Care and Cancer Screening of the Transgender Population

As sex and gender are assigned at birth before gender identity development, many individuals experience feelings of discordance between their gender identity and their sex and gender assigned at birth. The transgender community has not been well understood by medical and mental health fields. As such, this marginalized and vulnerable community faces multiple barriers to receiving health maintenance and specialized care, both at the community and patient-specific level. Many transgender individuals undergo some form of transition to the gender that matches their gender identity. Transition efforts look different for each patient because gender and gender identity occur along a continuum. Transition may include social, hormonal, and/or surgical components. As providers are caring for transgender patients, it is imperative to understand where a patient is in their gender transition and how hormonal and/or surgical therapies affect their cancer risk and screening. The aim of this article is to describe appropriate cancer screening practices and important care considerations for the primary care physician and generalist gynecologist taking care of transgender individuals.