How to Navigate Cancer Screening as a Queer Person
By Allie Neenan, PhD, LP | Last updated 5/5/26
Cancer in young adults is on the rise. There are more than 12 kinds of cancer that are becoming more common in people under 50, and nobody knows exactly why. Staying up to date on cancer screening recommendations has never been more important. But there are many reasons why preventative care can be harder for access for queer* people at all ages. This article will contain key information on queer-affirming and gender-affirming cancer screening guidelines as well as tips for navigating medical visits.
*For the purpose of this article, "queer" serves as an umbrella term that includes, but is not limited to: lesbian, gay, bisexual, transgender, intersex, asexual, and two-spirit.
If you haven't been here before, welcome to Cancer Cushion! Every post on this website is written by licensed clinical psychologist, Allie Neenan. Cancer Cushion is my resource library for every age, role, and stage in the childhood cancer journey. While I wish websites like this weren't necessary, I'm glad you're here.
Cancer screening is for everyone. Screening guidelines often assume that only "men" or "women" require screenings for certain body parts. In reality, people across genders need various cancer screenings that align with their anatomy. An organ-based cancer screening is the default for cisgender people and equally appropriate for transgender people. What does this mean in practice?
If a person has a cervix, they should be screened for cervical cancer. If a person has a prostate, they should be screened for prostate cancer. Medical professionals should avoid assuming anatomy on the basis of one's gender.
Cancer prevalence varies by age. Because of this, cancer screening guidelines reflect age-based and anatomy-based criteria. The guidelines shared below are some of the most important for young adults to be aware of.
Queer-Affirming Cancer Screening Guidelines
Breast Cancer - for individuals with breasts whose breast tissue mostly developed during puberty (most commonly cisgender women), mammogram screening is advised every other year at age 40. For individuals with breasts whose breast tissue mostly developed following initiation of hormone therapy (most commonly transgender women), mammogram screening is advised at age 50 and after at least 5 years of continuous hormone therapy. Guidelines vary to account for differences in lifetime exposure to estrogen and progesterone, an important risk factor for developing breast cancer. Standard guidelines may not be appropriate for all patients - consult with your doctor to determine if individual risk factors require a tailored plan of care. Cervical Cancer - individuals across genders who have a cervix are advised to complete cervical cancer screening every 3 years between ages 21 to 29, and every 3-5 years between ages 30-65 depending on screening method used. From ages 21 to 29, a cervical cytology (pap test) is recommended every three years. From ages 30 to 65, there are several screening options. First, a cervical cytology can continue to be completed every 3 years. Second, a high-risk HPV test can be conducted every 5 years. Third, a cervical cytology and a high-risk HPV test can both be completed every 5 years. Standard guidelines may not be appropriate for all patients - consult with your doctor to determine if individual risk factors require a tailored plan of care. Colorectal Cancer - all adults ages 45 to 75 are advised to complete colorectal cancer screening. There are many ways to complete colorectal cancer screening. The most well-known test is a colonoscopy, which is completed every 10 years. There are also stool tests which are completed annually. Additional screening methods vary in intensity and frequency. Standard guidelines may not be appropriate for all patients - consult with your doctor to determine if individual risk factors require a tailored plan of care.
How to Follow Cancer Screening Guidelines as a Queer Person
Knowing the recommendations is just the first step to completing all of the recommended cancer screenings. Ideally, your primary care provider will monitor when you are due for screenings and help you schedule these procedures. Unfortunately, many medical providers lack competency in queer cancer prevention, and many queer patients experience discrimination in healthcare settings. If you feel intimidated by the idea of seeking out cancer screening, you are not alone. Healthcare is an incredibly vulnerable topic. It is hard enough to complete screening tests without navigating dysphoria, homophobia, or transphobia. Most people are uncomfortable with medical self-advocacy, especially if they have never done it before. The good news is, there are steps you can take to build a strong relationship with your doctor. Feeling safe is one of the most important steps toward getting the care you need.
Tips for Requesting Cancer Screening as a Queer Person
Know your rights. Cancer screening is for everyone. If a doctor says that you are "too complicated" or otherwise dismisses you because of your gender, that is not ok. Your body is never the problem. If possible, request a different doctor or follow your healthcare provider's grievance protocol if you encounter discrimination. Practice the conversation ahead of time. Write down the organs you have and cancer screenings that you are currently eligible for. The United States Preventative Services Task Force and the Gender Affirming Health Program at UC San Francisco are both helpful resources for clarifying current guidelines. Bring it up first. Annual wellness visits are the perfect time to review cancer screenings and other preventative care. Consider what anatomy language is most comfortable for you and request that this be noted in your chart to help your care team provide affirming care. Bring a loved one. A partner, family member, or friend can help you take notes or prompt you to ask important questions if you get flustered. If you encounter inappropriate comments, having a witness can buffer the stress and help you find the confidence to advocate as needed. Ask for what you need. People of all genders find cancer screening to be distressing for many different reasons. Some patients need to defer screening until they have had several opportunities to meet with their doctor and build trust. Once it's time to complete screening, a queer-affirming provider will be happy to explain the steps of the procedure and develop a comfort plan with you. It is ok to take breaks, ask for distraction, or explore options for pain relief. Every patient deserves compassionate care.