Identity among adolescent and young adult cancer survivors: an exploratory qualitative study

Research on the implications of cancer on identity formation in adolescent and young adult (AYA) survivors is limited, particularly for sexual and gender minority (SGM) AYA cancer survivors. The aims of this study were to (1) identify concepts related to the impact of cancer and its treatment on identity among AYAs (ages of 15-39) cancer survivors; and (2) explore the unique identity-related experiences of sexual and gender minority (SGM) AYA cancer survivors.

This is a secondary qualitative analysis of six focus groups conducted during the development of an AYA program. Transcripts were coded using a grounded theory approach to identify how cancer diagnosis and treatment shape AYA identity formation, which informed the development of a novel conceptual framework.

AYA cancer survivors' identity is influenced by interrelated physical, psychological, and social changes. Surrounding these interrelated changes are experiences unique to SGM, including navigating heteronormative assumptions and disclosures within healthcare settings. These interrelated changes to identity contribute to an evolution of the self through the cancer trajectory.

Our findings deepen the literature on the need for clinician awareness of how cancer diagnosis and treatment shapes AYA identities, and the need for increased support for AYAs (e.g., psychological intervention, peer support groups). From a public health perspective, this analysis contributes new insight into SGM AYA cancer survivors, as they may have a cancer experience that differs from that of their heterosexual peers. Further research to understand the needs of this population is warranted.