Surgery to treat some types of cancer may mean removing a part of the body that affects how you look. After surgery, you may choose to live with your new body shape, wear a prosthesis or have a reconstruction. For some people, the surgery can affirm their gender. Only you can decide what feels right for you.
Learn more about:
- Removal of a breast
- Removal of the ovaries
- Removal of the uterus (hysterectomy)
- Removal of parts of the vulva
- Removal of a testicle
- Removal of the prostate
- Shortening or loss of the penis
Removal of a breast
Breast cancer treatment may include breast-conserving surgery (removing part of a breast) or a mastectomy (removing one or both breasts). Having a mastectomy is different from top surgery.
After a mastectomy, you may choose to have a breast reconstruction or “go flat”. Some people who go flat choose to have a tattoo to cover scars or express themselves. Your decision may depend on whether the surgery helps your body better reflect your gender. Your cancer care team may talk to you about reconstruction, but the choice is yours.
Visit Breast Cancer Network Australia for more information on body image and gender identity.
Removal of the ovaries
Removal of the ovaries can affect how you experience sexual intimacy. This can often be managed with menopausal hormone therapy.
Removal of the uterus (hysterectomy)
Most people can still have orgasms as the clitoris and labia remain and control much of sexual sensation. However, orgasms may feel different.
Removal of parts of the vulva
Surgery for vulvar cancer may remove part or all of the labia and, in some cases, the clitoris. This can affect your sense of identity, confidence and sexual pleasure. A fulfilling sex life is still possible, but it may take time to adapt. Talk to your doctor; they may refer you to a sexual health physician.
Removal of a testicle
Some people who have had a testicle removed may have less confidence and feel less sexually desirable. For cisgender men, the loss of a testicle may make them feel less masculine. Some people adjust quickly to having one testicle, while others find that it takes some time.
If you’re self-conscious about how your scrotum looks, you may want to consider having an artificial testicle (called a prosthesis) inserted.
Trans women or non-binary people with testicles may also have a testicle removed for cancer. For some, this could affirm their gender; for others, it could feel distressing.
Removal of the prostate
During surgery, the tubes from the testicles are sealed and the prostate and the small glands called seminal vesicles are removed. This means semen is no longer ejaculated during orgasm. The pleasure from rubbing or stimulating the prostate during anal sex will also be lost. This may also affect erectile function. Talk to your doctor about ways to manage these changes.
Shortening or loss of the penis
After prostate cancer treatment, your penis may be a bit shorter (only by about 1–2 cm) or be a different shape. After treatment for cancer of the penis, all or part of the penis may be removed (partial or total penectomy). If the size of your penis is affected, you may avoid intimacy for fear of rejection. Your cancer care team can recommend a range of methods to change how the penis looks.
For more on this, download Prostate Cancer Foundation of Australia’s booklet Understanding Prostate cancer for LGBTIQA+ people.
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This resource was developed as part of the Western Sydney University Out with Cancer research project.
Prof Alison Brand, Clinical Professor, The University of Sydney and Director, Department of Gynaecological Oncology, Westmead Hospital, NSW; Dr Daniel Brown, Clinical Psychologist and Researcher, School of Psychology and Public Health, La Trobe University, VIC; Dr Rosalie Power, Senior Research Fellow and Deputy HDR Director, Translational Health Research Institute (THRI), Western Sydney University, NSW; Dr Sarah Bishop Browne, Palliative and Supportive Care Staff Specialist, Chris O’Brien Lifehouse, NSW; Collette Butler, Clinical Nurse Consultant and McGrath Breast Care Nurse, Cancer Support Centre, Launceston, TAS; Prof Ada Cheung, Endocrinologist, NHMRC and Dame Kate Campbell Research Fellow and Head, Trans Health Research Group, The University of Melbourne, VIC; Dr Tiffany Daly, Radiation Oncologist, Princess Alexandra Hospital, Raymond Terrace, QLD; A/Prof Ian Faragher, The University of Melbourne and Head, Colorectal and General Surgery Unit, Western Health, VIC; Hall & Wilcox (law firm); A/Prof Peter Heathcote, Urologist, Brisbane Urology Clinic, QLD; Prof Richard Hillman, Senior Staff Specialist, HIV and Immunology, St Vincent’s Health Network, Sydney, NSW; Mads Kennedy, Project Coordinator, Silver Rainbow, LGBTIQ+ Health Australia, NSW; Dr Sanjeev Kumar, Breast Cancer Medical Oncologist and Clinician Scientist, Chris O’Brien Lifehouse, NSW; Madeline Lee, 13 11 20 Consultant, Cancer Council NSW; Luke Mitchell, Urological and Sexual Health Nurse Practitioner, Men’s Health Melbourne, VIC; Nadia Reddish, Consumer; Dr Stephen Rowles, Sexual Health Physician and General Practitioner, The Centre Clinic and Melbourne Sexual Health Centre, VIC; Teresa Simpson, Senior Clinician, Psycho-Oncology Social Work Service, Cancer Therapy Centre, Liverpool Hospital, NSW; Mel Tume, Consumer; Prof Jane Ussher, Professor of Women’s Health Psychology and Chief Investigator, Out with Cancer Study, Western Sydney University, NSW; Syr Lumi Vor, Community Member; John Wenborn, Shine a Light (LGBTQIA+ Cancer Support Group). We also thank the health professionals, consumers and editorial teams who worked on the first the edition of this title. We particularly acknowledge ACON and Intersex Human Rights Australia for their extensive input on the first edition. Intersex-Inclusive Progress Pride Flag designed by Valentino Vecchietti (2021).
View the Cancer Council NSW editorial policy.
