About LGBTIQA+ people and cancer

It’s your choice what you tell your healthcare team about your sexual orientation, gender or variation in sex characteristics. However, sharing this information can help them provide person-centred care. This is care that treats you the way you’d like to be treated and listens to your needs, preferences and values. It means that you are an equal partner with your healthcare professional in planning your treatment and ongoing care (known as shared decision-making).

Research shows that many LGBTIQA+ people do not disclose their sexual orientation, gender or sex characteristics to health professionals for fear of discrimination or harassment. To get the best possible care, it’s important to feel comfortable with your healthcare team.

Knowing more about your experiences and how they have affected your health – such as your sexuality, fertility and any past trauma – can help your cancer care team provide safe and inclusive care. It also makes it easier for your partners (e.g. same-gender or trans partners) and chosen family to be recognised and involved in your care.

I was open about being a lesbian with a life partner and 2 children. My wife, Melissa, was acknowledged and respected by my doctors and the team. This openness was important because I became very ill during treatment and lost the capacity to speak.

Julie Lesbian, oropharyngeal cancer

Health professionals are experienced in discussing sensitive health information and are required to keep your information confidential under the Health Practitioner Regulation National Law (if they are a registered health practitioner). If the information is not already on your medical records and you think it’s relevant to your cancer care, you may want to tell them about your:

• sexual orientation
• gender, pronouns, preferred name
• variations of sex characteristics
• preferred terminology for body parts
• medical history (e.g. surgeries, gender-affirming hormone therapy)
• concerns about preserving fertility
• concerns about the impact of cancer on gender-affirming care
• concerns about sex and intimacy
• history of trauma, including medical trauma, if it feels safe.

You may be reluctant to disclose these details, especially if previous experiences have affected your trust in health professionals or you are not “out” in all areas of your life. But being open and sharing information with your cancer care team:

• helps them consider all possibilities when trying to diagnose the cause of your symptoms (such as ovarian cancer in a trans man)
• ensures they have all the information they need to offer informed, safe and trauma-informed care for you
• means they can connect you with the right support services.

Ultimately, it’s your choice how much information you share. You may tell only health professionals you see regularly, or ask that some details are not included in your patient record (however, doctors should include clinically relevant information). 

For more, see Sharing personal information with health professionals.

In Australia, everyone has the right to: safe and competent health care; be free from unlawful discrimination; accept or refuse treatment; and privacy and confidentiality. This means your healthcare professionals should:

• respect your body, sexual orientation and gender
• respect your partner/s and family
• listen to and respect your treatment goals
• respond to your care needs, preferences and values
• involve you in decisions about your treatment and ongoing care
• recognise when you may need for extra support, such as clearance letters for gender-affirming care during cancer treatment
• only collect or disclose your health information to others with your consent, or when required by law.

After a cancer diagnosis, you will need to make many decisions. To help you get the best care and treatment, it’s important to be involved in your care and feel able to ask questions.

If you are concerned about the security of your health information, talk to your healthcare provider or ask to see a copy of their privacy policy. For more information, visit the Office of the Australian Information Commissioner.

For more information, see Protecting your health information.

Australian laws recognise how important carers are in supporting family, partners and friends. Under the Carer Recognition Act 2010 (Commonwealth), carers should have the same rights, choices and opportunities as other Australians, regardless of their sex or sexuality. Similar laws exist in all states and territories, although the details vary. Laws about carers generally apply to unpaid carers and to government and government-funded agencies that support them, not to paid care workers. These laws set out a range of rights for carers, including the right to:

• be treated with respect and be considered as a partner by healthcare workers or providers
• support for their own health and wellbeing
• participate in family, social and community life
• opportunities to work and study.

Children and young people who are carers also have the right to the same opportunities as their peers.

Partners or carers of LGBTIQA+ people may experience lack of recognition or discrimination. For example, health professionals may mistakenly assume a partner is a friend and exclude them from discussions about your care, or direct conversations to other family members. If you have told your cancer care team about your relationship and your partner continues to be excluded, see Dealing with discrimination.

