Gender-Affirming Surgery and Cancer : Considerations for Radiation Oncologists for Pelvic Radiation in Transfeminine Patients

Access to gender-affirming surgery is increasing for many transgender and nonbinary people in the United States, and radiation oncologists must be equipped to care for patients who have undergone such surgery in the region of their planned radiation treatment field. There are no guidelines for radiation treatment planning after gender-affirming surgery, and most oncologists do not receive training in the unique needs of transgender people with cancer. We review common gender-affirming genitopelvic surgeries for transfeminine people, including vaginoplasty, labiaplasty, and orchiectomy, and summarize the existing literature on the treatment of cancers of the neovagina, anus, rectum, prostate, and bladder in these patients. We also describe our systematic treatment approach and rationale for pelvic radiation treatment planning.& COPY; 2023 Elsevier Inc. All rights reserved.

Automated summary

Access to gender-affirming surgery is increasing in the United States, and radiation oncologists need to be prepared to treat patients who have undergone such surgeries. However, there are currently no guidelines for radiation treatment planning in these patients, and most oncologists lack training in the unique needs of transgender individuals with cancer. This review explores common gender-affirming surgeries for transfeminine people and summarizes the existing literature on cancer treatment in these patients. Additionally, it describes a systematic treatment approach and rationale for pelvic radiation treatment planning.