What Trans Women Should Know About Prostate Cancer


The prostate is a gland present in individuals assigned to males at birth. It’s located below the bladder and surrounds the urethra. Even after transitioning, the prostate remains intact. Hormone replacement therapy (HRT), often used by trans women during their transition, can reduce the size of the prostate but does not eliminate the gland or the risk associated with it (1).

HRT, which often involves the intake of estrogens and anti-androgens, helps to feminize the body. When testosterone levels drop due to these treatments, the prostate may shrink. However, this reduction in size doesn’t correlate with a decreased risk of developing prostate cancer. The mechanisms of prostate cancer in trans women, especially those on HRT, are still not entirely understood and necessitate ongoing research.

Given that the prostate remains in trans women, it’s vital to recognize and act on any symptoms associated with prostate issues:

Any of these symptoms should prompt a visit to a healthcare provider for further investigation.

Regular screenings are essential, especially for older trans women. PSA (Prostate-Specific Antigen) tests, which measure the level of PSA in the blood, are often used to detect prostate anomalies. Though this test can indicate other prostate issues and not just cancer, an elevated PSA level can be an early warning sign.

However, it’s essential to note that HRT can lower PSA levels. Thus, a PSA level that might be considered “normal” for cisgender men might be elevated for a trans woman on HRT. Healthcare providers must interpret PSA results in the context of HRT. In case of suspicious PSA levels, further tests, like a biopsy, may be recommended (2).

Importance of Tailored Healthcare for Trans Women

Trans women often face disparities in healthcare, stemming from societal biases, lack of provider knowledge, or even personal apprehensions about seeking care. Healthcare providers need to approach prostate health in trans women with sensitivity, understanding, and expertise. Trans women should ensure they have a healthcare provider who acknowledges their unique needs and can guide them through the specifics of prostate health post-transition.

Prevention and Awareness of Prostate Cancer

While the exact cause of prostate cancer is not known, some general guidelines can reduce the risk (3):

  • Maintain a balanced diet rich in fruits, vegetables, and whole grains

  • Stay physically active

  • Regularly consult with a healthcare provider about any prostate-related concerns or symptoms

  • Stay informed about the latest research on prostate health in trans women

Prostate health remains a critical consideration for trans women. Awareness, regular check-ups, and open communication with healthcare providers are vital. Being proactive about prostate health can lead to early detection and better outcomes should any issues arise.
By addressing these concerns head-on and seeking the necessary medical advice, trans women can continue to live vibrant, healthy lives while being well-informed about all aspects of their health.

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References:

  1. Crowley F, Mihalopoulos M, Gaglani S, Tewari AK, Tsao CK, Djordjevic M, Kyprianou N, Purohit RS, Lundon DJ. Prostate cancer in transgender women: considerations for screening, diagnosis and management. Br J Cancer. 2023 Jan;128(2):177-189. doi: 10.1038/s41416-022-01989-y. Epub 2022 Oct 19. PMID: 36261584; PMCID: PMC9902518.


  2. Bertoncelli Tanaka M, Sahota K, Burn J, Falconer A, Winkler M, Ahmed HU, Rashid TG; Gender Research Collaborative. Prostate cancer in transgender women: what does a urologist need to know? BJU Int. 2022 Jan;129(1):113-122. doi: 10.1111/bju.15521. Epub 2021 Jul 21. PMID: 34157213.


  3. Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, Eeles RA, Ford LG, Hamdy FC, Holmberg L, Ilic D, Key TJ, La Vecchia C, Lilja H, Marberger M, Meyskens FL, Minasian LM, Parker C, Parnes HL, Perner S, Rittenhouse H, Schalken J, Schmid HP, Schmitz-Dräger BJ, Schröder FH, Stenzl A, Tombal B, Wilt TJ, Wolk A. Prevention and early detection of prostate cancer. Lancet Oncol. 2014 Oct;15(11):e484-92. doi: 10.1016/S1470-2045(14)70211-6. PMID: 25281467; PMCID: PMC4203149.

Source: Medindia



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