LGBT Health
NHS Choices

Screening for trans people

What is screening?

Screening is a way find out whether you are at risk of, or have, certain health conditions. Early treatment and information increases the options available.

Screening can present specific problems for trans people, especially when it means that specific parts of the body have to be looked at. The chest, cervix, testicles and prostate are all areas that need screening and/or self checking to reduce the chance of cancer developing. However,  because these areas are sex specific, trans people may find it emotionally or practically harder to engage with screening. You may also find that you are not invited to screening tests when you should be, if you have asked the health service to change your gender on their records.

What kind of screening do trans people need?

You will usually need the same screening invitations as others of your birth-assigned gender. Even if you have had gender-affirming treatment (such as a mastectomy), you may still need screening. The exact screening you need will depend on the gender-affirming treatment you have had, if any. If you have changed your gender on your NHS records but still have body parts of your assigned gender, you may not receive reminders and invitations to screening. Talk to your GP and your consultant, if you have one, about this.

If you are taking hormones, this may put you at higher risk of certain cancers. Talk to your consultant about what screening tests you require when taking hormones.

It is also important to self-check regularly. This may be hard, particularly if you do not like the part of your body that you need to check. There is some evidence that transgender people may not always properly self-check their breasts, breast tissue or testicles. If you do not like these parts of your body, you may not want to touch them or be reminded of them. However, it is very important to try to be aware of any changes to your body.

List of screening tests

You may need annual hormone replacement therapy (HRT) blood tests if you are on HRT and there are other routine screening tests that everyone should be invited to take.

a) Abdominal Aortic Aneurysm (AAA) screening: If you are registered as male you will be invited at age 65. If you are not registered as male, you should talk to your healthcare professionals to decide whether this is a test you need.

b) Breast screening: If you are registered with your GP as female and aged 50-70 years old you will be invited. If you are either assigned female at birth or are a trans woman who has taken hormones in the long term, it is a good idea to take part in breast screening as you are at higher risk of breast cancer. If you are not registered as female you will not be invited for screening and should speak to your doctor to ensure you are included. Visit Breast Test Wales for more information.

c) Cervical screening: If you are registered as female and aged 25 or over you will be invited. If you have a cervix, regardless of your gender identity, you should be screened. Visit Cervical Screening Wales for more information.

d) Prostate screening: Gender affirming surgery for trans women does not remove the prostate. If you are a trans woman aged over 50, you should ask your GP to have your prostate screened as you remain at risk. Some information on prostate cancer among trans women is available here.

For more screening information for trans people, see this leaflet by the Gender GP.

For information on trans specific sexual health and HIV and advice for people with a surgically constructed vagina, see the Trans Health Factsheet on Sexual Health.

See Gires for a list of all of the trans health factsheets.

When things go wrong

You have a right to be treated with dignity and respect by your healthcare professionals.

Going for screening can be hard for trans people. Sometimes it can help to have your screening at the beginning or end of a session. Speak to your healthcare providers or phone the screening service directly if there is anything that can be done to make the process easier on you.

If you experience any problems in accessing screening or any other health care, you can complain here. You have a right to complain and you should not get worse care as a result.

Further trans info

Screening for trans people

Trans access to healthcare

Trans sexual health

 

Resources

Trans Health Factsheet on General Healthcare.

Transfigurations for Trans Friendly Doctors

Breast Test Wales

Cervical Screening Wales

See also the Health Checks and Screening for LGBT people page