In partnership with OUTpatients and Macmillan Cancer Support

If you need cancer treatment

If you are transgender or non-binary and have been diagnosed with cancer, you may have questions about how treatment could affect your body, gender identity or gender-affirming care.

If you have never talked about your gender identity before, you may also have questions or concerns about your social, medical or surgical plans.

If you need advice about how to start this conversation with your GP or healthcare team, Transactual have guidance that may help.

For more information about healthcare appointments, hospital stays, your rights or finding support, visit our page, Transgender and non-binary people and cancer.

Making decisions about your treatment

When you are diagnosed with cancer, a team of healthcare professionals will work together to advise on treatment that is best for you. This is called your multidisciplinary team (MDT).

After the MDT meeting, you usually meet your cancer doctor and specialist nurse to talk about your treatment options. Together you make decisions about your treatment plan.

It is important your team understands what matters most to you when making these decisions. If there is anything you are worried about, tell them so they can help. They may not be aware of things that are difficult for you. By understanding more, they will be able to support you with your decisions.

Sometimes cancer treatment can affect or be affected by gender-affirming treatments. Your cancer team may need specialist advice about this. There is more information about the UK Cancer and Transition Service (UCATS) below.

Related pages

UK Cancer and Transition Service (UCATS)

If you or your cancer team need advice about how your cancer care and your gender-affirming care may affect each other, the UK Cancer and Transition Service (UCATS) can help.

UCATS is a service for anyone with cancer, or a history of cancer, who feels it affects their gender-affirming care.

This is a free service provided by NHS professionals for people anywhere in the UK. If you have not been to a gender identity clinic in the UK, your cancer team can still get advice from UCATS.

Your cancer team should ask permission to share your information before they contact UCATS. You can also refer yourself to this service. You can have a virtual appointment with them on your own or with your cancer team.

Side effects of cancer treatment

Most people will have some side effects during treatment for cancer. It can depend on the type of cancer and the type of treatment. Your cancer team will explain what to expect and how side effects can be managed.

Changes to your body

For transgender and non-binary people, some side effects can be upsetting because the physical changes do not reflect how you identify. For example, hair loss or a change in your weight or body shape may be upsetting if your appearance is an important part of your gender identity.

Some treatments might change parts of your body that you have worked hard to match with your gender. Other changes and side effects may not be visible, but may still affect how you feel about yourself.

It is important that your team understands how you feel about this as they plan your treatment. Sharing how you feel will help them support you and fit your care to your needs.

You can find more about coping with changes in our information about body image and cancer.

Cancer treatment that supports gender transition

In some cases, cancer treatment may help with changes that support a person’s planned gender transition. For example, surgery to remove cancer might also remove a body part that is causing you dysphoria. Or, a drug treatment might have effects that you feel help align your body with your gender identity.

Again, it is helpful if your team understands how you feel about this, so they can support you and plan your treatment well.

Related pages

Help with how you're feeling

Gender-affirming hormones during cancer treatment

If you take gender-affirming hormones, it may be safe to keep taking them during cancer treatment. But it is important to get advice from your cancer team. They will work with you to help decide what is best for your situation.

Sometimes your cancer team may talk to you about pausing, stopping or reducing hormone treatment.

Reasons for this may include some of the following:

If you have a high-risk of blood clots, heart attacks, strokes or diabetes.
If you need to take a cancer drug that is not safe to take at the same time as your hormone treatment.
If you are diagnosed with cancer that is sensitive to hormones, such as most types of breast cancer. Your team may suggest pausing your hormone treatment while they do tests to find out more about the type of cancer.

In some situations, taking hormones long term may make the cancer more likely to come back after treatment. Your team might discuss different treatment options with you to reduce your risk, including changing how you take your hormones – for example, as tablets, gels or injections.

It is not always clear how much gender-affirming hormones increase your risk in these situations. Your reasons for taking the hormones are also important and you may feel the benefits of continuing to take them outweigh the risks for you.

Talk to your team about the possible risks and benefits before you make any decisions about changing your hormone treatment. Decisions should be made together. If possible, they should involve both your cancer team and a gender identity specialist. If you choose to involve UCATS, they can provide up-to-date evidence and specialist advice.

Radiotherapy and the pelvic area

The pelvic area is the area between the hips. Radiotherapy to this area can cause changes that may affect sexual wellbeing. We have more information about pelvic radiotherapy and possible side effects.

If you are planning to have genital surgery in the future, talk to your team about this before having pelvic radiotherapy. Surgery is not always possible after an area has been treated with radiotherapy. Your cancer team can explain what cancer treatment you need and how this may affect genital surgery in the future.

If you have had genital surgery to change the appearance of your genitals or how they work, pelvic radiotherapy may affect these areas. It is important to ask your radiotherapy team what to expect and whether there is a risk of long-term changes. This may depend on the exact area of the pelvis being treated and the way treatment is given.

If you were assigned female at birth and have a vagina

Radiotherapy may cause changes such as dryness, narrowing or bleeding. Your cancer team may suggest using dilators regularly after treatment to help prevent narrowing. This can be helpful if you still need to have cervical screening or want to use the opening for sex.

