Prostate cancer treatments for trans women

If you’re a trans woman, or a non-binary or intersex person, and have been diagnosed with prostate cancer, then your doctor will have done tests to decide the best treatment for you.

The information on this page is based on research about trans women. But some of it will be relevant to non-binary and intersex people who’ve had gender affirming surgery or taken feminising hormones.

You may have had the following:

• A prostate specific antigen (PSA) blood test to find out your PSA level. This can show how fast your cancer is growing.
• A biopsy to find out how likely your cancer is to grow and spread. You may have been told your Gleason score.
• An MRI scan, CT scan, bone scan or PET scan to find out if your cancer has spread outside the prostate, and how far it has spread. You may have been told your cancer stage.

Read more about what the results of your biopsy and scans may mean. This information is based on guidelines for cis men, but is likely to be similar for trans women, and non-binary and intersex people.

Does having prostate cancer mean I can’t take hormones?

No, it’s very unlikely that you’ll be asked to stop taking feminising hormones. Some feminising hormones, such as anti-androgens and testosterone blockers, are actually used to treat prostate cancer. This type of treatment for prostate cancer is called hormone therapy.

Your doctor might suggest that you change to a different type of oestrogen that is used to treat prostate cancer. But you won’t have to change your feminising hormones if you don’t want to. Your doctor should talk you through the advantages and disadvantages of each treatment, and if they might impact your gender affirming care.

What are the treatments for a trans woman with prostate cancer?

You will have many different options to treat or monitor your prostate cancer. Some treatments will aim to get rid of the cancer completely, while others will aim to control it. Read about the different types of prostate cancer treatments.

Or you may not have any treatment, but have it monitored instead. There are two types of monitoring, active surveillance and watchful waiting.

Your treatment will depend on your cancer stage. Read about what can affect your prostate cancer treatment options. If you’re a trans woman, your medical transition can also affect your treatment options. For example, some treatments are not advised before gender affirming surgery, and others are not advised after gender affirming surgery.

It’s up to you how much of your trans history you share, but telling your doctor about any hormones or surgery you’ve had can help them find the right treatment for you.

Can I have gender affirming surgery if I have prostate cancer?

If you’re planning to have gender affirming surgery, this may need to be delayed until after your treatment for prostate cancer.

Some types of gender affirming surgery, such as a vaginoplasty, might not be possible or might be more difficult after some prostate cancer treatments. These include surgery to remove the prostate (radical prostatectomy) and radiotherapy. You should ask the doctor planning your prostate cancer treatment to discuss this with your genital surgeon.

If you are planning to have an orchidectomy (surgery to remove the testicles) as part of your gender affirming surgery, this will not be affected by your prostate cancer treatment. In fact, you may be offered an orchidectomy as a treatment for your prostate cancer.

What are the side effects of treatment in trans women?

All prostate cancer treatments have side effects, and these can affect which treatment you choose. After your treatment, the doctor or nurse will ask you about any symptoms or side effects you’re having. They can help you manage these side effects, or refer you to someone else who can.

Side effects can include:

• sexual problems
• urinary or bowel problems.

Read about living with prostate cancer and the side effects of treatment. You may find that some of the side effects are not a problem, as they will be similar to the effects of your feminising hormone therapy. For example, hormone therapy to treat prostate cancer can cause muscle loss, breast swelling and loss of body hair.

What happens after treatment?

You’ll have regular tests after your treatment to check how well your cancer has responded. You’ll also have regular appointments where you can discuss any side effects and ask questions. This is sometimes called follow-up.

During follow-up, you will usually have regular PSA blood tests to measure your PSA levels. This will show how well your treatment is working. Read more about follow-up after treatment for prostate cancer.

If you’re taking feminising hormones or have had an orchidectomy, your PSA levels during follow-up may be lower than in cis men. Your doctor will take this into account when using your PSA levels to monitor your cancer.

During follow-up, you might also have a prostate biopsy and scans to see if your cancer has spread. These include: 

• magnetic resonance imaging (MRI) scan
• computerised tomography (CT) scan
• bone scan
• positron emission tomography (PET) scan.

