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As a trans woman or non-binary person assigned male at birth, do I need to get tested for prostate cancer?

  1. Home
  2. Cancer information
  3. Find cancer early
  4. Screening in 2SLGBTQI+ communities
  5. As a trans woman or non-binary person assigned male at birth, do I need to get tested for prostate cancer

Trans, non-binary and gender-diverse people face significant barriers to accessing healthcare and are less likely than cisgender people to be tested for cancer. Barriers that can make participating in cancer testing challenging for people in the trans community include:

  • transphobia and discrimination
  • limited healthcare provider knowledge about issues affecting trans people (such as gender dysphoria)
  • a lack of trans-specific resources
  • concerns about physical and emotional safety

As a trans woman or non-binary person assigned male at birth, do I need to get tested for prostate cancer?

Anyone with a prostate can get prostate cancer. This includes trans women and non-binary and gender-diverse people assigned male at birth, regardless of transition, because the prostate is not removed during gender-affirming surgery. The risk of prostate cancer appears to be lower for those taking gender-affirming hormones. But we need more research to understand how hormone therapy affects the risk of prostate cancer, including in high-risk populations like those of African or Caribbean ancestry and those with a family history of prostate cancer.

No matter where you are in your transition, it’s important to think about your prostate health. You may decide to test for prostate cancer early, before you have any symptoms, after having a conversation with your healthcare provider about prostate cancer testing.

Our recommendation

If you have a prostate, you should make an informed decision about whether the prostate-specific antigen (PSA ) test is right for you by talking to your healthcare provider about the benefits and limitations of testing, your personal risk, your values and preferences, and what other procedures may follow.

  • If you are at average risk of developing prostate cancer, consider testing from age 50.
  • If you are at high risk of developing prostate cancer, consider testing from age 45. Those of African or Caribbean ancestry and those with a family history of prostate cancer are considered to be at high risk.

Your PSA levels will determine how often you get tested. The decision to stop testing is based on your PSA levels, age and overall health.

Your healthcare provider should help you understand the benefits and limitations of cancer testing for early detection. They should affirm your gender and perform any tests in a way that reduces your discomfort and any feelings of gender dysphoria you may have as much as possible. Bringing a trusted friend or loved one with you to your appointment may also help you feel more comfortable. And if you don’t feel comfortable, you are allowed to leave and book another appointment with a different provider.

I am taking estrogen. Will this affect my PSA test results?

If you are taking estrogen, your PSA levels may be lower, so some experts suggest that a lower cut-off level of 1.0 ng/mL should be used to determine if you have a higher than normal PSA level.

Other tests used to find prostate cancer early
A digital rectal exam (DRE) is used to check for any changes to the prostate. You may have a DRE if you are experiencing symptoms. If you have had gender-affirming surgery to create a vagina (called vaginoplasty), the prostate is located in front of the vaginal canal and a digital vaginal exam may be more effective.