We have more information about vaginal changes and cancer treatment.
If you have had surgery to make a penis (phalloplasty or metoidioplasty)

Pelvic radiotherapy can usually be given in a way that avoids this area to limit damage to the penis. Ask your cancer team for advice if you notice any skin changes or have problems passing urine (peeing) during and after treatment.
If you have had surgery to make a vagina (vaginoplasty)

Pelvic radiotherapy may narrow the vagina or make the skin more fragile and sensitive. You may need to use dilators more often than usual to help prevent the vagina closing.

Some people find using a dilator upsetting, so it is important to talk to your cancer team if you find this difficult. Keeping the vagina open may be important for future medical examinations and sexual activity.

Practical tips and support during treatment

Cancer treatment can be physically and emotionally challenging. It may help to think about what support you might need before treatment starts.

You may find the following tips helpful:

Ask your cancer team any questions you have about treatment and side effects. Tell them if there are things you are worried about.
Take someone you trust to appointments if this helps you remember information or feel more supported.
Ask your cancer team about practical support, emotional support and other services that may be available during treatment.
Talk to your team if treatment is affecting your wellbeing or making it harder to cope. Support is available, and you do not need to manage on your own.

Related information

You may also find the following information helpful:

Transgender and non-binary people and cancer - information about healthcare appointments, hospital stays, support and your rights.
Cancer screening and risk for trans and non-binary people - information about screening, reducing cancer risk and symptoms to be aware of.
LGBTQIA+ people and cancer treatment.
Making treatment decisions.

Related pages

Macmillan's wellbeing hub

Booklets and resources

Get this information in another language or format

We are committed to making our website as accessible as possible, to make sure that everyone can use it.

We have information about cancer for LGBTQIA+ people in over 16 languages. You can also listen to our audiobook LGBTQIA+ people and cancer for free.

If we do not have what you are looking for, you can ask for information to be translated for free or provided in a format to suit you. Email us at informationproductionteam@macmillan.org.uk or call us on 0808 808 0000.

About our information

This information was developed in partnership with OUTpatients. OUTpatients is a cancer support and advocacy charity for the LGBTIQ+ community. It provides a safe space for anybody who identifies as part of the queer community and has had an experience with any type of cancer. This is for any stage of cancer, from testing, diagnosis, treatment and remission through to long-term care.

LGBTQIA+ is an acronym for lesbian, gay, bisexual, transgender, queer, intersex and asexual people. The plus sign (+) represents 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 LGBTQIA+ 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 LGBTQIA+ 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 informationproductionteam@macmillan.org.uk

References

Below is a sample of the sources used in our information for people who are LGBTQIA+. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Adley M, O'Donnell A, Scott S. How LGBTQ + adults' experiences of multiple disadvantage impact upon their health and social care service pathways in the UK & Ireland: a scoping review. BMC Health Services Research [Internet]. 2025; 25 (1): 244. Available from: doi.org/10.1186/s12913-025-12232-8 (accessed October 2025).

Berner AM, Atkinson SE. The implications of hormone treatment for cancer risk, screening and treatment in transgender individuals. Best Practice and Research Clinical Endocrinology and Metabolism [Internet]. 2024; 38 (5):101909. Available from doi.org/10.1016/j.beem.2024.101909 (accessed October 2025).

Braybrook D, Rosa WE, Norman C, Harding R, Bristowe K. The inclusion of LGBTQ + people within UK health policy: a critical discourse analysis. International Journal for Equity in Health [Internet]. 2025; 24 (1):88. Available from doi.org/10.1186/s12939-025-02446-x (accessed October 2025).

D'Elia M, Nabhani-Gebara S, O'Callaghan S. Safe and supportive prescribing in transgender and non-binary patients with cancer. British Journal of Clinical Pharmacology [Internet]. 2024; 90(10): 2401-2408. Available from doi.org/10.1111/bcp.16235 (accessed October 2025).

Giblin, J., Coad, B., Lamb, C. et al. UK recommendations for the management of transgender and gender-diverse patients with inherited cancer risks. BJC Reports [Internet]. 2023; 1:1. Available from doi.org/10.1038/s44276-023-00002-0 (accessed October 2025).

Kneale D, Henley J, Thomas J, French R. Inequalities in older LGBT people's health and care needs in the United Kingdom: a systematic scoping review. Ageing and Society [Internet]. 2021; 41(3):493-515. Available from doi.org/10.1017/S0144686X19001326 (accessed October 2025).

Monro, S., Wall, S. S., & Wood, K. (2023). Intersex equality, diversity and inclusion and social policy: Silences, absences, and erasures in Ireland and the UK. Critical Social Policy [Internet]. 2024; 44(1): 3-22. doi.org/10.1177/02610183231175055 (accessed October 2025).

Zeeman L, Aranda K. A systematic review of the health and healthcare inequalities for people with intersex variance. International Journal of Environmental Research and Public Health [Internet]. 2020;17 (18):6533. doi.org/10.3390/ijerph17186533 (accessed October 2025).