Transgender Cancer Care Discrimination Linked to Poorer Outcomes
CANCER care discrimination is significantly more common among transgender, gender-nonconforming (GNC) and non-binary (NB) individuals, with new research indicating a strong link to poorer self-reported health outcomes.1
Cancer treatment often involves complex care pathways and long-term survivorship support, making patient experience and access to equitable care particularly important.1 Within this setting, inequities in patient experience may directly affect outcomes and engagement with services.
Understanding Transgender and Non-Binary Cancer Care Discrimination
Transgender, GNC and NB are umbrella terms describing a diverse range of gender identities. Transgender people have a gender identity that is different from their sex assigned at birth. NB individuals may reject gender entirely or identify in ways that exist outside the traditional gender binary. GNC refers to those whose gender expression does not align with societal expectations, and this can include people who identify with their sex assigned at birth.2
These distinctions are relevant for clinicians aiming to deliver personalised, respectful care.
Higher Burden of Discrimination in Cancer Settings
The study included 1,476 cancer survivors, of whom 246 were transgender, GNC or NB. Analysis found that 63.8% of transgender, GNC and NB individuals reported experiencing some form of healthcare discrimination, compared with 48.5% of cisgender women and 29.8% of cisgender men.1
Transgender, GNC and NB participants also had more than twice the odds of reporting negative care experiences, including not being listened to, being treated with less respect, and receiving poorer service. They were also more likely to perceive provider discomfort or dismissive behaviour. Furthermore, those who reported discrimination had more than threefold higher odds of describing their overall health as poor.1
Research Gaps and Clinician Preparedness
Despite an estimated 62,530 transgender cancer survivors in the USA, research into their care remains limited. Only 0.8% of National Institutes of Health-funded projects focus on sexual and gender minority health, most centred on HIV/AIDS.1
Clinician training gaps may contribute: Survey data indicates that only one in five oncologists in America report confidence in treating transgender, GNC and NB patients, although most express interest in further education.1
European Evidence Highlights Similar Inequalities
European data also indicates persistent inequalities in cancer care for LGBTQ+ populations, including barriers to access, discrimination, and delays in diagnosis and treatment.3
Furthermore, societal stigma and marginalisation have contributed to delayed diagnoses, inadequate screening, and suboptimal treatment options for LGBTQ+ individuals with cancer.3
Screening disparities further illustrate these gaps. Uptake of mammography and cervical screening is lower among European LGBTQ+ populations compared with the general population, with 10% reporting mammography in the previous year versus 36% in the general population, and 27% reporting cervical screening compared with 36%.³ Reported cancer diagnoses were also higher among intersex individuals, at 2% compared with 0.6% in the general population.³
Altogether, the data suggests inequalities may begin from the earliest stages of the cancer care pathway. However, most available evidence remains concentrated in North America, with European data still limited in scope and depth.3
In the UK, the British Medical Association has also highlighted the need for equitable access to care for transgender and non-binary patients, alongside improvements in training and service provision.4
Interpreting Findings and Next Steps
The study’s cross-sectional design limits causal interpretation, and findings rely on self-reported data, which may introduce recall and reporting bias.1
Despite this, experts call for inclusive screening approaches, improved clinician education, and wider action on social determinants of health.3,4 Addressing cancer care discrimination in isolation may not eliminate disparities, suggesting that broader, system-level changes are needed to improve outcomes for transgender and non-binary patients.
References
- Minarim DS et al. Health care discrimination and self-reported health in transgender, gender nonconforming, and nonbinary individuals with cancer. Cancer. 2026;DOI:10.1002/cncr.70409.
- List of LGBTQ+ terms and inclusive definitions. https://www.stonewall.org.uk/resources/list-lgbtq-terms?gad_source=1&gad_campaignid=23242401261&gclid=EAIaIQobChMI9r_uhd78kwMVgptQBh3sNwooEAAYASAAEgK9B_D_BwE. Last Accessed 20 April 2026.
- European Cancer Organisation. Cancer care for the LGBTIQ community: addressing inequalities.2024. Available at: https://www.europeancancer.org/resources/publications/reports/cancer-care-for-the-lgbtqi-community-addressing-inequalities.html. Last Accessed 21 April 2026.
- British Medical Association (BMA). Policy position on the rights of transgender and non-binary people in healthcare settings. 2026. Available at: https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/policy-position-on-the-rights-of-transgender-and-non-binary-people-in-healthcare-settings. Last accessed 20 April 2026.
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