Challenges in Transgender Healthcare: The Pathology Perspective

Sarika Gupta, FRCPath; Katherine L. Imborek, MD; Matthew D. Krasowski, MD, PhD


Lab Med. 2016;47(3):180-188. 

In This Article

Abstract and Introduction


Background: The transgender community is one of the most marginalized sections of our society. The literature is scarce regarding the pathology and laboratory medicine challenges associated with caring for transgender patients.

Objective: To summarize the available gender-transitioning options and to discuss healthcare challenges, from a pathology/laboratory medicine perspective, in the care of transgender patients.

Method: We reviewed the current terminology and epidemiology relevant to the transgender population in preparing our analysis.

Conclusions: The main transgender healthcare challenges in pathology/laboratory medicine practice include the inflexibility of electronic medical records in documenting affirmed gender, unfamiliarity among medical and laboratory professional with the needs of and terminology related to the transgender population, lack of reference ranges for laboratory tests, unclear guidelines regarding gender classification for blood donation eligibility criteria, and paucity of experience in handling and interpreting surgical and cytologic specimens from gender-transitioning individuals. Directed efforts to overcome these shortcomings, coupled with a more welcoming posture, are essential to achieving the highest standards of care for the transgender population.


The transgender community is among the most underserved and underrepresented subgroups in our society.[1] In this review, we focus on the common terminology regarding the epidemiology of and challenges faced by transgender people in receiving essential healthcare, from the pathology/laboratory medicine perspective.