Prostate cancer awareness among transgender women after gender-affirming surgery

The prostate gland remains unresected during gender-affirming surgery (GAS) for transgender women (TGW), and may develop malignancies in later life. We sought to evaluate prostate cancer awareness (PCA) among post-GAS TGW.

The investigators implemented a cross-sectional study and enrolled a sample of Thai post-GAS TGW without medical background. Predictor variables were categorized as demographic, clinical, operative, or postoperative. The outcome variable was PCA (yes/no). Appropriate statistics were computed, and a p-value ≤ 0.05 was considered statistically significant.

The sample consisted of 100 Thai post-GAS TGW (4% bisexual, 12% bachelor [or higher] graduates, 51% service workers, 64% had monthly net income <40,000 TB [or ca. 1050 Euro], 92% operated by plastic surgeons) with a mean age of 26.2 ± 5.4 years (range: 18-45). On bivariate analysis, PCA was significantly associated with educational level (p = 0.007; adjusted odd ratio [OR_adj. ]: 5.85; 95% confidence interval [95% CI]: 1.65-20.69), being operated ≥ 10 years  (p = 0.01; OR_adj. : 0.16; 95% CI: 0.04-0.76), self-recognition of the remaining prostate gland (p = 0.0001; OR_adj. : 0.02; 95% CI: 0-0.12), and emphasis on PCA by the GAS operator (p = 0.01; OR_adj. : 0.07; 95% CI: 0.01-0.63). Multiple linear regression analysis revealed a statistically significant, positive correlation (r = 0.78; p = 0.0001) among these four predictors, and continued to confirm the positive effect on PCA in TGW with high education and realization of the prostate gland (r = 0.56; p = 0.04) or information on PCA by the operator (r = 0.68; p = 0.003).

The GSA operator should intensively inform TGW about the remnant prostate and the risk of PC, especially those with low and middle levels of education attained.