Cancer Care Needs of Transgender, Transsexual, and Other Gender Nonconforming Populations

Cancer genetic counselors' experiences with transgender patients: A qualitative study

“…Moreover, counselors were unsure about risk assessment and follow up screening for patients who have had gender affirming surgeries. Counselors who are unaware of a patient's anatomical inventory may not know how to conduct a risk assessment for patients: for example, transgender women may have a risk for developing prostate cancer, and transgender men may have risks for cervical cancer (Lombardi & Banik, ). The Center for Excellence of Transgender Health at the University of California, San Francisco has published recommendations for increasing comprehensive, gender affirming cancer screening and services to transgender people (Center of Excellence for Transgender Health, ).…”

“…Transgender patients may have unique questions and concerns regarding their cancer care, all of which could be complicated by genetic predisposition and family history. Large doses of hormones taken by some transgender individuals could increase their risk for developing hormone‐dependent cancers (Lombardi & Banik, ). Time exposed to exogenous hormones may play a factor in understanding cancer risks for the transgender population, especially as people begin taking hormones at younger ages, and therefore, will be exposed to elevated levels of hormones for longer periods of time (Lombardi & Banik, ).…”

“…Large doses of hormones taken by some transgender individuals could increase their risk for developing hormone‐dependent cancers (Lombardi & Banik, ). Time exposed to exogenous hormones may play a factor in understanding cancer risks for the transgender population, especially as people begin taking hormones at younger ages, and therefore, will be exposed to elevated levels of hormones for longer periods of time (Lombardi & Banik, ). Some studies suggest hormone therapies could increase various cancer risks (Dizon, Tejada‐Berges, Koelliker, Steinhoff, & Granai, ; Futterweit, ; Schover, ), though others suggest that hormone treatments do not affect cancer mortality or may even have protective factors (Anderson et al, ; Bösze, Tóth, & Török, ; Schoemaker, Swerdlow, Higgins, Wright, & Jacobs, ; Taylor & Bryson, ; van Kesteren, Asscheman, Megens, & Gooren, ).…”

“…Risk assessment can be further challenged by misrepresentation of transgender identities and lack of anatomical inventories in medical records (Deutsch et al, ). Moreover, cancers that are related to reproductive organs, breasts, and prostates may be particularly sensitive topics for transgender patients, since these organs may not correspond with patients' gender identities (Lombardi & Banik, ; Taylor & Bryson, ).…”

“…This may adversely affect transgender people's healthcare access and utilization (Poteat, German, & Kerrigan, ). Discrimination is also associated with risky health behaviors, like alcohol, tobacco, and drug use, which are known risk factors for various cancers (Bradford, Reisner, Honnold, & Xavier, ; Lombardi & Banik, ). Moreover, widespread stigma can lead to employment, housing, and insurance access problems (Bradford et al, ; White Hughto et al, ).…”