RESEARCH SHOWS SOME LGBTQ+ PEOPLE have higher risk for certain cancers, lower cancer screening rates and higher mortality in certain cancers than people who are both heterosexual and cisgender. But the LGBTQ+ community is made up of people with various identities. A study published Jan. 27, 2026, in Cancers found transgender and bisexual people tend to face greater barriers to cancer survivorship care than cisgender lesbians and gay men.

Study co-author Jennifer Jabson Tree, a public health researcher at Purdue University in West Lafayette, Indiana, says her personal experiences inspired the research. Jabson Tree describes herself as queer, meaning she is attracted to people with a range of gender identities. Her partner is transmasculine, meaning he was assigned female at birth but is a masculine transgender person. Both have been diagnosed with breast cancer and have completed treatment.

Her partner began treatment in 2019 before his transition. At the start of his care, the couple asked about fertility preservation. Jabson Tree had previously had her uterus removed due to noncancerous growths called fibroids, and faith-based agencies could deny same-sex couples’ applications for adoption in their state of Tennessee, she says. However, the doctor did not consider those factors and refused to discuss fertility preservation options “because there were other ways to have babies,” Jabson Tree recalls.

When Jabson Tree was diagnosed with breast cancer herself in 2024, however, her doctor “understood our queer identities, and that made a really big difference,” she says. The doctor “acknowledged my relationship status and concerns, and she asked if I had any concerns specifically related to my identity as it might also relate to my cancer treatment.”

In the study, Jabson Tree and Purdue University doctoral candidate Madeline Brown-Savita analyzed survey responses from 3,502 cancer survivors who are lesbian, gay, bisexual or transgender/gender expansive. The survey questions asked about how they interacted with the health care system, levels of perceived stress and discrimination, and social support. The researchers rated whether each participant faced low, medium or high barriers to health care depending on the number of barriers they reported facing, and they tested for patterns based on gender and sexuality.

The researchers found 18% and 28% of bisexual and transgender survivors, respectively, reported facing high barriers to health care, compared with 8% of cisgender lesbians and gay men. Trans and bisexual people were more likely to delay care due to difficulty finding transportation to appointments, getting time off work and paying medical costs. In particular, they were less likely to be able to afford prescription medicine, which led them to delay refills, skip doses and request lower-cost medications. They also were more likely to avoid emergency care.

Research shows bisexual and transgender people often face barriers that prevent them from accessing health care in general, so these findings show the same is true of cancer survivorship care specifically, Jabson Tree says.

“There is such a strong anti-trans sentiment in our country,” she says. “We’re seeing discrimination playing out in the health care setting, actual and feared, as well as in the economic capacity for folks who have those identities to make a living.”

Research suggests bisexual people often face higher levels of discrimination than gay men and lesbians, in part because they face prejudice from both straight people and others in the LGBTQ+ community. “Bisexual people can sometimes be very highly educated but making less money,” Jabson Tree says.

Overall, LGBTQ+ survivors who encountered discrimination, experienced chronic stress and had a low income were more likely to face high barriers to health care, Brown-Savita says.

People in the low-, medium- and high-barrier groups reported similar levels of social support—having people to confide in, who make you feel loved and who help with tasks like chores, according to the study. But support from family and community was not enough for those in the high-barrier group to overcome issues like cost and perceived discrimination, Brown-Savita says.

Advocating for LGBTQ-inclusive Health Care

“Many cancer centers have financial navigators or prescription assistance programs, transportation vouchers, or payment plan options,” which can make care more affordable, Brown-Savita says. Nonprofit organizations, such as CancerCare and the Cancer Financial Assistance Coalition, also offer financial assistance for people receiving cancer treatment.

Charles Kamen, a cancer disparities researcher at the University of Rochester Medical Center in New York, encourages LGBTQ+ people to discuss their concerns, including those relating to sexual orientation and gender identity, even when it can feel awkward. He says many health care workers have good intentions but may not be informed about how to best help LGBTQ+ patients.

Kamen suggests LGBTQ+ people tell their care team what pronouns to use and how to address their partner, share concerns they have related to their gender or sexuality, and explain their health priorities. For example, they may want to explore if they can continue receiving gender-affirming hormone therapy while undergoing cancer treatment.

Additionally, Kamen says LGBTQ+ patients may also discuss the following topics with their care team:

  • the type of sex they have and related concerns about sexual side effects from treatment;
  • potential treatment interactions with gender-affirming medications;
  • resources for LGBTQ+ cancer survivors, like identity-specific support groups;
  • what language they feel comfortable with to describe specific body parts; and
  • the cancer center’s nondiscrimination policies, what education staff receive regarding respect for LGBTQ+ patients and what consequences employees face if they engage in disrespectful behavior.

Kamen also encourages LGBTQ+ patients to ask people close to them for support when needed. A friend can, for example, help advocate during appointments and ask the questions a patient may be nervous to ask. “Know your community, and lean on the community,” he says.