Simone Saint Laurent: Combating Breast Cancer, Thanks to Support from the LGBTQIA+ Community

The Monday before Thanksgiving of 2021, Simone Saint Laurent, a proud New Yorker from Brooklyn, received a phone call from her health care provider letting her know that she had breast cancer and that she needed a mastectomy.

The diagnosis stunned Simone. After getting over her initial shock, her next thought was, “Am I going to die? And my third thought was, how am I going to tell my wife this news?” recalled Simone.

She was 51 years old.

“As a lesbian, and a member of the LGBTQIA+ community, I came from a place of low self-worth, where the larger culture tells me that it’s not all right to be who I am. For a long time, I didn’t treat myself very well because of that. But in the last 10 years things had changed. I felt more supported in the culture, and I was taking better care of myself. I was eating well; I did not drink or smoke; I worked out five days a week. So, I was shocked to be diagnosed with breast cancer,” she said.

After turning 40, Simone received routine mammograms once every two years. Unfortunately, because of the pandemic and the resulting backlogs in screening, her latest appointment was delayed by almost a year. In late 2021, she received a mammogram that showed suspicious calcifications in her breast. She was immediately referred to a specialist for a biopsy, which led to her diagnosis of ductal carcinoma in situ (DCIS), also known as stage 0 breast cancer.

Even though the cancer was DCIS, biopsies revealed that she had an aggressive form of the disease. To ensure the best outcome and prevent future recurrence, her doctor recommended surgical removal, also known as mastectomy, of both breasts and testing of nearby lymph nodes to check if her cancer had spread.

“Hearing that I had stage 0 and then to be told in the same breath that I needed a mastectomy was shocking, to say the least,” Simone said. “I had to decide whether to undergo one mastectomy or both, or to take sentinel nodes or not, or to reconstruct my breast or not. That was an overwhelming amount of information to receive, and I didn’t have a lot of time to make these decisions, which was the hardest part of this experience.”

What helped Simone the most was reaching out to her LGBTQIA+ community and, especially, talking to her transgendered friends about their experiences with breast surgeries.

When Simone’s physicians recommended the mastectomy, they also recommended reconstructive surgery. Her providers assumed she would want breast implants. She did not.

“I didn’t know that there was an option of going flat. It was an assumption that I would have implants. That was difficult for me because I didn’t want a foreign object in my body,” Simone recalled. Ultimately, she chose a procedure called deep flap which used her own tissue to reconstruct her breasts. Throughout her decision-making process, she benefited from talking with transgender friends about their experiences with breast surgery, and she wishes her providers had discussed all options with her.

Simone did not feel comfortable discussing her sexual orientation or gender identity with her providers.

“I never felt discriminated against by doctors, but I did think that this was information I had to reveal throughout the process, by me referring to my wife. It was never asked of me, and I think medical intake forms should ask specific questions on gender identity, sexual orientation, and preferred pronouns, how they are partnered or married,” she said. “It would be amazing if providers could get that information before they met the patient and put it into consideration while recommending treatments. I think it would give more understanding and ability to empathize with the patient and improve quality of care.”

Simone was also apprehensive about her cancer being associated with a “genderized” color.

“I thought, oh no, everything’s going to be pink. It forced me to be a part of a culture that rejects me,” she said. “I also think that calling it breast cancer survivor group, instead of women’s breast cancer survivor group, would be more encompassing and more inclusive,” she added.

For Simone, the next steps of treatment involve ensuring that she is fully satisfied with her breast reconstruction. Once her breasts have healed, she will decide with her surgeon whether she needs further revisions. While she may need yearly exams, Simone is now considered someone with a “past history” of cancer.

“I never thought I would say I was grateful to cancer, but I am. Facing difficult situations helps you find out about qualities that you didn’t know you had. I had no idea that I could persevere. I didn’t know I had the strength to go through this experience. It has given me an opportunity to share my feelings with friends and family. I have a stronger family and relationships with my friends,” she said. “I can speak and advocate for my community and be a voice that says we need to change things and that we’re worth it. We are worth it to survive so that we can share this message and help generations to come.”