LGBTQIA+ Ovarian Cancer Care: Breaking Down Barriers to Better Treatment

LGBTQIA+ ovarian cancer care remains one of the most overlooked areas in oncology, yet members of this community face unique challenges that can significantly impact their diagnosis, treatment, and survival outcomes.

The Reality: Higher Risks, More Barriers

Members of the LGBTQIA+ community often face compounded challenges when it comes to ovarian cancer. Research shows that lesbian and bisexual women may be at increased risk for ovarian cancer compared to heterosexual women. 

Why? Several factors come into play.

• Lesbian and bisexual women are less likely to use oral contraceptives, which have been shown to decrease ovarian cancer risk. 
• According to research, they’re also less likely to become pregnant, bear children, or breastfeed: all factors that reduce ovarian cancer risk.

But it’s not just about biological risk factors. The barriers to care are just as concerning.

When Healthcare Becomes a Hurdle

According to research by Frontiers of Oncology, more than 40% of LGBTQIA+ cancer patients reported high or very high distress levels: 3 to 6 times higher than in non-LGBTQ cancer studies. Even more troubling: 33% experienced discrimination during their cancer care.

The challenges start before diagnosis even happens.

Many LGBTQIA+ individuals skip regular cancer screenings because they don’t feel welcome at medical facilities. Fear of discrimination is real — and backed by lived experience. Some have been treated poorly or even refused care altogether simply because of who they are or who they love.

The lack of health insurance compounds the problem. Many policies historically didn’t cover unmarried partners, and while marriage equality has helped, older LGBTQIA+ women — one of the demographic groups most likely to develop ovarian cancer — may have spent most of their lives without access to partner-based insurance.

As a result, many in this community visit gynecologists less frequently, missing crucial opportunities for early detection that could save lives.

The Knowledge Gap Among Healthcare Providers

Here’s an uncomfortable truth: many healthcare providers report lacking education on the unique risk factors and recommended cancer screening tests for LGBTQIA+ people.

When providers assume all patients are heterosexual and cisgender, they miss critical information needed for proper screening and care. Some LGBTQIA+ patients report being told they don’t need ovarian cancer screening if they aren’t having sex with men. This is dangerously false and can delay potentially life-saving early detection.

Transgender and Non-Binary Patients Face Additional Complexity

For transgender men and non-binary individuals with ovaries, the challenges multiply.

Cancer screening recommendations are typically based on binary gender categories. A transgender man listed as male on his insurance might not get coverage for ovarian cancer screening, even though he still has ovaries and remains at risk.

According to research, transgender patients are twice as likely to die from certain cancers compared to cisgender patients. They are also often diagnosed at more advanced stages and less likely to receive treatment for certain cancer types.

Researchers point to a critical gap: most medical records don’t collect gender identity information separately from sex assigned at birth. Without this data, we can’t fully understand cancer disparities in this population or address them effectively.

There’s also a practical reality that data will never fully capture: transgender men and non-binary individuals with ovaries are less likely to seek gynecologic care in the first place. Whether due to fear of rejection by their provider, the dysphoria of attending an OB/GYN, or concern about social scrutiny, many avoid appointments altogether. And the medical system isn’t always ready to meet them. Despite growing awareness, caring for transgender patients remains largely absent from standard medical school curricula: something many OB/GYNs only begin to address through continuing education well into their careers.

There’s also the question of hormone therapy. Many transgender individuals use gender-affirming hormone replacement therapy. When cancer treatment requires hormone suppression — as some ovarian cancer treatments do — patients and oncologists face difficult decisions about balancing cancer treatment with gender-affirming care.

Research on the long-term effects of gender-affirming hormone therapy on ovarian cancer risk remains limited. This is particularly concerning for conditions like borderline ovarian tumors and low-grade serous ovarian cancer, which disproportionately affect younger people, the same age group most likely to be seeking or undergoing gender transition.

How to Talk to Your Doctor About Your Sexual Orientation or Gender Identity

Discussing your identity with healthcare providers can feel daunting. You might worry about discrimination, being misunderstood, or whether you even need to disclose this information.

When you do disclose, you can:

• Start the conversation during your first appointment or when discussing your medical history
• Be direct: “I want to make sure you have complete information about my health. I identify as [your identity].”
• Ask about their experience treating LGBTQIA+ patients with ovarian cancer
• Request that your partner or chosen family be recognized in medical decision-making

If your provider responds poorly, know that you have the right to find someone else. The Cancer Network maintains a database to help locate LGBTQIA+-friendly providers.

Finding a gynecologic oncologist who understands your specific needs becomes even more critical when facing an ovarian cancer diagnosis. These specialists have advanced training in treating ovarian cancer and can provide the nuanced, individualized care that LGBTQIA+ patients deserve.

What Inclusive Ovarian Cancer Care Actually Looks Like

Real inclusivity goes beyond platitudes.

Providing relevant information. LGBTQIA+ patients need information about sex during chemotherapy, fertility preservation options like fertility sparing surgery in ovarian cancer, and how treatment might affect their bodies and relationships.

Recognizing chosen family. For many LGBTQIA+ patients, close friends serve as primary support systems. Include them in consultations and recognize them as legitimate caregivers.

Understanding treatment side effects differently. For transgender patients, treatment-induced or surgery-induced menopause may have different implications. Discussions about ovarian cancer and sex need to be tailored to each patient’s actual relationships and concerns, and not heteronormative assumptions.

Resources That Can Help

You don’t have to navigate this alone. Several organizations specifically support LGBTQIA+ individuals facing ovarian cancer:

The Cancer Network (formerly National LGBT Cancer Network) works to improve the lives of LGBTQIA+ cancer survivors through education, provider training, and advocacy. They offer free peer support groups via Zoom three times weekly and maintain a directory of LGBTQIA+-friendly healthcare providers. 

Their mission focuses on educating the LGBTQIA+ community about increased cancer risks, training healthcare providers to offer culturally competent care, and advocating for LGBTQIA+ survivors in mainstream cancer organizations.

Out with Cancer in Australia provides an online support community specifically for LGBTQIA+ cancer survivorship and caregiving, offering connection with others who truly understand the experience.

SAGE focuses on LGBTQ+ elders, providing advocacy and services around health and aging, particularly relevant for older individuals navigating an ovarian cancer diagnosis.

Queering Cancer in Canada is dedicated to supporting sexual and gender diverse people affected by cancer. The team advocates for inclusive cancer care for sexual and gender diverse communities in Canada by providing education, resources, and support, amplifying queer, trans and non-binary voices, and advancing inclusive care through community-driven research.

For healthcare providers seeking to improve their practice, the Society of Gynecologic Oncology offers free training modules specifically on treating LGBTQIA+ patients.

LGBTQIA+ Ovarian Cancer Care: What Needs to Change

The path to truly inclusive ovarian cancer care requires systemic change.

We need more research. Studies should include LGBTQIA+ participants and analyze outcomes by sexual orientation and gender identity.

We need provider education. Cultural competency training shouldn’t be optional. It should be standard in medical education and ongoing professional development.

And we need to challenge discrimination wherever it appears. Anti-inclusive practices, whether overt hostility or subtle microaggressions, have no place in healthcare.

You Deserve Dignity and Expert Care

At Not These Ovaries, we support everyone in the ovarian cancer community: survivors of any age, ethnicity, race, religion, socioeconomic level, sexuality, and gender identity.

We advocate for the needs of underserved communities. And we support patients and families through every stage of the journey. Because dignity and professionalism aren’t too much to ask. They’re the bare minimum every patient deserves.