Cancer screening for transgender people can require a modified approach to current mainstream guidelines. If your provider isn’t sure what that looks like, you can point them towards UCSF Center of Excellence for Transgender Health.

Unfortunately, I know from professional experience that transgender people are often less likely to have routine screenings and cancer screenings due to discomfort with health care providers’ use of gendered language, providers’ lack of knowledge about surgery and hormones, gender-segregated systems, and insensitive care.

2. Discuss your goals and expectations around medical transition, whether it's something you have done, are in the process of doing, or are interested in pursuing.

Of course, not all transgender and gender nonbinary individuals are interested in medical transition—including surgery and/or hormones—but for those who are considering these options, it’s important to select health care providers who understand how to administer and monitor hormones and who are knowledgeable about what is needed for pre- and post-operative care.

So it’s a good idea to ask your provider about their experiences with transition-related medical care or if they can refer you to someone who is experienced in that field. You’ll want to talk with your provider about your goals of hormone therapy, any lab work needed, and any relevant information from your and your family’s medical history.

There are many different surgeries that transgender individuals may undergo to align their body with their gender identity. Share with your medical provider any gender affirming surgeries you have had or are interested in. You deserve to feel comfortable with your surgeon and feel that your health care team is working together.

As your body changes, stay informed about what additional screenings may be needed. For instance, although the data linking hormone therapy to cancer is inconclusive (when taken correctly and monitored by a medical provider), it is still important to discuss risks with your provider.

For patients who currently have hormone-dependent cancers, it is imperative that you discuss with your oncologist and your primary care provider any past history or current use of hormones.

I know that some cancer screenings such as Pap smears and prostate screenings can be incredibly uncomfortable for some transgender and gender nonbinary people. Finding sensitive providers is essential to not delay important screenings.

3. As awkward as it may be, discuss your sexual history and activity in a way that allows your medical provider to accurately assess your sexual health needs.

It’s unfortunately not uncommon for transgender men to skip pelvic exams (whether they fear discrimination, think they don't need them, or avoid them for dysphoria-related reasons). It’s also not uncommon to forego preventive health care, such as STI screenings, out of fear of discrimination or disrespect. This can hurt the transgender population’s health.

Of course it can be awkward, but your sexual health is an important topic to discuss with your provider, so they shouldn't make you feel too uncomfortable to talk about it. If you feel your provider is not conducting transgender-sensitive sexual histories, you should feel empowered to give them this feedback. You can even ask your provider to use the language you feel most comfortable with to describe your and your partner’s bodies. This is important because they can help you to understand how to have sex that is safe, affirming, and specific to your body and identity.

It’s also important to tell your provider the nitty gritty details about your sex life and history (like: how many sexual partners you have had, whether you're using condoms or dental dams during sex, what kind of sex you are having, and if and when you were last tested for STIs and HIV).