Health Screening for Transmasculine Individuals on Testosterone Therapy

Introduction to Screening Guidelines

• The American College of Physicians recommends that transmasculine patients on testosterone therapy undergo regular health screenings, including cervical cancer screening, breast cancer screening, cardiovascular risk assessment, and bone density assessment, if risk factors are present 1

Testosterone Therapy Monitoring

• Testosterone levels should be monitored to ensure therapeutic dosing, and liver function tests should be obtained as baseline values are needed and ongoing monitoring is recommended 1
• Annual monitoring is typically appropriate for stable patients after 5 years of testosterone therapy, but more frequent monitoring may be needed if dose adjustments are made or complications arise 1

Cancer Screening

• The US Preventive Services Task Force recommends that transmasculine patients with a retained cervix follow standard cisgender female screening guidelines for cervical cancer, regardless of testosterone use 1
• Transmasculine patients without chest surgery have a breast cancer risk comparable to cisgender women, and routine mammography is not yet indicated unless additional risk factors are present 1

Cardiovascular and Metabolic Screening

• The American Heart Association recommends that transmasculine patients on testosterone therapy undergo periodic monitoring of serum cholesterol, as androgen therapy can affect serum cholesterol 1

Bone Health Assessment

• The National Osteoporosis Foundation recommends that transmasculine patients on testosterone therapy undergo bone density preventive health education, and baseline bone density assessment should be considered if risk factors are present 1

Sexually Transmitted Infection Screening

• The Centers for Disease Control and Prevention recommends that transmasculine patients undergo STI screening according to sexual practices and risk factors, not gender identity 1

Additional Screening Considerations

• The American Thyroid Association recommends that thyroid screening (TSH) may be appropriate if symptoms suggest thyroid dysfunction, although it is not specifically indicated by testosterone use alone 2
• The American Urological Association recommends that routine prostate screening is not indicated for transmasculine individuals on testosterone therapy 1