Prostate cancer, a topic predominantly associated with cisgender men, often remains in the shadows when it comes to transgender women's health. However, the unique challenges that might be experienced by transgender women is something that needs to be discussed and there is little information out there.
A number of people, including trans women, do not realise that they will still retain a prostate, even after genital reconstructive surgery, often referred to as "bottom surgery" in common parlance. Though the function of producing semen that the prostate usually performs is no longer required, the risks of removing the prostate is high, possible leading to urinary issues or nerve damage.
Prostate cancer is the second most common cancer among cisgender men worldwide, but the incidence of this disease among transgender women is not well-documented. While comprehensive statistics are scarce, it is crucial to acknowledge that transgender women, retain their prostate glands. This means they can still develop prostate cancer. Though data is limited, there seems to be evidence for it to suggest there are lower levels of prostate cancer diagnoses within transgender women, however, no conclusive study has been completed. Why this would be could be due to any of a number of factors, it could be due to the change in hormone levels, the fact that the prostate can shrink when on hormone for some or a number of other factors. The fact is, that prostate cancer can remain rather symptomless until later stages, and without regular screenings or checks, might not be detected. The risk increases if you are over 50 and regular checks are advised at this point, however as a transgender woman, this may be triggering and another way that they can be impacted by their gender dysphoria.
Gender dysphoria, the distress associated with one's gender identity not aligning with their assigned sex at birth, can pose significant barriers to prostate cancer screenings in transgender women. The discomfort and anxiety surrounding medical procedures that involve the prostate may deter some from seeking necessary healthcare. It's crucial to understand that such emotional struggles are real and valid. Empathy from healthcare providers is essential to foster trust and encourage transgender women to prioritize their health and should be at the forefront of any healthcare interaction, especially when addressing sensitive topics like prostate cancer in transgender women. Sadly, some healthcare professionals struggle to see past someone transition and will relate everything back to it directly, seeing symptoms as side effects of HRT, blockers or even post surgery complications. A transgender person has to advocate for themselves and this can be exhausting when it feels relentless. Finding support can be essential, whether this be professional, familial, friendship or from groups and other sources
Transgender women navigating prostate health should be aware of the support and resources available to them:
LGBTQ+ Healthcare Providers in the UK: Seek out healthcare professionals who are well-versed in transgender healthcare issues and provide culturally competent care. Some NHS trusts do have Gender Clinics, however the waitlist for these can be extremely long
UK LGBTQ+ Organizations: Numerous UK-based LGBTQ+ organizations offer resources and support, both online and in person. Examples include Stonewall and Mermaids.
Peer Support Groups in the UK: Connecting with peers who have undergone similar experiences can offer invaluable emotional support, and many UK cities have local LGBTQ+ support groups. One place you can search for these is through www.transunite.co.uk
Mental Health Services in the UK: Gender-affirming therapy and mental health services are available and can be found through such resources as Pink Therapy.
Prostate Cancer UK: A charity dedicated to stopping prostate cancer have some factual information around prostate health in transgender women. Can trans women get prostate cancer? | Prostate Cancer UK
Prostate cancer may not discriminate based on gender identity, but society often overlooks its potential impact on transgender women. Empathy, understanding, and awareness are essential in addressing this issue, but also education and space to share. By recognizing the unique challenges faced by transgender women with gender dysphoria, promoting empathy in healthcare, and providing accessible support, it is possible to ensure that no one is left behind in the fight against prostate cancer. Every individual, regardless of their gender identity, deserves the opportunity for early detection and timely treatment.
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