Dealing with prostate cancer

Being diagnosed and living with prostate cancer can change how you think and feel about life. If you or your loved one is dealing with prostate cancer, it’s normal to feel scared, stressed or even angry. Lots of people with prostate cancer can get these kinds of thoughts and feelings as they deal with the emotional impact of prostate cancer.

But there’s no ‘right’ way to feel, and everyone reacts in their own way. You may find it helpful to read our information on dealing with your diagnosis and living with advanced prostate cancer. Our Wellbeing Hub has information to help support you in looking after your emotional, mental and physical wellbeing. This information applies to you whether you are trans, intersex, non-binary or cis.

Trans women, and some non-binary and intersex people, may have additional worries and fears about their prostate cancer diagnosis. Some may worry about being treated as male. Others may feel pressured to ‘out’ themselves. Some may feel anxious about sitting in a urology waiting room full of cis men. If you feel this way, there are things that can help.

• Ask your GP to refer you to a counsellor for support with these feelings. If you’re not already under the care of a NHS gender dysphoria clinic, ask to be referred to one for more support. You can also refer yourself for counselling on the NHS website, or you could see a private counsellor via the British Association for Counselling & Psychotherapy.
• If you feel comfortable speaking with your GP, ask them to share your trans history with other health professionals so you don’t have to explain your situation over and over again. You’ll need to give your GP permission, as they’re not allowed to share details about you without your permission.
• When you go for tests and appointments, ask if you can be seen at the beginning or end of the clinic when it may be quieter.
• If your GP tells you they don’t know as much about prostate problems in trans women, they have a duty of care to find out more. You could suggest they contact an NHS gender dysphoria clinic or the UK Cancer and transition Service (UCATS) for expert guidance.
• Read our checklist for talking to a healthcare professional about prostate cancer. You can download the checklist and take it with you to your appointment.

Getting support for prostate problems as a trans woman

Prostate Cancer UK’s services are free and open to everyone. Partners and family members can also use our services. 

Our health information

On our website, we have other information for trans women on:

• other prostate problems
• prostate cancer
• prostate cancer diagnosis.

Our Specialist Nurses

Our Specialist Nurses can answer your questions and explain your diagnosis and treatment options. All our Specialist Nurses can provide sensitive and appropriate support and information to trans women and non-binary people assigned male at birth.

Our online community

Our online community is a place to talk about whatever’s on your mind – your questions, your ups and your downs. Anyone can ask a question or share an experience.

The online community is open to all. It includes a dedicated section for trans women, where you can talk to people who may share or understand your experiences of prostate cancer.

Who else can help?

Clinical services

The UK Cancer and Transition Service (UCATS) is an NHS clinic that supports trans and non-binary people affected by cancer. The service aims to help you manage your cancer and gender affirming care. They can also signpost you to further support and show you how you can get involved in research.

If you have been diagnosed with prostate cancer, you can refer yourself to UCATS, or your doctor or nurse can refer you.

UCATS is part of TransPlus, which is a gender, sexual health and HIV service.

Support groups

At support groups, you can share your experiences of living with prostate cancer. You can also ask questions and share worries, knowing that people will understand what you’re going through.

These are support groups for gay and bisexual men with prostate cancer who also encourage trans women and non-binary and intersex people to attend:

• LGBT Walnut – London
• Out with Prostate Cancer 

OUTpatients provides support groups for any LGBTIQ+ person with and beyond cancer. They host regular peer support meetings and workshops, and have a strong transgender representation.

Organisations

You may also find it helpful to contact organisations that support trans and non-binary people, such as:

• CliniQ
• Gender Identity Research & Education Society (GIRES)
• LGBT Foundation
• LGBT Health and Wellbeing – Scotland
• Stonewall
• Switchboard – National LGBTQIA+ Support Line
• TransgenderNI – Northern Ireland
• Umbrella Cymru – Wales

References and reviewers

Updated: April 2025. To be reviewed: April 2028.