions specifically tailored to this population are lacking.

To assess feasibility, acceptability and preliminary efficacy of a modified Dignity Therapy (DT) intervention for sexual and gender minority (SGM) patients with cancer.

We modified DT to incorporate questions about sexual and gender identity and a novel poetic interpretation of the dignity narrative (DT-SGM). The intervention was evaluated in a prospective pilot trial. SGM people with cancer diagnoses were recruited from a designated comprehensive cancer center. They participated in a single episode of DT-SGM, which was recorded and transcribed. The recording was used to generate a narrative and poem, which were reviewed with the patient. Feasibility was assessed by recruitment and completion rates; acceptability through questions in the DT Feedback Questionnaire and qualitative analyses of follow-up interviews.

45 individuals were screened and 27 approached; 13/27 (55.6%) completed the study. Participants were demographically mixed in terms of age, cancer diagnosis, sexual orientation, gender identity and race. All participants (13/13; 100%) found the intervention acceptable. Qualitative analysis revealed four themes regarding intervention acceptability: (1) timing and duration, (2) feeling connected, (3) DT as a helpful processing tool, and (4) meaningfulness of the experience. We identified 4 additional themes related to sexual and gender orientation, including: (1) charting one's own course, (2) finding meaning, (3) lack of acceptance/ discrimination, (4) love and belonging.

DT-SGM is feasible and acceptable to SGM people with cancer.