LGBTQI+ people and cancer

 

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Cancer in trans and/or gender diverse people

Making decisions about treatment can be difficult when cancer develops in your chest or in a reproductive organ. Having cancer treatment and managing side effects often means doctors will refer to the sex you were assigned at birth. You can ask your doctor to talk about you as your affirmed gender.

If you find the information below distressing, read the parts you are comfortable with now and come back to others when you feel ready. You can also contact QLife on 1800 184 527 (3pm–midnight) for support.

Cancer as a trans and/or gender-diverse person

Your cancer care team should offer you care, support and information that meets your needs, respects who you are, and helps you to make informed decisions about treatment. They should treat you as an individual and work with you in a way that respects your privacy and dignity. But research shows that because health professionals have less confidence and experience in treating trans people, they may struggle to provide inclusive and gender-affirming care.

Discrimination and past negative experiences are common reasons why a cancer diagnosis may be challenging for trans and/or gender-diverse people.

Challenges you might face

  • Lack of experience – It may be harder to find cancer specialists with an understanding of the ways in which trans health needs affect cancer care. It can be difficult dealing with health professionals who think of sex as binary and you may fear being misgendered.
  • Misgendering – Health professionals may incorrectly assume your gender or that of your partner and use the wrong words or pronouns when referring to you. You might find this misgendering upsetting and it could undermine your trust and confidence.
  • Outdated forms – Many medical forms do not include options to record your gender, pronouns and sexual orientation. It can also get complicated if the gender or name you use on the form doesn’t match the details on other official documents, such as your Medicare card.
  • Using gender-affirming hormones for a long time – Taking oestrogen for a long time may increase the risk of breast cancer. At this stage, it isn’t clear if taking testosterone for a long time increases cancer risk.
  • Services that are gendered – Some cancers are screened and treated in a cisgender way (e.g. ovarian cancer in a women’s hospital), which can feel isolating if you are trans or gender diverse.

Ways to manage challenges

  • See a health professional who is affirming of your gender. To find a suitable doctor, use word of mouth or search transhub.org.au.
  • Look for services that are trans friendly.
  • Tell your cancer care team about your relevant anatomy, the sex you were assigned at birth, and any hormone therapy you’re taking. This can help the team recommend treatments and give you information that is right for you.
  • Ask the receptionist to update your record with your name and pronouns or consider wearing a pronoun badge or pin.
  • Practise what you want to say to your doctor before an appointment to help the words come out more easily. Or read from a pre-prepared letter. Avoiding eye contact may make it easier.
  • Let your health professionals know what language you are comfortable with for body parts.
  • Bring someone to your appointments for support. They can speak for you if you don’t know what to say, get tongue-tied or freeze in a challenging situation.
  • Use the Genders, Bodies and Relationships Passport to make telling your health professionals about your gender, body and relationships easier.
  • Explain what is important to you. This could include concerns about whether you will be able to continue gender-affirming treatment.
  • Visit canwe.org.au to find screening programs that are right for you.
  • Consider making a complaint if you think you’ve been treated inappropriately.

How cancer affects trans and gender-diverse people

Cancer can affect anybody, but there may be additional distress involved for trans people who have cancer in body parts that their doctors may not expect due to their gender, e.g. trans men with cervical cancer, trans women with prostate cancer, or non-binary people with any form of cancer.

It is important to screen for the parts of your body that you have. If you have had surgery to remove certain body parts (e.g. a mastectomy/ top surgery, or reproductive organ/s), it can be helpful to talk with your surgeon and health care team about what (if any) cancer risk still remains after that surgery.

Breast Cancer

Prostate Cancer

Other cancers of the reproductive organs

Cancer treatment and gender affirmation

Some cancer treatments can have an effect on your identity. Talk to your cancer care team about what is important to you so this can be considered when working out your treatment options.

Surgery

Surgery to treat cancer may result in physical changes that make you feel uncomfortable or distressed about your body (dysphoria). Or surgery can affirm your gender and/or ease existing feelings of gender dysphoria. It’s okay to not be sure how you’re feeling or how you will feel.

If you need to stay in hospital, ask what ward you will stay on. You may be able to stay in a private room or mixed-gender ward. It can feel isolating to receive treatment in settings that do not reflect your gender.

Radiation Therapy

If you have had genital reconfiguration, including surgery to make a penis or vagina, radiation therapy to the pelvic area may affect these organs.

If you have had surgery to make a penis

If you have had surgery to make a vagina

If you have had other genital surgery

Using gender-affirming hormones during treatment

If you are taking gender-affirming hormones, you may be able to continue taking them during cancer treatment. This will depend on the type of cancer and treatment you had. Talk to your team about the possible risks and benefits before you make any decisions about taking a break, stopping or reducing your gender-affirming hormone treatment. Your reasons for taking the hormones are also important and you may feel the benefits of continuing to take them outweigh the risks for you.

Impact of cancer treatment on body image

Some treatments for cancer may change how you look or affect a part of your body that aligns with your gender. For example, hair loss or a change in your body shape may be upsetting if your appearance is an important part of your identity. These changes may affect your body image and sense of self and can be difficult to cope with.

You may also feel relieved if the changes affirm your gender. For example, surgery to treat cancer may remove a body part that you would prefer not to have. Or you may feel distressed if the changes threaten how comfortable you are in your body. How you react will depend on the type of cancer and treatment you have.

LGBTQI+ People and Cancer

Download our LGBTQI+ People and Cancer booklet to learn more.

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