Trans women
A trans woman is a person who lives as feminine or female but was assigned male at birth. Like everyone else, trans women need access to culturally sensitive cancer screening. Some factors, however, can pose barriers to that access or can affect screening recommendations and procedures. Barriers include:
- perceived or actual transphobia or poor treatment in healthcare settings
- lack of healthcare provider knowledge about trans bodies and screening guidelines for trans people. For example, many but not all trans women have had surgical procedures (such as a vaginoplasty or breast enhancement) and/or take gender-affirming hormones, like estrogen and testosterone blockers, to create bodies that align more closely with their gender identities. Healthcare providers need to understand the impact of these procedures on cancer-screening needs, while remaining sensitive to trans clients’ privacy
- gender dysphoria, which can make tests — like Pap tests, vault or cuff smears, colonoscopies or mammograms — that expose and/or examine the genitals or the chest, particularly challenging or risky
- often extreme levels of social exclusion, which can contribute to instability and have adverse health outcomes
This section discusses colon, breast and cervical cancer screening information for trans women, as well as some strategies that you as a healthcare provider can use to make screening more accessible to your trans female clients.
For trans clients: Changing sex designation on identification
Having access to proper and accurate identification is crucial to a person’s access to employment, housing, healthcare and the many other circumstances that require government documentation. It is also a valuable affirmation of a person’s identity.
For these reasons, many trans people in Ontario may wish to change the sex designation (“male/M” or “female/F ”) on identification such as health (OHIP) cards, birth certificates and driver’s licenses. To change the designation on all these documents, trans clients require — among other things — a signed letter from a healthcare provider who has treated them and supports the change. This document by Rainbow Health Ontario (PDF) provides details on the format of and the information that must be included in these letters.
As a healthcare provider, you can maximize the health of your trans clients by helping them access proper identification. Be prepared to assist your trans clients if they request documentation to support changes to their government ID and let them know that you are willing to provide them with that support should they need it.