LGBTQ+ people and cancer treatment
In partnership with
If you are LGBTQ+ and have cancer, you may have questions about if this will affect your cancer treatment. Sexual orientation and gender identity should not affect your access to the right healthcare. Your healthcare team should offer you care, support and information that meets your needs. But we know that sometimes LGBTQ+ people may face extra challenges in getting the right help.
If you are transgender or non-binary
If you are transgender (trans), non-binary, or both, you may also find our page about trans and non-binary people and cancer helpful. It includes information about:
- cancer screening
- cancer risk and gender-affirming treatment
- symptoms of cancer
- cancer treatment.
There may be times when members of your healthcare team ask you about:
- sexual and romantic orientation
- sexual activity
- gender identity.
Your team may ask because they want to give the right care and support to you and the people close to you. They may also ask to collect some of this information for equality monitoring. This means the information is used to ensure that NHS services are accessible for everyone.
If you are unsure why you are being asked these questions, you can ask:
- why they need the information
- why they think the information is relevant to your care.
You do not have to give your team this information. But it may be an important part of who you are. It might be helpful for your team to know. And you may find it makes things easier or less stressful for you. Tell your team if the questions they ask do not fit with who you are or how you identify.
If your healthcare team have not asked, it is still important that you feel able to come out to them, if you want to. You may choose to do this when you first meet someone from your team. Or you may decide to wait until you find someone you feel comfortable with.
If a healthcare professional is wearing an NHS Rainbow Badge , you could start by asking them about it. The badge means they should be open to talking about LGBTQ+ needs and able to offer support. Some healthcare professionals wear rainbow lanyards or other items because they are LGBTQ+ themselves. Others do so to show they support the LGBTQ+ community.
It may also help your healthcare team to know the following things:
- Whether you are out or not. Your team should treat all information about you confidentially. They may only share information with other healthcare professionals when it is needed for your care. If you are not out in all areas of your life, explain this to your team. They should not share your sexual orientation or trans status without your permission.
- Your name, title and pronouns. You can ask your team to make a note and use these even if they are different from those in your medical records.
- The people who are important to you. Your team needs to understand who supports you and your relationship to them. Tell your team who you give consent for them to talk to about your care.
- What is important to you. Tell your team if they are offering you the wrong information or support. For example, some cancer treatments can affect your ability to get or make someone pregnant (your fertility). If you want information about this but have not been offered it, ask your team. If they talk to you about it but you do not want or need this information, tell them.
- What you are worried about. You may be worrying about things your team are not aware of. Tell them if something is making you anxious so they can help.
Your healthcare team are there to support you and treat you in a way you feel comfortable with.
However, some LGBTQ+ people may worry about being treated less well. This may be because they have had difficult or negative experiences before. They may worry about:
- not getting the right information or support for their body or identity
- healthcare professionals making assumptions about sexual and romantic orientation or gender identity
- a partner being mistaken for a friend or family member, or being ignored.
Your healthcare team must not treat you less favourably because of your sexual orientation or gender identity. This is called discrimination and is against the law.
Facing discrimination can be stressful and upsetting. It may be especially difficult when you are already dealing with cancer. If you are being treated unfairly, there are things you can do:
Talk to your healthcare team
Talk to someone from your team, if it feels safe and comfortable to do so. Sometimes they may not realise that there is a problem. Giving feedback about this may help your team make things right. Many healthcare professionals welcome feedback so they can learn and offer better care.
Start by talking to someone you trust. This may be someone close to you or a healthcare professional you know well. Switchboard, the LGBT+ Helpline and the LGBT Foundation offer safe spaces to talk by phone or online. Galop offer support to LGBT+ people who have experienced hate crime, domestic abuse or sexual violence. They also have a Trans Advocacy Service.
Give feedback or make a complaint
Cancer and some cancer treatments can affect many areas of sexual well-being. Sometimes, they can also affect your ability to get pregnant or make someone pregnant (fertility). Your cancer doctor or specialist nurse can explain before you start a cancer treatment if it is likely to cause sexual side effects or fertility problems. They can also give advice and information about this during or after treatment.
The side effects of cancer treatments are often the same whatever your sexual orientation or gender identity. But as an LGBTQ+ person, you may have some specific questions about how these will affect your sex life or your fertility options. And some side effects may be more of a problem depending on the type of sex you have.
Some people have already made decisions about fertility before being diagnosed with cancer. You may have decided you do not want to have children. Or you may have planned it for the future. Some people may have stored sperm, eggs, embryos or ovarian tissue. If you have questions about fertility before or after cancer treatment, talk to your cancer team. It might be helpful to write down your questions to take to appointments. Your team can give you information, or refer you to a fertility clinic for more support.
Finding more information
Live Through This have information for LGBTQ+ people about sex with and beyond cancer. We also have information about cancer, sex and side effects for anyone before, during or after cancer treatment. This information is for you whether or not you are in a relationship or having sex, and whatever your sexual orientation or gender identity.
