Erasure of identity or gender euphoria : the impact on cancer on trans embodiment

This chapter reviews current knowledge about experiences of identity and embodiment for trans people with cancer and trans cancer carers, drawing on existing literature, as well as the findings of our recently completed Out with Cancer Study, involving 430 LGBTQI cancer survivors and 130 carers, including 63 patients and 23 carers who identified as trans. For trans people diagnosed with cancer, both the symptoms of cancer and the cancer treatment may affect gender, embodiment, and processes of gender affirmation. In the Out with Cancer Study, we found significantly higher levels of distress in trans participants in comparison to the cis participants, with distress associated with impact of cancer on trans identity. In qualitative analysis we identified heightened gender dysphoria and interrupted gender affirmation as the primary negative impacts of cancer on identity. However, for some trans individuals, cancer interventions had a positive impact, reflected in gender euphoria" comfort or joy in one's gender" and facilitation of gender affirmation. Interactions with healthcare professionals had the potential to exacerbate or ameliorate the negative impact of cancer on trans identity and embodiment. There is a pressing need for attention to be paid to the cancer survivorship and cancer caring experiences of trans people, in order to inform practice and policy, and the development of culturally safe cancer information and care.