What Trans Men Need to Know About Ovarian Cancer

Nearly 20,000 people will be diagnosed with ovarian cancer this year, according to the American Cancer Society (ACS), often at later stages of the disease when survival rates are lower. That’s at least in part because many people don't recognize the symptoms of ovarian cancer as serious and therefore don't bring them up with their doctors.
This may be more likely to occur among transgender men who “don’t feel comfortable with anyone seeing those parts of their body because they don't want to be seen as their parts versus who they are,” says Kelly Haviland, NP, a nurse practitioner and a cochair of the LGBTQ Clinical Advisory Committee at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City.
That’s why it’s so important for all trans men with ovaries to know what to watch for and when to talk to a trusted medical professional.
Know the Symptoms
The most common signs of ovarian cancer may not seem like a big deal. According to the ACS, they include:
- Bloating
- Pelvic or abdominal pain
- Issues with urinating, including feeling like you need to pee often or urgently
- Feeling full more quickly than normal or discomfort when eating
You might experience these symptoms for any number of noncancerous reasons, but any notable change is worth bringing up with your doctor, especially if these symptoms occur more than 12 times in a month, according to the ACS.
Pay attention to any abnormal bleeding, too. “That can be confusing for someone who's on hormone supplementation. Bleeding patterns might be abnormal because of the hormones, but they need to be discussed because that can be a sign of cancer,” says Kara Long Roche, MD, a gynecological surgeon at MSKCC.
If any of your symptoms last for two weeks and don’t go away and aren’t easily explained by something else, talk to your doctor, Dr. Long Roche says.
Ovarian cancer symptoms are often related to a growing mass or tumor, says Louise Perkins King, MD, a gynecologic surgeon and a member of the Center for Transgender Health at Brigham and Women’s Hospital in Boston. “By the time you have those symptoms, the cancer’s gotten really big.”
There is currently no effective ovarian cancer screening method, which means tumors are often discovered later when they are larger and therefore harder to treat, Dr. King explains.
That means it’s also important to continue advocating for yourself if a doctor doesn’t take your symptoms seriously, Long Roche says. “Our patients so often are told that they have irritable bowel syndrome, overactive bladder, or UTIs.”
Certain Reproductive Milestones Decrease Your Risk
A history of birth control pill use, pregnancy, or breastfeeding is linked to a lower risk of ovarian cancer, but trans men are less likely to have these experiences and therefore may have a higher risk of ovarian cancer, according to the National LGBT Cancer Network.
There are different theories as to why these experiences might decrease the risk of cancer. One is that all three temporarily decrease natural estrogen production, King says. “Cancers develop when genetics take the wrong path at some point and start overproducing or increasing cell turnover in ways that are damaging,” she says. But if instead the ovaries are “sleeping” or down-regulated by hormonal birth control, pregnancy, or lactation, there’s a lower chance of cell mutations, she explains.
When pregnancy isn’t one of your goals, you miss out on that protection. “Trans men may be less likely to have multiple pregnancies or periods of lactation or maybe even less time on a birth control pill, so that may be a protective factor that they don't have as much exposure to,” Long Roche says.
Little Is Known About How Testosterone Affects Your Risk
It’s hard to do the kind of research needed to get a full picture of testosterone therapy's effect on ovarian cancer risk in trans men, King says.
Currently, there are only a handful of case studies of trans men who went on to develop ovarian cancer, she explains, not the kind of large-scale, long-term observational studies that would help doctors understand the potential relationship here. “It’s a question that needs answering, and we don’t have an answer,” she says.
That said, this is no reason to pause your medical transition or ongoing hormone therapy, says King. The risk of ovarian cancer — or any other cancer — shouldn’t stop anyone from pursuing gender-affirming care, Haviland says.
Ask Questions About Family History
“Without a doubt, the strongest risk factor for ovarian cancer is family history,” Long Roche says. “Every other risk factor that we have pales in comparison.”
Ask relatives about any cases of breast, colorectal, or ovarian cancer in your family. If a parent, sibling, or child of yours has or had ovarian cancer, you have a higher risk, too, according to the ACS. And if certain inherited genetic mutations that cause breast and colorectal cancer run in your family, you may have an increased risk for ovarian cancer, too.
If your family history indicates you’re at higher-than-average risk for ovarian cancer, King and Long Roche both recommend seeking out genetic testing. “[You] should be empowered to see a doctor who can help with risk-reducing options,” Long Roche says.
You might consider having your ovaries, fallopian tubes, or both removed — even if you didn’t or weren’t planning to as part of your transition — if genetic counselors determine you carry an inherited mutation that could lead to ovarian cancer down the line. “We really need to be helping our gender-diverse patients have equal access to those preventive care options like genetic testing and risk-reducing surgery,” Long Roche says.
Risk-reducing surgery can even be part of gender-affirming surgery, Long Roche says. If you’re already planning to have a hysterectomy, you can talk to your doctor about removing your fallopian tubes at the same time. “Fallopian tube removal is probably the most effective way to prevent ovarian cancer in the general population. We need to make sure this is being offered to our trans and gender-diverse patients just as often as it's being offered to everyone else,” she says.
Find a Gender-Affirming Care Team
A long list of obstacles might prevent trans folks from seeking out routine preventive care, Haviland says. “The barriers that we see are so numerous, including lack of insurance coverage, fear of stigmatization, a long history of being discriminated against and having [negative or disparaging] comments made. We have to make sure to create a comfortable environment where someone feels safe to talk about who they are.”
While there is still discrimination and bias in doctors’ offices, King says efforts are being made to make these spaces more inclusive. She notices more healthcare workers asking for a person’s pronouns and using their correct names and genders. Increasingly, she says, it’s easier to tell from a clinic’s website or other promotional materials if it will be a welcoming environment to trans and gender-nonconforming folks.
King suggests visiting a standalone gynecological clinic that doesn’t include obstetrics. Otherwise, “maybe 80 percent of people are actively pregnant. Coming into that space as a man alone may not feel right,” she says.
To find a gynecologist you feel comfortable talking to about your ovaries as a trans man, you can try an online search for a local hospital or clinic with a center for transgender care. Try typing in “transgender healthcare near me” to start. Or you can search for providers near you using directories such as:
- OutCare: The Outlist
- World Professional Association for Transgender Health
- GLMA: Health Professionals Advancing LGBTQ Equality
Tap your community, too, Haviland says. “Ask around a little bit: Ask your friends who they're seeing and what their experiences are.”
Once you’ve identified someone who looks like they could be a good fit, get to know them, she says. “Interview your provider as you would at a job interview. This is the person that you're trusting to care for you. If it's not a good fit, if you don't feel comfortable and safe, you can move on.”
The Takeaway
- Health advocacy is crucial for transgender men when monitoring ovarian cancer symptoms, because early detection often hinges on recognizing vague signs like bloating or abdominal discomfort.
- Establish care with a gender-affirming health provider and stay informed about personal cancer risks raised by genetic and hormonal histories.
- To feel empowered and safe, it's most important to find a respectful and trusted healthcare relationship with a provider.

