Abstract
Purpose: This study examined the relationship between clinician recommendation and receipt of cancer screenings among a transgender and gender-nonconforming (TGNC) sample (n=58).Methods: Respondents self-identified as TGNC, age 40+ years, and residents of the Washington, D.C. area. Odds ratios were calculated to compare provider-recommended with received screenings. An open-text question asked for recommendations to improve screening experiences.Results: Provider recommendations were associated with screenings for breast, colorectal, prostate, lung, and anal cancer. Respondents cited interpersonal skills, affirming language, and clear information as important health care provider characteristics.Discussion: Participants reported being more likely to be screened if a provider recommended one regardless of evidence from current published guidelines.Conclusion: Gender identity, anatomy, and hormone exposure are critical elements that should be collected in future cancer screening research to build a stronger evidence base for provider recommendations based on population-level and individual-level risks of TGNC people.
Highlights
Transgender and gender-nonconforming (TGNC) people have unique health care needs due to genderaffirming hormonal therapy and/or surgical interventions
Purpose: This study examined the relationship between clinician recommendation and receipt of cancer screenings among a transgender and gender-nonconforming (TGNC) sample (n = 58)
Gender identity, anatomy, and hormone exposure are critical elements that should be collected in future cancer screening research to build a stronger evidence base for provider recommendations based on population-level and individual-level risks of TGNC people
Summary
Transgender and gender-nonconforming (TGNC) people have unique health care needs due to genderaffirming hormonal therapy and/or surgical interventions. Health care curricula in professional schools are lacking, and most health care professionals receive little training to provide clinically and culturally appropriate health care to TGNC patients.[1,2,3,4] Yet, the TGNC community is at a higher risk for some cancers. Sexual and gender minorities have higher rates of alcohol and tobacco use.[5] HPVrelated cancers are associated with exposure: individuals, regardless of transgender status, who have oral and/or anal-receptive sex are at risk for oropharynx and anal cancers, respectively.[5] Breast cancer risks for transgender women with longitudinal exposure to estrogen are reported to be greater than cisgender women but less than cisgender men.[6] Cervical cancer risks for transgender men are sometimes erroneously assumed by providers to be lower than for cisgender women.[7]
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