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Some members of the LGBTQIA community may be at risk of prostate and testicular cancers. Anyone with a prostate and/or testicles can develop prostate and testicular cancers, including men and trans women assigned male at birth. However, some people may have a higher risk than others for one or both of these cancers.

Knowing the risk factors, symptoms and screening procedures can increase the chances of finding cancer early. Finding cancer early can mean earlier treatment and better long-term experiences.

LGBTQIA+ Prostate Cancer Basics

Prostate cancer is the most common cancer besides skin cancer that affects men in the United States. About one out of eight U.S. men (or people assigned male at birth) will develop prostate cancer in their lifetimes. The risk of prostate cancer gets higher with age, especially after age 65.

Prostate cancer is the second leading cause of cancer death after lung cancer. One out of 10 men who died of cancer in 2022 died of prostate cancer. But, screenings and finding prostate cancer early increase the chances of survival.

Black men and men in their 70s and 80s are more likely than other men to develop prostate cancer. It’s not clear if gay and bisexual men and men who have sex with men get prostate cancer more than other men. But, it does seem that men who have sex with men get prostate cancer at younger ages than other men.

Men who have sex with men also appear to get prostate cancer screenings less often than other men. Fewer screenings mean not finding cancer early, which delays treatment.

LGBTQIA+ Testicular Cancer Basics

Testicular cancer is much less common than prostate cancer but occurs more often in younger men and middle-aged men. Anyone with at least one testicle can develop testicular cancer, including anyone assigned male at birth who has a different gender identity.

The average age of men diagnosed with testicular cancer is 33, and it occurs mostly between ages 15 to 35. About 1 out of 250 U.S. males develop testicular cancer during their lifetimes.

Testicular cancer is also less deadly than prostate cancer because doctors can treat it effectively. The average man’s risk of dying from testicular cancer is about one in 5,000. But, men living with HIV or AIDS may have a higher risk of testicular cancer than other men.

LGBTQIA+ Health Disparities

Experts are still learning about the risks of prostate and testicular cancer in men who have sex with men. The chances of developing these cancers in men who have sex with men are about the same as in other men.

But, the quality of life and long-term outcomes of having prostate cancer are often worse for men who have sex with men. Gay and bisexual men who survive prostate cancer may have worse mental health than other men who survive prostate cancer. They might also have a worse function in their bowels, urination, and hormones.

There are several reasons gay and bisexual men have worse experiences with prostate cancer than other men. The biggest reason is less access to health care. Men who have sex with men are less likely than other men to have:

• Access to health care that is right for their needs and culture.
• Health insurance.
• Health care without judgment or stigma.
• A job and a home.
• A primary health care provider.

Other barriers also exist for gay and bisexual men getting high-quality health care. Many health care providers don’t have the training and knowledge to give appropriate care to men who have sex with men. Men who have sex with men may also have concerns about seeing a doctor because of discrimination, bias, or stigma.

Many gay and bisexual men have experienced poor treatment, rudeness, or no care at all. For example, a 2023 study asked LGBTQIA+ men with prostate cancer about their experiences of discrimination.

That study found:

• Almost half the men (46%) experienced at least one instance of discrimination.
• 43% of the men said their provider did not listen to them.
• 25% said the provider talked down to them.
• 20% said they received worse care than others.
• 10% said one of their providers seemed to be afraid of them.

LGBTQIA+ Prostate Cancer Risk Factors

Some men are more likely to develop prostate cancer than other men. Black men and those with a relative who had prostate cancer have a higher risk of prostate cancer.

Prostate cancer risk also increases with age, especially in men over age 65. Gay and bisexual men can lower their risk of prostate cancer by talking to their doctor about prostate cancer screening.

LGBTQIA+ Prostate Cancer Screening

LGBTQIA+ men, men who have sex with men, and other people with a prostate should ask their provider about prostate cancer screening. The U.S. Preventive Services Task Force recommends men consider prostate cancer screening between ages 55 to 69. But, men with higher risk should talk to their providers earlier.

• Men age 40 and older should ask about screening if they have a BRCA gene mutation.
• Men age 40 and older should also ask about screening if more than one man in their immediate family had prostate cancer.
• Men aged 45 and older should ask about screening if they are Black or had a father or brother with prostate cancer.

The American Cancer Society recommends all other men ask about prostate cancer screening at age 50 or older. Screening can involve the prostate-specific antigen (PSA) blood test or a rectal exam done with a provider’s gloved hand.

A PSA test does not always tell you for sure if you have prostate cancer, but it gives you more information. Men with a high PSA level may have cancer and need more tests to find out. However, some men with a high PSA level do not have cancer.

Also, about one in seven men with a normal PSA may have prostate cancer. A physical exam to look for a swollen prostate can help find cancer in these men.

LGBTQIA+ Testicular Cancer Risk Factors

Gay and bisexual men and trans women can reduce their risk of testicular cancer by knowing their risk. The most common ages of men with testicular cancer is between ages 15 to 35. About half of all men who get testicular cancer are between the ages of 20 and 34.

Intersex individuals may also be at higher risk for testicular cancer if they have certain chromosome variations. If you’re intersex with at least one Y chromosome and one testicle, ask your doctor about your cancer risk and screening options.

White men are more likely to get testicular cancer than men of other races or ethnicities. Other factors can raise the risk of testicular cancer:

• A condition called hypospadias is where the hole in the penis is not at the tip.
• Having a family member who had testicular cancer.
• Having had testicular cancer once already.
• Having HIV or AIDS.
• Having one undescended testicle, or a testicle that has not dropped.
• High exposure to pesticides may increase risk.

Men who have sex with men should talk to their provider about their risk of testicular cancer.