Cancer Screening Recommendations for Trans, Non-Binary, and Gender Diverse People

Trans women aged 50 to 69:

• who have taken gender-affirming hormones for 5 or more years.

Recommendation: Routine screening mammograms may be considered at BreastCheck (no doctor's referral required) or a diagnostic imaging site (doctor's referral required). 

• who have taken gender-affirming hormones for 5 or more years and have breast implants.

Recommendation: Routine screening mammograms may be considered at a diagnostic imaging site (doctor's referral required). 

• who have not taken gender-affirming hormones or have taken gender-affirming hormones for less than 5 years.

Recommendation: Routine screening mammograms are not recommended. 

Trans men aged 50 to 69:

• who still have breast tissue (have not had top surgery).

Recommendation: Routine screening mammograms are recommended every 2 years at BreastCheck (no referral needed) or a diagnostic imaging site (doctor's referral required). 

• who no longer have breast tissue (have had top surgery).

Recommendation: Individualized assessment is required by the healthcare provider.

Transgender persons age 45 to 49 and 70+

There is no evidence to recommend for or against screening in this population. Individuals aged 45 to 49 and 70+, if eligible would follow guidelines similar to those used for transgender persons (men & women respectively) aged 50 to 69.  Informed decision-making that considers the potential benefits and potential harms of screening should be used to determine whether to screen.

Non-binary and gender diverse people age 45+:

Recommendation: Non-binary and gender diverse people born with a cervix aged 45 and over may have breast cancer screening mammograms.

BreastCheck Access

• People eligible for screening at a BreastCheck site can call BreastCheck at 1-855-952-4325 to make a screening mammogram appointment. 

Recommendations for people who have a cervix or neo-cervix age 21-69, and have ever had sexual contact. Sexual contact refers to:

• oral, genital, or anal skin-to-skin contact, or

• sex with shared sex toys.

Routine cervical cancer screening is every 3 years for most people. 

Trans women, non-binary, and gender diverse people:

• who have had bottom surgery (vaginoplasty) with the creation of a neo-cervix.

Recommendation: Routine cervical cancer screening is recommended. 

• who have had bottom surgery (vaginoplasty) without the creation of a neo-cervix.

Recommendation: Cervical cancer screening is not recommended.

• who have not had bottom surgery (vaginoplasty).

Recommendation: Routine cervical cancer screening is not recommend.

Trans men, non-binary, and gender diverse people:

• who have not had their cervix removed.

Recommendation: routine cervical cancer screening with a Pap test. 

• who have had their cervix removed and have a history of high-grade dysplasia or cervical cancer.

Recommendation: Routine cervical cancer screening with a vault test.

• who have had their cervix removed and do not have a history of high-grade dysplasia or cervical cancer.

Recommendation: Cervical cancer screening is not recommended.

CervixCheck Access

• Those eligible to participate in cervical cancer screening should make an appointment with their primary care provider or visit the CervixCheck website to find a cervical cancer screening clinic. 

Most people age 50-74 at average risk of colon or rectal cancer, regardless of their gender identity, should do a colon cancer screening test every 2 years.

ColonCheck Access

Those eligible to participate in colorectal cancer screening can request a kit at ColonCheck.