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 physical attributes 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 find this difficult. 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 with your GP and aged 25 or over you will be invited for cervical screening. If you have a cervix, regardless of your gender identity, you should be screened. Visit Cervical Screening Wales for more information.

Your risk of certain conditions can depend on the sex you were assigned at birth.

d) Prostate screening: Gender affirming surgery for trans women does not remove the prostate. If you are a trans woman or non-binary person assigned male at birth and aged over 50, you should ask your GP to have your prostate screened as you remain at risk.

For a list of trans health factsheets visit Gires.

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 and non-binary 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 you believe you have been discriminated, bullied or harassed on the grounds of sexual orientation,  gender identity or expression you can raise a concern via the Putting Things Right process. You will not get worse care as a result.