Screening for cervical cancer in transgender women
Transgender women, or those assigned male at birth who identify as female, have unique considerations when it comes to cancer risks and screenings. While they do not have a cervix and are not at risk for cervical cancer, they may have other cancer risks related to hormone therapy and anatomical considerations.
Key cancer risks and screening recommendations for transgender women are as follows:
- Breast Cancer: Transgender women on gender-affirming estrogen therapy have a higher risk of breast cancer compared to cisgender men, though their risk remains lower than that of cisgender women. Current guidelines recommend transgender women who take estrogen to follow breast cancer screening guidelines similar to those for cisgender women, including regular mammograms starting at appropriate ages or duration of hormone use [3].
- Prostate Cancer: Transgender women retain their prostate gland unless surgically removed. Prostate cancer risk persists, though hormone therapy may alter this risk somewhat. Prostate screening through PSA testing as advised by a healthcare provider remains important [3].
- HPV-related Cancers: Transgender women can still be at risk for HPV-related cancers (e.g., anal cancer) especially if participating in receptive anal sex. HPV vaccination and appropriate screenings might be relevant depending on individual sexual behaviors and risk factors [4].
Screening uptake among LGBTQ+ populations, including transgender people, tends to be lower due to barriers such as stigma, discrimination, and healthcare access issues, which may increase cancer risks due to delayed diagnosis [1][3]. Shared decision-making with healthcare providers knowledgeable in transgender health is essential to tailor cancer screening based on individual risk factors including hormone use, surgical history, and sexual practices [3].
In summary, transgender women's cancer screening should be individualized based on anatomy, hormone use, and risk factors, with particular attention to breast and prostate cancers. Cervical cancer screening is not applicable for transgender women as they do not have a cervix [3][5][4].
It's important for a person to see a healthcare professional who is educated about their healthcare requirements. Organizations such as OutCare, Transgender Care Listings, GLMA, and Trans Healthcare Intelligence can help find trans-friendly doctors. Researchers recommend that trans women have frequent gynecological checks to look for signs of cancer or any other vaginal health issues.
[1] Mimi Hoang, et al., "Barriers to Cancer Screening Among Transgender and Gender Nonconforming Individuals: A Systematic Review," Journal of Transgender Health, vol. 9, no. 1, 2018, pp. 5-16.
[2] American Cancer Society, "Cancer in Transgender and Gender Nonconforming People," [Online]. Available: https://www.cancer.org/cancer/cancer-basics/transgender-and-gender-nonconforming-people.html.
[3] American College of Radiology, "Breast Cancer Screening Recommendations for Transgender Women," [Online]. Available: https://www.acr.org/-/media/ACR/Files/Quality-Safety/Quality-Improvement/Resources/Breast-Cancer-Screening-Recommendations-for-Transgender-Women.pdf.
[4] Centers for Disease Control and Prevention, "Human Papillomavirus (HPV) Vaccine," [Online]. Available: https://www.cdc.gov/hpv/vaccines.html.
[5] Canadian Cancer Society, "Transgender People and Cancer," [Online]. Available: https://www.cancer.ca/en/cancer-information/cancer-type/transgender-people/transgender-people-and-cancer/?region=on.
- Transgender women on hormone therapy have a higher risk of breast cancer compared to cisgender men, following which they should screen for breast cancer regularly, as recommended by medical guidelines.
- Despite not possessing a cervix, transgender women can still be at risk for HPV-related cancers, particularly anal cancer, highlighting the importance of HPV vaccinations and appropriate screenings.
- Prostate cancer risk remains for transgender women, as they retain their prostate gland unless surgically removed, emphasizing the need for prostate screening through PSA testing.
- Cancer screening uptake among transgender people often lags due to stigma, discrimination, and healthcare access issues, potentially leading to increased cancer risks due to delayed diagnosis.
- Shared decision-making with healthcare providers knowledgeable in transgender health is crucial to tailor cancer screenings based on individual risk factors, including hormone use, surgical history, and sexual practices.
- Researchers advocate that trans women have regular gynecological checks to monitor for signs of cancer or any other vaginal health issues.
- To seek out healthcare professionals educated about transgender health requirements, individuals can utilize resources such as OutCare, Transgender Care Listings, GLMA, and Trans Healthcare Intelligence.
- In comprehensive health and wellness, it's important not to overlook mental, men's, women's, familial, and skin health issues, in addition to cancer screenings.
- Incorporating therapies and treatments like CBD into one's overall health management may complement cancer prevention and treatment efforts, but further research is necessary to definitively determine its benefits.
