Cancer can cause extra distress for trans people who have cancer in a part of their body that doctors may not expect due to their gender. For example, a trans man may have cervical cancer or a trans woman may develop prostate cancer. It’s important to screen the parts of your body that you have.
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Overview
If you’ve had surgery to remove certain body parts (e.g. a mastectomy or top surgery, or surgery to remove reproductive organ/s), talk with your surgeon and healthcare team about what (if any) cancer risk remains after that surgery.
Breast cancer
Everyone has breast tissue in the breast and chest area, which means anyone can get breast cancer. But risks can vary:
- Trans and gender-diverse people who develop breasts at puberty have a similar level of risk to cisgender women.
- Trans women and gender-diverse people who develop breasts from taking gender-affirming hormones have a higher risk than cisgender men, but a lower risk than cisgender women.
- Trans men and other people who have had gender-affirming top surgery have a lower risk of developing breast cancer than cisgender women, but may still need to screen for breast cancer.
Having a mastectomy to treat cancer is different from gender-affirming top surgery. A mastectomy removes all the breast tissue from part or all of the chest area and often the nipple. Top surgery usually keeps some breast tissue to form into a masculine chest and the nipple is often retained. You may have had top surgery before you were diagnosed with cancer.
Prostate cancer
The prostate is not removed during gender-affirming genital surgery (e.g. vaginoplasty). This means all trans and genderdiverse people who were born with a prostate can get prostate cancer.
It’s common for the prostate to grow larger with age. You may be at higher risk of prostate cancer if you have a family history of prostate cancer, or if you started gender-affirming hormone therapy later in life and cancer had already started to grow in your prostate.
Taking feminising hormones (such as oestrogen or testosterone blockers) or having your testicles removed, reduces your risk of prostate cancer by lowering testosterone levels. Although the risk of prostate cancer is likely to be low, keep in mind the following:
- if your doctor does not know your trans status, they may not ask about prostate symptoms
- PSA blood test results may look different if you’re taking hormones such as oestrogen
- you may not have any prostate cancer symptoms, or urinary symptoms may be mistaken for effects of gender-affirming surgery
Other cancers of the reproductive organs
There are many cancers that affect reproductive organs, including cancer of the cervix, ovaries, vagina, vulva, testicles or penis.
Some trans people have gender-affirming surgery to create a vagina or penis. Cancer can also develop in these body parts, but this is very rare. If you have concerns, talk to your doctor.
All people with a cervix should have a cervical cancer screening test every 5 years. It’s now possible to collect the sample for screening yourself. For information about self-collection, visit canwe.org.au or cancercouncil.org.au.
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Key resource
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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.
