Addressing the fertility concerns of LGBTIQ+ people with cancer: a reproductive justice perspective

This chapter explores the fertility experiences of LGBTIQ+ people diagnosed with cancer, drawing on data from the Out with Cancer Study. Using a reproductive justice framework, it challenges the assumption that cancer-related fertility loss is less distressing for LGBTIQ+ individuals. Participants’ narratives reveal a strong desire for parenthood and a deep sense of loss when cancer or its treatment compromises fertility. These emotional impacts are compounded by intersecting forms of systemic discrimination, including cisnormativity and heteronormativity, which shape access to fertility preservation and care. The chapter highlights the structural and institutional barriers that LGBTIQ+ people with cancer face in forming families, including restrictive legal frameworks, high costs of fertility preservation, inadequate support, and exclusionary practices in assisted reproductive technologies. Experiences of medical trauma, particularly among intersex individuals subjected to non-consensual interventions in childhood, and their connection to fertility are discussed as forms of reproductive injustice. Many participants described fertility services as “incredibly heteronormative” and lacking in LGBTIQ+ inclusive information or support. Fertility discussions with healthcare professionals were often absent, inadequate, or delivered with insensitivity and bias. These experiences discouraged disclosure of identity and undermined patient trust and satisfaction with fertility-related care. Contrary to stereotypes, many LGBTIQ+ participants expressed a strong commitment to parenthood. The chapter argues that reproductive justice for LGBTIQ+ people with cancer demands more than access to fertility technologies – it requires systemic reform. Advocacy, policy change, and LGBTIQ+ community leadership are essential to address the complex realities of infertility and cancer among marginalised populations. The chapter calls for inclusive, equitable, and culturally safe reproductive care that recognises all people’s right to parent – or not – on their own terms.