Table 3:

Snapshot of Previous Recommendations and Future Directions

	2017 Recommendations	Future Directions
Quality Improvement Strategies	• Collect and use SGM-relevant data for quality improvement • Ensure prompt follow-up and continuity of care	• Organizational change is needed to ensure SOGI data are collected routinely across cancer centers and are used to ensure equitable outcomes among SGM people treated for cancer • Cancer centers may consider signing onto standardized, inclusive quality metrics
Workforce Development & Diversity	• Expand and promote cultural competency training • Incorporate SGM training into curricula, training requirements and certification exam content • Foster safe environments for SGM staff and providers • Integrate a focus on SGM physicians in oncology workforce diversity efforts through SOGI collection	• Cancer centers should collect data on their workforce using an intersectional lens • These data should then be used to inform mentorship and promotion programs • SGM members of the workforce should be protected against microaggressions from co-workers as well as patients.
Patient Education & Support	• Enhance patient navigation and care coordination • Expand education for SGM patients with cancer and survivors • Increase patient access to culturally competent support services • Create safe space for SGM patients • Increase cancer prevention education for SGM individuals	• Widespread distribution of evidence-based patient education materials for SGM individuals across the cancer continuum is still needed • Quality metrics that include SOGI variables can help determine which areas of patient care need to be enhanced and prioritize patient education and support programs
Research	• Promote the inclusion of SOGI as a required data element in cancer registries and clinical trials • Promote research among SMG populations • Train the next generation of researchers	• Concerted effort to include SGM patients in cancer clinical trials is needed • Increase the number of studies addressing fundamental questions for transgender and gender diverse people with cancer • More training for and grants to early-stage investigators interested in SGM cancer research are still needed to ensure a strong pipeline of researchers.
Policy Solutions	• Create and enforce policies ensuring access to culturally affirming, equitable cancer care • Ensure adequate insurance coverage to meet the needs of SGM individuals affected by cancer • Ensure policies prohibiting discrimination	• Health care institutions should fully implement robust privacy and nondiscrimination protections for all patients • Universal training is needed to create affirming clinical care environments; cancer centers should mandate SGM cultural competency and humility training for their workforce • Oncology providers and leaders should advocate at state and national levels to change policies that contribute to inequitable care for SGM patients and other populations