Priority populations

Provide care that is safe, respectful and culturally appropriate for all patients.

Recognise that some populations may experience racism, stigma or have specific cultural and spiritual needs. These populations include:

• Aboriginal people
• culturally and linguistically diverse communities
• people who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex, or gender diverse (LGBTQI+).

Be aware of these populations to enable you to identify and respond to patient's individual care needs and to support equitable care.

Aboriginal people

Aboriginal people experience higher rates of gynaecological cancers and related mortality than non-Aboriginal people.¹ These disparities reflect social determinants of health, systemic inequities and barriers within the health system.¹

Provide care that recognises reproductive health can be sensitive for many Aboriginal patients and may be considered Women’s Business. Deliver care with privacy and respect, and acknowledge the ongoing impacts of:

• colonisation
• racism
• stigma
• historical traumas
• mistrust of mainstream health services.

Also recognise how these factors continue to influence how Aboriginal people access and experience care.

These factors reduce participation in cervical screening and engagement with health services, contributing to higher cancer prevalence and poorer outcomes. Provide trauma-informed, integrated care to support safety and improve the patient’s experience.

Deliver culturally safe and responsive care

Where appropriate, offer female clinicians to support cultural preferences. Involve Aboriginal Cancer Care Navigators, where available, to improve cultural safety, support system navigation, advocate for patients and facilitate effective communication. Where these roles are not available, refer to an Aboriginal Liaison Officer.

Clinicians should take time to yarn with patients and engage in respectful, open conversations to understand individual preferences and avoid assumptions. Where appropriate, involve family or community supports. Base discussions on what matters to the patient and aligns with best clinical practice. Support discussions with plain language and culturally appropriate resources.

Addressing cultural needs alongside clinical care improves safety, participation and outcomes for Aboriginal patients affected by gynaecological cancer.

Ensure timely progression through each stage of care by coordinating appointments, follow-up and access to treatment. Provide culturally safe, inclusive support to promote equitable outcomes across the care pathway.

• Clinician resources 
• Consumer resources

Culturally and linguistically diverse people

Provide care that is sensitive to cultural, religious and interpersonal differences.

Recognise that cultural beliefs and practices influence how patients:

• experience gynaecological cancer
• make treatment decisions
• engage with care.

Consider how cultural and spiritual views on fertility, reproduction, sexuality, modesty and body image may affect discussions.

Important considerations

• Respect cultural and religious beliefs about fertility, reproduction and sexuality.
• Maintain privacy and dignity during examinations and treatment.
• Acknowledge differing views about illness, treatment and decision-making.
• Use professional interpreters to support clear communication.

Recognise that stigma associated with cancer in some cultures may lead to:

• social isolation
• relationship strain
• psychological distress.

Patients from communities where female genital mutilation is practised experience additional trauma, physical and psychological challenges, and stigma, particularly if surgery is required. These factors may increase psychosocial stress and should inform how care is provided.

Interpreters are essential

Use professional interpreters for patients, their families or support people who are hearing impaired, or from culturally and linguistically diverse backgrounds.

In public health settings, rely on qualified healthcare interpreters to ensure accuracy and avoid loss of critical health information. Do not use family members as interpreters, as this can compromise communication and disadvantage the patient. For example, in some cultures, family members don’t want the patient knowing their diagnosis for fear it will cause them to die sooner or because of the stigma of cancer. In private settings, patients accessing Medicare-funded services can use the Translating and Interpreting Service.

Provide culturally safe care by:

• asking about preferences
• avoiding assumptions
• involving family or community supports where appropriate.

Address cultural needs alongside clinical care to build trust, improve safety and support better outcomes. Ensure timely progressions through care, as culturally and linguistically diverse people may face additional barriers. Prioritise coordination of appointments, follow-up, access to treatment, and provide culturally safe, inclusive support to promote equitable outcomes.

• Consumer resources

LGBTQI+ people

People who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex or gender diverse (LGBTQI+) often face additional challenges and have specific needs across the cancer pathway.

Previous negative healthcare experiences, including discrimination and lack of recognition, can reduce engagement with healthcare and limit disclosure of important information.

There are a range of challenges that affect the willingness of LGBTQI+ people to seek the healthcare they need.^2,3

Fear of stigma

• LGBTQI+ people may fear disclosing their identity due to concerns about negative reactions from health professionals.
• Health professionals may make assumptions about sexual orientation, gender identity or sex characteristics.
• LGBTQI+ people experience higher levels of depression and anxiety related to marginalisation, violence, stigma, exclusion and discrimination.
• Health services may not recognise partners or significant others as family.
• Some people may have limited or no support from their family of origin.

Limited access to care

• LGBTQI+ people may have limited access to cancer information and tailored support services.
• Health services may provide limited access to clinicians with expertise in trans health, leading to gaps in clinical knowledge of LGBTQI+ health needs.
• Services organise care around cisgender women, which can exclude or isolate trans and gender diverse people.

Impacts on body image and identity

• Cancer and its treatment can cause physical changes, e.g. loss of gynaecological organs or hair loss, that may lead to dysphoria and affect body image and intimacy.
• Administrative systems and forms may not capture gender, pronouns or sexual orientation, and may not align with the patient’s recorded name.

Patient-centred care

To support LGBTQI+ patients, provide patient-centred, inclusive care. Use respectful, affirming language and ensure intake and consent forms allow patients to self-identify.

Ask about current anatomy, prior surgeries and gender-affirming hormone use rather than making assumptions based on gender presentation. Inclusive practices help ensure that decisions respect each person’s body, history and identity.²

Use neutral terms, e.g. partner, to support safe disclosure. Refer to psychology or sexual health services where needed.

Recognise that gynaecological cancer treatment may affect fertility, body image and gender affirmation, with particular impact for LGBTQI+ people.

Provide clear information, psychosocial support and use appropriate referral pathways that reflect diverse relationships, family structures and reproductive goals.

Create inclusive environments

Health services should create inclusive environments for LGBTQI+ people. Provide integrated trauma-informed care to support safety and improve the patient experience. Ensure all staff complete LGBTQI+ sensitivity training to support affirming care.

Use patient record systems that accurately capture names, pronouns, titles, gender identity and sex characteristics, so all communications reflect the patient appropriately.

Create waiting environments with inclusive resources and clearly display non-discrimination and confidentiality statements. Encourage safe disclosure of diverse sexualities and genders to support patients to share what is important to their care.⁴

Ensure timely progression through each stage of care as LGBTIQ+ people may face additional barriers. Prioritise coordination of appointments, follow-up, access to treatment, and provide culturally safe care to promote equitable outcomes.

• Clinician resources
• Consumer resources

References

1. Australian and New Zealand Gynaecological Oncology Group (ANZGOG). Gynaecological cancers in Australia 2025: An overview. Camperdown, NSW: ANZGOG; Aug 2025 [cited 24 Sep 2025].
2. Cancer Council Victoria. LGBTQI+ Communities Barriers to cancer screening and working with community. Melbourne: Cancer Council Victoria; [cited 23 Sep 2025].
3. Cancer Council NSW. LGBTQI+ People and Cancer: A guide for people with cancer, their families and friends. Sydney: Cancer Council NSW; Feb 2023 [cited 23 Sep 2025].
4. Australian Government Department of Health. Cervical screening is important for trans and gender diverse people with a cervix. Canberra: Australian Government Department of Health; Jun 2025 [cited 23 Sept 2025].