We also have more information about cancer and fertility. At the moment, it is divided into fertility in men and fertility in women. We plan to make this information more accessible to trans and non-binary people as we update it.
If you were assigned male at birth, you may find our information about fertility in men helpful. If you were assigned female at birth, you may find our information about fertility in women helpful. If you have questions about your fertility and cannot find the information you need, call our cancer support specialists on 0808 808 00 00.
Support groups are a way of meeting people in similar situations and sharing experiences. Many people find they help them cope with cancer and cancer treatment.
Each group is unique. There are groups for people affected by a certain type or stage of cancer, or having a particular treatment. There are also a small number of groups for LGBTQ+ people affected by cancer.
Some people find they try a few different groups before finding the right one for them. Or they may try a mixture of groups. Sometimes it might take a few meetings to feel comfortable and able to take part.
LGBTQ+ cancer support groups include the following:
- Live Through This run a peer support group for LGBTIQ+ people affected by cancer. This group focuses on LGBTIQ+ experiences of cancer and support, rather than on any one cancer type. You can find out more and sign up at livethroughthis.co.uk
- LGBT Walnut is a support group based in London for any LGBT person affected by prostate cancer.
- Out with Prostate Cancer is a support group based in Manchester, aimed at gay and bisexual men and trans women affected by prostate cancer.
Online and social media groups can be a good way to find and connect with people. Online support may also feel safer or more comfortable for people who are not out or who want to be anonymous. Macmillan’s Online Community offers a safe space to ask questions, share experiences and emotions. You can visit the LGBTIQ+ group or explore all the cancer support forums.
This page was developed in partnership with Live Through This – a cancer support and advocacy charity for the LGBTIQ+ community. They provide a safe space for anybody who identifies as part of the queer spectrum and has had an experience with any type of cancer at any stage, from testing, diagnosis, treatment, remission to long-term care.
LGBTQ+ is an acronym for lesbian, gay, bi, trans and queer people, plus (+) any other romantic or sexual attraction other than heterosexual, and any gender identity other than cis.
Macmillan is working to improve how our cancer information works for LGBTQ+ people. There are areas of our information that we are still working on to make more inclusive.
When we write or update our information, we think about the needs of all different audiences. This includes people of all sexual orientations and gender identities. We are careful about the language and wording we use. We include information about specific LGBTQ+ issues when needed. We offer other useful sources of information and support when this is helpful.
We welcome feedback on any of our information. If you have feedback, please contact us at firstname.lastname@example.org
Below is a sample of the sources used in our information for people who are LGBTQ+. If you would like more information about the sources we use, please contact us at email@example.com
Alpert AB and Cicero E. Removing barriers to health care for transgender people with and without cancer. Ethics, Medicine and Public Health. 2020. 13. Available from doi.org/10.1016/j.jemep.2020.100468 (accessed Feb 2022).
Alpert AB, Gampa V, Lytle MC, et al. I’m not putting on that floral gown: Enforcement and resistance of gender expectations for transgender people with cancer. Patient Education and Counselling. 2021. 104 (10): 2552-2558. Available from doi.org/10.1016/j.pec.2021.03.007 (accessed Feb 2022).
De Blok CJM, Dreijerink KMA and den Heijer M. Cancer risk in transgender people. Endocrinol Metab Clin N Am. 2019. 48: 441–452. Available from doi.org/10.1016/j.ecl.2019.02.005 (accessed Feb 2022).
Fish J, Brown J and Williamson I. Coming out in cancer care: Is disclosure of sexual orientation beneficial? Cancer Nursing Practice. 2019. 18(2): 36-41. Available from doi.org/10.1186/s12885-019-5895-7 (accessed Feb 2022).
Fish J, Williamson I and Brown J. Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment. BMC Cancer. 2019. 19: 678. Available from doi.org/10.1186/s12885-019-5895-7 (accessed Feb 2022).
Kerr L, Fisher CM and Jones T. "I’m not from another planet": The alienating cancer care experiences of trans and gender-diverse people. Cancer Nursing. 2021. 44(6): E438-E446. DOI: 10.1097/NCC.0000000000000857 (accessed Feb 2022).
Webster R and Drury-Smith H. How can we meet the support needs of LGBT cancer patients in oncology? A systematic review. Radiography. 2021; 27: 633-644. Available from doi.org/10.1016/j.radi.2020.07.009 (accessed Feb 2022).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by Chief Medical Editor, Prof Tim Iveson, Consultant Medical Oncologist.
With thanks to: Dr Alison May Berner, Medical Oncologist; Julie Cain, Clinical Nurse Specialist; Charlotte Etheridge, Clinical Nurse Specialist; Ben Heyworth, Survivorship Network Manager/ Consultant in LGBT and Cancer; Kirstie McEwan, Psychotherapist and Counsellor; Stewart O'Callaghan, Chief Executive, Live Through This; and Rachael Webster, Radiographer.
Thanks also to the other professionals and the people affected by cancer who reviewed this information.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.