Some cancer treatments can affect your identity. Talk to your cancer care team about what is important to you, so this can be considered when planning your treatment.
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Surgery
Surgery to treat cancer may cause physical changes that make you feel uncomfortable or increase gender dysphoria. In some cases, surgery can affirm your gender, reduce gender dysphoria, or even lead to gender euphoria (when your body and gender feel aligned).
If you need to stay in hospital, ask which ward you will be 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’ve had gender-affirming treatment, such as surgery to create a penis (phalloplasty or metoidioplasty) or a vagina (vaginoplasty), radiation therapy to the pelvic area may affect these organs.
If you’ve had surgery to make a penis
Pelvic radiation therapy can usually be given in a way that avoids this area. If you also still have a vagina (sometimes described by trans people as a front hole), radiation therapy may make this area dry, narrow or cause bleeding.
Your treatment team may suggest using dilators after treatment to help keep the vagina/front hole open. Dilators can help with cervical screening or sex, but it’s your choice whether or not to use them.
If you’ve had surgery to make a vagina
Pelvic radiation therapy may narrow the vagina or make the skin more fragile and sensitive. Keeping the vagina open and supple can make penetrative sex more comfortable and it’s also important for having medical examinations in the future.
You may be offered dilators to prevent scarring and shortening of the vagina. Some people find using a dilator upsetting. Talk to your doctor about your recovery goals, so they can understand what you’d like and how you feel.
If you’ve had other genital surgery
Other genital surgeries, including zero-depth vaginoplasty (to create a vulva) and metoidioplasty (to create a penis from the clitoris), may also be affected by radiation therapy. Talk to your surgeon and treatment team about what to expect and how you can look after yourself.
Using gender-affirming hormones during treatment
If you’re taking gender-affirming hormones, you may be able to continue taking them during cancer treatment. This will depend on the type of cancer and the treatment you have.
Stopping or reducing hormones can cause physical changes and may bring back gender dysphoria.
Your reasons for taking hormones are also important, and you may feel the benefits of continuing them outweigh the risks for you. Your cancer care team should help you weigh up these effects alongside the cancer treatment outcomes. Ask whether gender-affirming hormone therapy could affect any cancer treatment side effects.
→ READ MORE: Impact of cancer treatment on body image
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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.