Ryland J. Gore, MD, MPH
Medical Reviewer
In addition to her professional responsibilities, Gore previously served on the board of directors for Every Woman Works, an Atlanta-based nonprofit organization whose mission is to empower women and help them transition into independence and stability from common setbacks. Gore served as the chairwoman of the American Cancer Society’s Making Strides Against Breast Cancer campaign in Atlanta for three years (2019 to 2021). She is currently the co-director of Nth Dimensions’ Strategic Mentoring Program and the alumni board chair of the Summer Health Professions Educational Program (SHPEP), which is a collaborative effort by the Robert Wood Johnson Foundation, Association of American Medical Colleges, and the American Dental Education Association.
Gore is a highly sought after speaker, consultant, and lecturer on breast cancer and breast health, as well as women’s empowerment topics.

Sarah Klein
Author
Sarah Klein is a Boston-based health journalist with over 15 years experience in lifestyle media. She has held staff positions at Livestrong.com, Health.com, Prevention, and Huffington Post. She is a graduate of the Arthur L. Carter Journalism Institute at New York University, and a National Academy of Sports Medicine–certified personal trainer. She moderated a panel on accessibility in fitness at SXSW in 2022, completed the National Press Foundation's 2020 Vaccine Boot Camp, and attended the Mayo Clinic's Journalist Residency in 2019.
- Russo A et al. Versican secreted by the ovary links ovulation and migration in fallopian tube derived serous cancer. Cancer Letters. September 1, 2022.
- Tordoff DM et al. Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Network Open. February 25, 2022.