Reinforcing or Disrupting Gender Affirmation: The Impact of Cancer on Transgender Embodiment and Identity

Abstract

There is a pressing need for greater understanding and focus on cancer survivorship and informal cancer caring of trans people (binary and non-binary), across tumor types, to inform culturally safe trans inclusive cancer information and care. This qualitative study, part of the mixed methods Out with Cancer project, examined experiences of trans embodiment and identity after cancer diagnosis and treatment. We drew on open-ended survey responses from 63 trans cancer survivors and 23 trans cancer carers, as well as interviews and a photo-elicitation activity with a subset of 22 participants (15 cancer survivors, 7 cancer carers). Reflexive thematic analysis identified three themes: Cancer enhances trans embodiment, through experiences of gender euphoria following cancer treatment, and acceleration of decisions about gender affirmation; cancer erases or inhibits gender affirmation; trans embodiment is invisible or pathologized in cancer care. These findings demonstrate that trans embodiment and identity, as well as the process of gender affirmation, may be disrupted by cancer or informal cancer caring. Conversely, cancer and cancer treatment can positively impact the embodied identity and lives of trans people, despite the anxiety and strain of negotiating medical procedures. However, if healthcare professionals operate within a cis-heteronormative framework and do not understand the meaning of embodied change following cancer treatment for trans individuals, these positive benefits may not be realized.

Editorial: Cancer prevention, treatment and survivorship in the LGBTQIA community

“…By doing so, we can bring visibility to this potentially vulnerable population. Additionally, it is crucial to recognize the intersectionality of identities and how they influence the experiences of individuals with cancer, with a specific focus on underrepresented groups such as trans (27), intersex (28), AYA (29), and racially/ethnically diverse [Bates et al] individuals. Engaging LGBTQI stakeholders through research co-design can help ensure that research methods and interpretations are culturally competent and culturally safe (30).…”

“I’ve had constant fears that I’ll get cancer”: the construction and experience of medical intervention on intersex bodies to reduce cancer risk

“…This sub-study was part of the broader mixed methods Out with Cancer project (Allison et al, 2024 ; Power et al, 2022 ; Ussher, Allison, et al, 2022 , 2023 ; Ussher, Perz, et al, 2022 ; Ussher, Power, et al, 2023 ; Ussher, Power et al, 2022 ; Ussher, Ryan, et al, 2023 ) that examined LGBTQI experiences of cancer from the perspectives of LGBTQI patients, their caregivers, and healthcare professionals. The study included same-gender attracted, trans (binary and non-binary) and intersex people who had cancer, and intersex people who had medical interventions to reduce a risk of cancer.…”

Estratégias para uma Assistência Inclusiva a Pessoas LGBTQIAP+ com Câncer

“…The literature about cancer in trans and nonbinary people is limited. However, studies suggest that this population face significant barriers to access the health care system in addition to poor quality of the service offered permeated by stigma and discrimination, culturally ill-prepared personnel, lack of insurance coverage and health policies 7 .…”

“…LGBTQIAP+ people have a higher risk of certain types of cancer, including breast, cervical, ovarian, uterine, anal, and prostate cancers 7 .…”