Cancer Screening in the Transgender Population

A Review of Current Guidelines, Best Practices, and a Proposed Care Model

Joshua Sterling; Maurice M. Garcia

Disclosures

Transl Androl Urol. 2020;9(6):2771-2785. 

In This Article

Social Transition and Cancer Risk

A patient's stage of gender transition can affect the type of medical specialist they see most regularly, which in turn can alter which cancer screening protocols are emphasized. Transgender patients report to us that they experience a sense of unease with seeking birth-sex based cancer screening during and after gender transition as doing so requires acknowledging that they retain birth-sex anatomy. For example, transmasculine men with ongoing gynecologic cancer risk factors may be less likely to follow-up with a general gynecologist after starting GAHT and/or genital GAS. For those patients who have already transitioned socially going to a gynecologist can be very difficult; it can be seen as a step backwards for transmasculine patients, and transfeminine patients may find that they are turned away. Again, examinations of a patient's birth sex organs are very likely to aggravate any gender dysphoria and need to be done with extra care and consideration for this fact. In 2011, ACOG released a statement that healthcare providers should be able to care for transgender individuals or at least be able to refer them for routine checkups and screening as appropriate.[26]

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