Skip to content

LGBTQI+ and navigating a cancer diagnosis

From diagnosis to treatment and beyond, the experience of having cancer is different for everyone. It affects every aspect of your life, including the way you look and feel, how you have sex and if you can get pregnant.

Extra challenges may include physical changes that impact your sense of identity, and practical issues such as getting appropriate cancer screening and hospital care. Support networks may be different because of limited contact, or no contact, with family of origin. Instead, you may rely on close friends (chosen family) for support.

Many LGBTQI+ people have experienced discrimination and other negative experiences throughout their lives because of their sexual orientation, gender, and/or sex characteristics. If you have experienced discrimination or been refused health care in the past, this may mean you do not feel safe seeking health care or disclosing information needed for treating cancer holistically.

This information discusses how to manage these practical, physical, and emotional issues and ways to find inclusive cancer care.

In Australia, about 151,000 people are diagnosed with cancer every year (excluding common skin cancers). It is estimated that LGBTQI+ people make up 5% of Australia’s population. This means it’s likely that over 7,500 LGBTQI+ people are diagnosed with cancer each year, and approximately 23,000 are cancer survivors.

Language and terms used in these pages

The words used to describe sexual orientation, gender and sex characteristics change constantly, and you may not use the terms we’ve used on these pages.

Sexual orientation – How a person thinks about their sexual identity, how they behave and the people they are attracted to. Examples include heterosexual, gay man, lesbian, bisexual, pansexual and asexual.

Gender – Whether a person is a man, woman, agender, genderqueer, genderfluid, or a combination of one or more of these things. Gender can be binary (man or woman)  or non-binary. Gender may align with the sex assigned for a person at birth (cisgender) or it may be different (transgender).

Sex characteristics – This refers to a person’s physical characteristics, including genitals, gonads (ovaries and testicles), reproductive organs, hormonal patterns and chromosomal patterns. Sex characteristics can change over a person’s lifetime and may be different from the sex assigned at birth.

Intersex – This is an umbrella term used to describe innate bodily variations in sex characteristics that don’t match the typical understanding of female or male bodies. Older terms for intersex variations include differences or disorders of sex development.

Research shows that as an LGBTQI+ person diagnosed with cancer you may have to deal with a number of unique challenges, including:

  • health professionals making assumptions about your sexual orientation, gender and sex characteristics, which can make you feel invisible
  • anxiety about coming out as LGBTQI+ and fear of negative reactions from health professionals
  • higher levels of depression and anxiety because of a history of marginalisation, violence, stigma, exclusion and discrimination (sometimes called minority stress)
  • difficulty having your partner/s or other significant people recognised as your family
  • less or no support from your family of origin
  • little or no LGBTQI+ specific cancer information or support
  • lack of knowledge among health professionals about issues specific to LGBTQI+ people.

Screening is organised testing to find cancer before any symptoms appear. Finding cancer early and when it hasn’t spread often makes it easier to treat. In  Australia, there are screening programs for breast, cervical and bowel cancer. Most people who are in a certain age group and who have a Medicare card, will receive an invitation in the mail to get screened.

LGBTQI+ people may face several barriers to screening.

Ask your doctor what screening tests are right for your body. It is now possible to collect your own sample for the cervical screening test. This needs to be done at the doctor’s office. For more information on screening, visit the Can We or Trans Hub websites.

The causes of many cancers are unknown, but some factors may increase the risk if you’re LGBTQI+. Risk factors for intersex people depend on their specific variation. Cancer risk has often been used as a reason for medical treatment of intersex people during childhood.

Delaying or avoiding cancer screening – Research shows that many LGBTQI+ people delay or avoid screening. This may be because they think mammograms or cervical screening are not for them because of who they have sex with. Trans people may find screening uncomfortable and upsetting. Trans, gender-diverse and intersex people may not receive appropriate screening reminders. Missing screening tests may mean cancer is diagnosed at a later stage when it is harder to treat.

Higher risk for smoking- and alcohol-related cancers – Studies show that there are higher rates of smoking and drinking alcohol among some LGBTQI+ people, often because of minority stress. These factors increase the risk of several cancers including breast, mouth, and bowel cancer. Smoking also increases the risk of lung and cervical cancers.

Higher risk of HPV (human papillomavirus) – This very common sexually transmitted infection causes many types of cancer, including cervical, anal, throat  (oropharyngeal), penile, vulvar and vaginal. HPV can be passed on sexually, including by fingers and oral sex, or through sharing sex toys. The HPV vaccine can  protect against the virus. For more information, visit the HPV Vaccine and The Bottom Line websites.

Living with HIV – Living with HIV/AIDS may make you more likely to develop some cancers. These are known as AIDS-defining cancers and include Kaposi sarcoma, aggressive B-cell non-Hodgkin lymphoma and cervical cancer. Some cancers are common in people living with HIV but are classified as non-AIDS-defining. They include anal, liver, oral cavity and pharynx and lung cancers, and Hodgkin lymphoma.

Lower rates of pregnancy – Pregnancy before age 30, breastfeeding and using oral contraceptives may all offer some protection from breast cancer and  gynaecological cancers. Lesbian, bisexual and trans people are statistically less likely than cisgender heterosexual women to have a child before age 30. If you  haven’t had children, you may not have breastfed or had a break in your menstrual cycle.

Featured resource

LGBTQI+ People and Cancer

Download PDF

This information is reviewed by

This information was last reviewed February 2023 by the following expert content reviewers: 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 Lead 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.

Related Content