The lack of culturally safe health screening for people who are transgender and gender diverse (TGD) is putting them at greater risk of cancer going undetected, but nurse practitioners could be trained to help close the gap.
That’s the view of Canadian and Australian researchers who are calling for improved access to prevention and screening services for the vulnerable TGD population.
A new paper published in Seminars in Oncology Nursing outlines the barriers that TGD individuals face when trying to access gender-affirming healthcare, particularly in low-income countries and where gender and sexual diversity is illegal.
While the proportion of TGT people in the overall community is small – conservatively estimated at between 0.3% and 4.5% of adults – they experience the same health issues and, in some cases, a greater risk of cancer due to a higher prevalence of alcohol and tobacco use and sexually transmitted diseases.
Due to actual or fears of discrimination, many TGD individuals are reluctant to seek health checkups, including cancer screening, which can delay cancer diagnosis and treatment, leading to poorer outcomes and even death.
The World Professional Association of Transgender Health recommends several guidelines that practitioners should follow when considering the needs of TGD individuals on estrogen therapy. These include factoring in the length of time on estrogen, the dose, patient age and the age when gender-affirming hormones were started.
Independent studies have identified that breast cancer occurs at a younger average age in transmasculine individuals who undergo a mastectomy, highlighting the importance of regular screening.
The risks could be reduced if nurse practitioners were trained to work in collaboration with clinicians to improve healthcare access for this vulnerable group, researchers say.
