Transgender Considerations for Ovarian Cancer

Medically Reviewed by Melinda Ratini, MS, DO on July 22, 2022
4 min read

If you’re a transgender man and you still have your ovaries, you have some risk for ovarian cancer.

That’s whether or not you take testosterone. It’s also possible your risk of ovarian cancer is somewhat different than it is for other people with ovaries.

What’s more, it can also be harder for you to get a timely diagnosis of ovarian cancer than it is for someone who identifies as a woman.

One reason is that you and your doctors may be less likely to talk about ovarian cancer and your risks for it. Also, transgender people are more likely to lack health insurance than some other groups are. They also may have a hard time finding doctors who know a lot about caring for them. You may feel uncomfortable talking to your doctor about your health risks and health care needs.

This can affect the quality of care you receive.

If you have ovaries, your risk of getting ovarian cancer at some point in your life is about 1 in 72. There’s no evidence that being transgender or nonbinary increases your risk of ovarian cancer. But your risk may be different than the average person.

Things that affect your risk of ovarian cancer are:

  • Your age. Most ovarian cancers happen in people with ovaries who are over age 63.
  • Your weight. People with ovaries who are obese may have a higher risk of ovarian cancer.
  • Having children later or never having children. If you have children after age 35 or never have kids, your risk of ovarian cancer is higher.
  • Having family members with ovarian cancer. If your mom or sister had ovarian cancer, you may be at more risk. You also could have more risk if ovarian cancer runs in your father’s family, too.
  • If you carry genes that increase ovarian cancer risk.
  • Your race. Ovarian cancer is more common in white people than other groups.
  • Smoking. People who smoke are at more risk for a rare kind of ovarian cancer.

Transgender men may have added risk for ovarian cancer due to some lifestyle and other factors. This has not been proven. But some experts think that risk is higher because:

  • Transgender men use birth control pills less often than women, and birth control pills lower ovarian cancer risk.
  • Transgender men may be less likely to have biological children.
  • Transgender men more often smoke and they’re more likely to be overweight.

Probably not.

While taking testosterone can cause changes in your ovaries, they may look similar to those of a woman with a condition called polycystic ovarian syndrome (PCOS). That’s when your ovaries make more male hormones. So, transgender men might have PCOS more often.

Doctors used to think that women with PCOS had more risk for ovarian cancer. That led to the idea that transgender men who take testosterone might have more risk for ovarian cancer, too. But more recent data suggests PCOS doesn’t increase ovarian cancer risk.

So there’s no reason to think that taking testosterone or having ovaries that look like those of someone with PCOS means you’re more likely to get ovarian cancer.

The short answer is no – or at least probably not.

Screening with blood tests or imaging tests isn’t usually recommended for anyone with ovaries unless your doctor thinks you have symptoms consistent with ovarian cancer.

Transgender and nonbinary people don’t have higher risk in general, and they can follow the same guidelines as women with ovaries.

In part, that’s because there isn’t a reliable test to screen for ovarian cancer. Doctors don’t have evidence that any known screening test makes people at average or near-average risk less likely to die of ovarian cancer.

Even if your risk of ovarian cancer is somewhat higher than average, you probably still don’t need ovarian cancer screening.

But there’s an exception. That’s if you’ve had genetic testing and found out you have a much higher chance of ovarian cancer. It’s still not clear that ovarian cancer screening tests help a lot, but people with ovaries who are at very high risk for ovarian cancer may start screening as early as age 30.

You could also talk to your doctor about having surgery to remove your ovaries. If ovarian cancer runs in your family and you don’t know if you’re at high risk, a genetic counselor might help you understand your risk and help you get genetic testing if you want.

Half of all people with ovarian cancer get diagnosed at a late stage. One reason is that ovarian cancer symptoms aren’t very distinctive. But if you have it, you may notice:

  • Bloating
  • Belly or pelvic pain
  • Trouble eating
  • Feeling full soon after you start eating
  • Needing to pee a lot
  • Fatigue
  • Stomach upset
  • Back pain
  • Constipation

If you have these symptoms and they aren’t going away, tell your doctor.

Sadly, transgender and nonbinary people can face discrimination from some doctors. But fortunately, an increasing number of doctors are better understanding the health and cancer care needs of transgender people. Look for one who’s gender-affirming.

Some tips to help you feel more comfortable talking to your doctor about ovarian cancer include:

  • Remember you’re in control. Don’t talk about anything you don’t want to.
  • Bring along someone you trust for support.
  • Write down what you want to say and any questions ahead of time.
  • Ask for a telehealth appointment if you are more comfortable talking that way.

There’s no known way to prevent ovarian cancer, but having a doctor you trust to help you understand your risks are important steps to protect your health.