Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management

healthtransgenderwomenkapak

ROUTINE GYNECOLOGICAL CARE AND CANCER SCREENING IN TRANSGENDER WOMEN

Kevser Arkan¹
Ali Deniz Erkmen²

1Gazi Yaşargil Training And Research Hospital, Department of Gynecological Oncology, Diyarbakır, Türkiye
2Gazi Yaşargil Training And Research Hospital, Department of Gynecological Oncology, Diyarbakır, Türkiye

Arkan K, Erkmen AD. Routine Gynecological Care and Cancer Screening in Transgender Women. Balsak D, Aksin Ş, eds. Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.163-173.

ABSTRACT

Recent years have witnessed a significant increase in transgender individuals seeking gynecological care. The transgender community encompasses a diverse group of people whose gender identity does not align with their birth assigned sex. Globally, an estimated 25 million individuals identify as transgender. Some transgender people opt for hormonal and/or surgical interventions to better match their physical appearance with their gender identity. For transgender women-those assigned male at birth but identifying as women-cross-sex hormone therapy typically involves administering exogenous estrogen and/or progesterone alongside antiandrogens. Conversely, transgender men-individuals assigned female at birth but identifying as men-generally receive testosterone treatment. Although uncommon, hormone-sensitive cancers can develop, and their long-term effects remain unclear. Surgical options for transgender women may include breast augmentation and vaginoplasty (vaginal construction), while transgender men may choose chest masculinization (bilateral mastectomy), metoidioplasty (clitoral lengthening to form a small penis), or phalloplasty (penile construction). Current studies on breast and reproductive tract cancers in transgender individuals are limited, making it challenging to determine cancer prevalence. Guidelines for screening and preventive care are based on patients’ hormonal and surgical histories. Even fewer data exist regarding individuals with a genetic predisposition to these malignancies. This review aims to summarize recommendations for gynecologists concerning individualized cancer screening risk assessment in transgender patients.

Keywords: Transgender persons; Diagnosis; Early detection of cancer; Gynecological examination

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