Table 2:

Recommended Competencies for Cancer Care Providers and Staff

Core Competency	Standard For all cancer care providers and appropriate staff	Intermediate Level For providers who identify as SGM allies and culturally competent providers	Advanced / Expert Level For providers who identify as leading resources and experts on SGM-related cancer care
Demonstrates Skills with SGM Patient Care and Procedures	Demonstrates the ability to complete a physical exam with a transgender patient; demonstrates additional communication skills to gather other pertinent information, such as sexual history, mental health history, and hormone use.	Demonstrates the ability to complete a physical exam with a transgender patient; demonstrates additional communication skills to gather other pertinent information, such as sexual history, mental health history, and hormone use; demonstrates ability to perform appropriate exam on any given SGM patient, including cervical and anal cancer screenings.	Demonstrates the ability to complete a physical exam with a transgender patient; demonstrates additional communication skills to gather other pertinent information, such as sexual history, mental health history, and hormone use; demonstrates ability to perform appropriate exam on any given SGM patient, including cervical and anal cancer screenings; moreover, serve as an instructor to clinicians on the performance of physical exams and cervical/anal cancer screenings.
Ability to Navigate Systems-Based Practices to Enhance Patient Care	Is aware of institutional or local specialists for SGM patient cancer care needs.	Is aware of institutional or local specialists for SGM patient cancer care needs; is capable of referring patients to SGM-specific cancer support groups.	Is aware of institutional or local specialists for SGM patient cancer care needs; coordinates cancer care outside known health system; maintains and utilizes national SGM cancer specialists referral list.
Knowledge of SGM Medical Conditions	Exhibits knowledge of SGM community terms and basic implications for quality cancer care.	Exhibits knowledge of SGM community terms and common SGM clinical cancer care guidelines.	Exhibits knowledge of SGM community terms and all SGM clinical cancer care guidelines; is well versed in best practices; is able to modify best practices to fit local SGM patient and community needs.
Adept at SGM Cross Cultural Communication	Demonstrates the clinical communication skills needed for SGM patients to feel comfortable enough to disclose all relevant identities.	Demonstrates the clinical communication skills needed for SGM patients to feel comfortable enough to disclose all relevant identities; uses direct, opened-ended questions when enquiring about patient information such as sexual history, mental health history, and hormone use.	Demonstrates the clinical communication skills needed for SGM patients to feel comfortable enough to disclose all relevant identities; demonstrates additional communication skills to gather other pertinent information, such as sexual history, mental health history, and hormone use; serves as institutional resource for educating clinicians on effective communication with SGM patients.
Demonstrates Professionalism	Displays capacity to define and give examples of microaggressions and make amends when they occur.	Displays capacity to define and give examples of microaggressions and makes amends when they occur; works actively to limit assumptions on patients’ identities, pronouns, and partners.	Displays capacity to define and give examples of microaggressions and makes amends when they occur; works actively to limit assumptions on patients’ identities, pronouns, and partners; advocates for policies that limit microaggressions, assumptions, and promotes a welcoming environment.
Ensures Institutional Commitment for SGM Patient Health Standards are Maintained	Utilizes SGM appropriate terminology when greeting patients and directing their efforts to complete necessary paperwork.	Advocates use of SGM appropriate terminology on intake forms, displays antidiscrimination policies.	Advocates use of SGM appropriate terminology on intake forms, displays antidiscrimination policies. ; advocates for patient-centered care, policies to ensure visitation by members of the patient’s chosen family, and SGM culturally-sensitive shared decision-making processes.