Transgender: Staying Healthy

Knowing your specific healthcare needs

As a transgender person, you may have special health concerns. Being honest and open with your healthcare provider will help you get the best care possible. So when talking with your healthcare provider, tell them about:

• All gender-affirming care that you have had in the past or that you plan to have in the future. Such care may involve treatments, such as hormone therapy or surgery. These may have risks. For example, transgender women taking estrogen may be more at risk for heart disease or blood clots. Anesthesiologists and surgeons need to know if a transgender woman has had surgery around the vocal cords because this may make intubation before surgery more complicated. Transgender women also need to be screened for osteoporosis, particularly if they stopped taking estrogen for any reason.

• Any unprescribed care. This may include hormones you got from the internet or supplements, such as black cohosh. Also tell your healthcare provider if you have had silicone injections. These can put you at risk for HIV if you share needles.

• Your family history. Health problems, such as heart disease that run in your family, can affect your care. For instance, transgender men who have breast or ovarian cancer in their families may want to think about genetic testing for these diseases.

• Your mental health. Transgender people are more at risk for mental health problems, such as depression and anxiety. If you suffer from such a problem, your healthcare provider can help you get treatment.

• Family planning. Gender-affirming care can affect your fertility. If you still want to have a family, you have choices, such as freezing sperm or eggs for later use. You may also want to think about birth control, if needed.

• Your sexual history. Your healthcare provider can decide if you need to be screened or tested for any sexually transmitted infections.

• Substance use. Drinking too much alcohol, using nonprescribed drugs, and smoking can raise your risk for some health problems.

Getting the right preventive care

Preventive care, such as screenings, can help protect you from diseases such as cancer. The screenings you need are mostly the same as those for cisgender people. But some gender-affirming care, such as taking hormones, may change that.

Transgender women may need to be screened for:

• Breast cancer. You may have a higher risk for this disease if you have taken hormones for a long time or if you have other risk factors for it, such as smoking. You may then need a mammogram after age 50.

• Prostate cancer. Transgender women are still at risk for prostate cancer even if they have had surgery to change their sex.

• Diabetes. Taking estrogen can raise your risk for this disease.

Transgender men may need to be screened for:

• Breast cancer. Even if you have your breasts removed, you may still have a low risk for this disease. You may need a mammogram or other imaging tests on a routine basis.

• Cervical cancer. It’s best to still have screenings for this disease, unless you have had a total hysterectomy.

Also talk with your healthcare provider about your risk for heart disease and osteoporosis. You may need certain tests for these diseases based on your risk for them. Your healthcare provider will also go over any vaccines you may need.