In Australia, spouses and de facto partners generally have similar rights. A de facto partner may need to provide evidence of the relationship to access some legal rights. Your spouse or partner can usually be involved in discussions about your treatment. Also see Advance care planning for information on appointing a substitute decision-maker.

LGBTIQA+ friendly health services create an environment that feels safe and is supportive, respectful and non-judgemental. They don’t make assumptions about pronouns, your body, partners and families of choice. This is known as culturally safe care.

Connecting with a health service that understands the needs of LGBTIQA+ people can help you feel safe and supported. They should include anyone you want to be part of your care plan, including your partner/s, family or chosen family. Where you live might affect availability of LGBTIQA+ friendly health services.

It’s great that clinics have ways of displaying their friendliness and openness such as the gay flag on the front door. We need visual signs to give us that comfort.

Rodney Gay man, skin cancer

How to spot an LGBTIQA+ friendly service

• Look for signs of inclusion – These can include LGBTIQA+ flags, rainbow ticks, posters and photos or statements about the service’s commitment to LGBTIQA+ communities. You may see these on the service’s website, in their window or in the waiting room.
• Find out about their experience and policies – Contact the service to ask if they regularly see LGBTIQA+ people and have an anti-discrimination policy. It may be easier for a friend or family member to ask these questions.
• Ask for recommendations – Your friends may know of LGBTIQA+ friendly services. Ask what they did and didn’t like. If you have an LGBTIQA+ friendly GP, ask them to refer you to a supportive cancer specialist.
• Visit websites – The DocDir website lists doctors and mental health professionals who are welcoming to LGBTIQA+ people. The AusPATH website lists health professionals committed to working with transgender people.
• Check forms and website – Before your appointment, check whether intake forms ask about sexual orientation, gender, variations in sex characteristics, and pronouns. Check the website for inclusive language and details about training or accreditation.
• Trust your judgement – Sometimes you may just have a feeling about whether a health professional or service will be right for you. It’s okay to trust your instincts.

Finding health professionals you trust is important at all stages of cancer. You shouldn’t miss out on treatments, help with side effects, or follow-up care because you feel uncomfortable or have had a bad experience in the past.

If you’re treated as a public patient in a public hospital, you’ll be seen by the specialist/s appointed by the hospital. If you have concerns, you may be able to talk to a specialist nurse, a patient representative or a patient advocate. Some hospitals have an LGBTIQA+ patient navigator who provides culturally-safe support to LGBTIQA+ people and advises health professionals about inclusive care. To find organisations that may help you navigate the health system as an LGBTIQA+ person, visit the QLife resources directory.

You can ask to see a different specialist or be treated at another hospital or treatment centre. If you feel comfortable, talk to your cancer care team about your concerns first; they may be able to address these issues or help with the change. Sometimes, it’s not possible to change services (e.g. if the cancer needs specialised care).

You have the right to make a complaint about any aspect of your health care. This applies whether you’re treated in a public or private hospital or treatment centre. You can usually find details about the complaints process on the healthcare service’s website, or for public hospitals on the government department’s website. You can also check with the cancer care coordinator, nursing unit manager, social worker, or one of the nurses looking after you. If you’re unhappy about the ethical or professional behaviour of a health service, contact the health complaints organisation in your state or territory. For more information, see Cancer care and your rights.

If you think you have been discriminated against because of your sexual orientation, gender or intersex variation, see Dealing with discrimination.

Most people with cancer find it helpful to have support from others. This can include your family, friends or wider community. You might lean on your partner/s or chosen family for support and comfort, particularly if you have limited or no contact with your family of origin. Not everyone wants support from others; some people are happy to manage alone. If you would like support, there are many ways to find it.

• Call Cancer Connect on 13 11 20, or join Cancer Council’s Online Community.
• Use the LGBTIQ+ Health Australia member directory to find good sources of support.
• Contact QLife on 1800 184 527 to connect with others in a safe space.
• Speak to your general practitioner (GP), social worker, psychologist or other health professionals. They can link you with local services.
• If you’re aged 12–25 and diagnosed with cancer, you can chat with other young people at Canteen Connect.