Cancer and Gender Diversity

At times, your gender expression can unfortunately make it difficult to access quality health care. It is important for transgender and gender-nonconforming people to find support and assistance where possible. This fact sheet covers:

• What gender diversity is
• How care can be harder to access
• Challenges during care
• Advocating for yourself
• Opportunities for support

What Is Gender Diversity

Gender diversity refers to the range of gender expression people can have beyond the binary of sex assigned at birth. Gender can be expressed in many ways, including one’s name, pronouns and clothing choices. Some people choose to medically transition with surgery or hormone therapy while others do not.

Structural Barriers to Care

Social stigma and a lack of trans-affirming medical care can make getting proper treatment difficult. A lack of federal, state and workplace protections can also present significant barriers.

Even with good insurance and access to care, there can still be challenges. Health care documentation may provide the limited binary gender choices, only male or female. A trans individual might have trouble changing the gender in records after transitioning.

Patients may also have difficulty locating referrals for specialists that affirm their anatomy. A transgender woman with prostate cancer, for example, is entitled to the care of a provider who can meet her needs without fear of discrimination. Or a trans man with a gynecologic cancer may feel unwelcome in a treatment space designated for “women’s cancers.”

Challenges Within Care

Difficulties may also stem from care providers themselves. Poor or prejudiced interactions can lead to a lack of trust or harmful outcomes. While some of these may be unintended, they can still greatly affect a person’s emotional well-being.

Discrimination may also be experienced from hospital administration and health care teams. Examples include misgendering and failure to use correct names or pronouns. Health care providers may also make assumptions during treatment, such as breast reconstruction after a mastectomy or desires about fertility, hair loss or other topics.

The Power of Self-Advocacy

It is not always easy to disclose a non-normative gender identity. Finding a supportive health care team can benefit your well being, allowing you to concentrate fully on coping with your cancer.

However, revealing personal information may cause you to relive difficult or even traumatic experiences. This is a highly personal choice. Your safety and comfort should always be first priority.

If you face discrimination, do not be afraid to seek a second opinion or find a better fit, if possible. The Affordable Care Act forbids health care providers who receive federal funding to discriminate on the basis of gender identity. This includes those accepting Medicare and Medicaid.

Finding Support

A lack of personal support can make things even harder. Many trans and gender-noncomforming individuals have reduced or no contact with their biological families. A lack of legal protections for partners may also cause difficulties. There are organizations that can help. These include:

• The LGBT Cancer Network provides online listings of inclusive medical providers across the country (cancer-network.org or 212-675-2633).

• Lambda Legal (https://cancer-network.org) and Transgender Law Center (transgenderlawcenter.org) can help you with legal challenges including name changes to gender markers.

CancerCare’s oncology social workers provide counseling in New York and New Jersey and resource navigation throughout the country. Support groups are available for those with cancer and their loved ones. All services are free of charge. Call 800‑813‑HOPE (4673).