Preventive care is different when you're trans: What to know

Are you a transgender or nonbinary person? Is someone you care about trans? Trans and nonbinary people need regular preventive healthcare, just like cisgender people.

Whether you’re seeing a PCP or a specialist, it helps to find someone who understands the full scope of your needs.

“I focus on each person in front of me and risks for their specific body,” says Lisa Rinker, MD, a family medicine doctor in Vancouver, Washington. “This means I don’t think in terms of gender but more a review of them as a whole and what they need to be healthy. We know that openness and acceptance by a physician goes a very long way in helping patients feel comfortable.”

Here’s how to feel comfortable getting whole-person care for your body.

First things first: the words we use

For trans and nonbinary people, the words below are probably familiar. For other people, they might be new. Sharing words that describe the nuances of sex and gender can help us understand each other.

• Sex: A label assigned at birth based on a person’s body parts, usually male, female or intersex.
• Gender: Your personal sense of who you are. Healthline lists 68 different terms to describe gender. Man and woman are just two of the possibilities.
• Gender identity: No matter what sex was assigned at birth, every person has an internal sense of their gender. This may or may not match the sex assigned at birth.
• Gender dysphoria: A feeling of discomfort or distress in people whose gender identity is different from their sex assigned at birth.
• Transgender or trans: Trans people have a gender identity different from their sex assigned at birth.
• Nonbinary: Nonbinary people don’t identify as 100% male or female. They may identify as some combination of male and female, or as neither male nor female.
• Cisgender or cis: A cisgender person has a gender identity that matches the sex they were assigned at birth.

Gender-affirming vs. preventive care: What’s the difference?

Gender-affirming and preventive care are connected. Both provide proven mental and physical health benefits to trans and nonbinary people.

Gender-affirming care helps people accept and live with their gender identities. This kind of support and affirmation can improve quality of life for trans people and help with gender dysphoria.

“For mental and social-emotional health, access to gender affirming care is key,” says Spencer Cassar, the events chair for PeaceHealth’s Pride employee group.

There are many kinds of gender-affirming healthcare – from talk therapy to medical or surgical treatment. It is a life-saving specialty.

Regular preventive care is also important for trans people, though, and it’s often overlooked. “I'm more than my gender, and the rest of me needs to be a priority too,” says Cassar, who uses they/them pronouns.

Preventive care includes things like annual checkups, vaccinations, routine lab tests and screenings to catch health issues early. For trans and nonbinary people, routine preventive care can be distressing because providers often focus on sex instead of gender. For example, if a trans man feels uncomfortable during a mammogram, he may end up avoiding breast cancer screenings.

Gender identity and body parts

Talking to doctors can be hard if your body parts don’t match your gender identity, but it’s important for your overall well-being.

It helps to have healthcare providers who respect the person you are and the organs you have. You may already have a doctor you see regularly. When looking for a new PCP or specialist, ask if they offer inclusive trauma-informed care.

There are many body parts that require specific kinds of tests and screenings to catch any signs of concern as soon as possible. To protect your health, plan for healthcare that supports your gender identity and your body.

Caring for your trans body

Healthcare providers are still catching up to the needs of transgender and nonbinary people. Here’s how to advocate for the care you need.

• Preparing for appointments: Filling out forms before appointments can be challenging. The questions don’t always seem to fit trans and nonbinary bodies. In this situation, do your best to communicate about your needs, your gender-affirming care history and your body parts.
• Whose health? Your health: People often talk about “women’s healthcare” or “men’s healthcare.” But a trans woman can have a prostate gland and a trans man can have a cervix. It’s important to know your risk for conditions that affect these organs. That’s why the National LGBT Cancer Network recommends the following cancer screenings:
  • If you have a cervix, regular screenings from ages 25 to 50.
  • If you have breast/chest tissue, monthly self exams starting at age 20 and yearly exams by a healthcare provider. If you haven’t had top surgery, a mammogram is recommended every year starting at age 40, or earlier if you have a family history of breast cancer.
  • If you have a prostate, regular screenings are recommended starting at age 50. If you are Black and have a prostate, your risk is higher so screenings are recommended starting at age 45.
• Sexual and reproductive healthcare: According to the National Center for Transgender Equality, one in three transgender people have delayed or avoided preventive health care such as pelvic exams or STI screening out of fear of discrimination or disrespect. If you are trans or nonbinary, you need a safe place to discuss your sexual health and family planning. Look for the words “gender-inclusive” and “trans-friendly” when you choose a gynecologist or urologist.

Finding trans-friendly providers

Healthcare systems and individual providers are learning to be more gender inclusive – and that’s good for everyone.

Some of this shift is due to the healthcare industry putting more resources into cultural competency training and data collection to understand the needs of the LGBTQ+ community says Megan Davenport, the co-chair of PeaceHealth’s Pride employee group.

It’s a welcome change, she adds, because “the more providers who are educated about LGBTQ+ healthcare, the easier it is for LGBTQ+ people to access and find the inclusive care we deserve.”

Here are some resources to help you find respectful, informed and inclusive care:

• Look up providers for cancer screenings in your area.
• Search for U.S. transgender health providers by location and medical specialty.
• Try this LGBTQ+ provider directory.
• Look for trans-friendly providers using search tips from WebMd.

Not easy, but worth it

If you are trans or nonbinary, or if someone you care about is trans or nonbinary, you’re likely to experience difficult situations and uncomfortable language. These situations cannot be avoided, but they can be managed.

Why should you bother? Because your health is important — for body, mind and spirit.

“The main source of depression and anxiety for LGBTQ+ individuals is typically not their gender identity or sexual orientation, but the degree to which they feel accepted and safe,” Davenport says. “Providing compassionate and accepting care can not only break down one of the most common barriers that prevents LGBTQ+ people from accessing care; it can also save lives.”

Your gender identity is an integral a part of being yourself — and that should be celebrated. A healthy body will help you enjoy your identity for years to come.