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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We thank the chief investigators from the Out with Cancer research project: Prof Jane Ussher, Prof Janette Perz, Prof Martha Hickey, Prof Suzanne Chambers, Prof Gary Dowsett, Prof Ian Davis, Prof Katherine Boydell, Prof Kerry Robinson and Dr Chloe Parton. Partner investigators were Dr Fiona McDonald and A/Prof Antoinette Anazodo. Research Associates were Dr Rosalie Power, Dr Kimberley Allison and Dr Alexandra J. Hawkey.
We thank the reviewers of our LGBTQI+ People and Cancer booklet: Prof Jane Ussher, Chair, Women’s Heath Psychology and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; ACON; Dr Kimberley Allison, Out with Cancer study, Western Sydney University, NSW; Dr Katherine Allsopp, Supportive and Palliative Care Specialist, Westmead Hospital, NSW; A/Prof Antoinette Anazodo OAM, Paediatric and Adolescent Oncologist, Sydney Children’s Hospital, NSW; Megan Bathgate, Consumer; Gregory Bock, Clinical Nurse Consultant–Oncology Coordinator, Urology Cancer Nurse Coordination Service, WA Cancer & Palliative Care Network, WA; Morgan Carpenter, Executive Director, Intersex Human Rights Australia (formerly OII Australia); Prof Lorraine Chantrill, Medical Co-Director Cancer Services, Illawarra Shoalhaven Local Health District, NSW; A/Prof Ada Cheung, Endocrinologist, Head, Trans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, VIC; Bonney Corbin, Australian Women’s Health Network; Cristyn Davies, Research Fellow, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney and Children’s Hospital Westmead Clinical School, NSW; Prof Ian Davis, Professor of Medicine, Monash University and Eastern Health, Medical Oncologist, Eastern Health, Chair, ANZUP Cancer Trials Group, VIC; Rebecca Dominguez, President, Bisexual Alliance Victoria; Liz Duck-Chong, Projects Coordinator, TransHub and Trans Health Equity, ACON, NSW; Lauren Giordano, 13 11 20 Consultant, Cancer Council NSW; Hall & Wilcox (law firm); Natalie Halse, BCNA Consumer Representative; Jem Hensley, Consumer; Prof Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne, and Director of the Gynaecology Research Centre, The Women’s Hospital, VIC; Kim Hobbs, Clinical Specialist Social Worker – Gynaecological Cancer, Westmead Hospital, NSW; Dr Laura Kirsten, Principal Clinical Psychologist, Nepean Cancer Care Centre, NSW; Amber Loomis, Policy and Research Coordinator, LGBTIQ+ Health Australia; Julie McCrossin and Melissa Gibson, Consumers; Dr Fiona McDonald, Research Manager, Canteen, NSW; Dr Gary Morrison, Shine a Light (LGBTQIA+ Cancer Support Group); Penelope Murphy, Cancer Council NSW Liaison, Prince of Wales Hospital, NSW; Dr Rosalie Power, Out with Cancer study, Western Sydney University, NSW; Jan Priaulx, 13 11 20 Consultant, Cancer Council NSW; Paul Scott-Williams, Consumer; Simone Sheridan, Sexual Health Nurse Consultant, Sexual Health Services, Austin Health, VIC; Cheryl Waller and Rhonda Beach, Consumers.
View the Cancer Council NSW editorial policy.
