Gynecological Care for Trans Men

Chest Tissue Monitoring and Wellness

Transgender men, whether or not they have had top surgery (removal of breast tissue), still have some chest or breast tissue. This tissue can develop health problems, including cancer, though the risk tends to decrease after surgical removal.

Regular Steps to Protect Chest Health

Share family history related to breast cancer with your healthcare provider.
Get familiar with your chest area to notice any changes in look or feel.
Report new lumps, rashes, or skin redness.
Follow personalized cancer screening recommendations. People with more breast tissue might need mammograms. Those with less tissue after top surgery might get MRI or ultrasound scans if screening is necessary.

Note for chest binders: Using binders for chest flattening can cause skin issues, rashes, or yeast infections. Talk to a knowledgeable provider to ensure safe binder use and get tips to avoid skin problems.

Screening Type	Indication	Frequency	Special Notes
Mammography	Significant breast tissue	As recommended by provider	Not always possible after surgery
MRI/Ultrasound	After top surgery	If at high risk or physician-directed	May substitute for mammogram
Self-checks	All trans men	Monthly	Report changes promptly

Lower Abdomen and Internal Organ Health

Trans men who have a uterus, cervix, or ovaries (with or without hormone therapy) still face risks for cancers affecting these organs. Testosterone does not remove these risks.

Pelvic Health Basics

Pelvic Exams: Regular exams can help find issues early, even if there are no symptoms. Some clinics may offer sedation to make the experience more comfortable.
Pap Smears: Testing the cervix for abnormal cells or HPV is recommended at intervals set by your provider.
Screening for Sexually Transmitted Infections (STIs): Trans men can get STIs from various sexual activities. Tests for chlamydia, gonorrhea, syphilis, HIV, herpes, and hepatitis may be advised.

Safe Practices for Sexual Health

Use condoms/barriers during all forms of sex. Change or clean these between partners or acts.
Do not use oil-based products with latex condoms.
Clean sexual devices with soap and water before and after each use.
Avoid sharing sexual items that contact mucous membranes unless covered properly and cleaned.

Prevention and Treatment

Get tested regularly and before unprotected sex with new partners.
Complete treatment for any STI, and make sure all partners do as well.
Ask about pre-exposure or post-exposure medications (PrEP/PEP) for HIV prevention if at higher risk.
Vaccines for hepatitis A, hepatitis B, and HPV are recommended where eligible.

Vaginal Dryness and Pelvic Pain

Some men on testosterone experience vaginal dryness or discomfort. Lubricants (preferably water-based) can help. Persistent pain may be a sign of infection or other health concerns and should prompt a clinic visit.

Organ	At Risk Without Surgery?	Screening Needed	Recommended Tools
Cervix	Yes	Pap smear, HPV test	Speculum, soft swab
Uterus/Ovaries	Yes	Physical exam, imaging	Pelvic exam, ultrasound, MRI
Vagina	Yes	Physical exam	Speculum, visual inspection

Reproductive Choices and Planning Ahead

Trans men who have not removed or altered their reproductive organs may still be able to conceive, even while on testosterone. Planning in advance is important.

Key Points for Thinking About Family Planning

Choices about having children are personal. Consulting with healthcare teams before starting hormone therapy or surgeries gives access to more options.
Fertility preservation can include egg freezing, embryo freezing, or ovarian tissue storage. These steps are best done before starting long-term testosterone or having surgery to remove ovaries, uterus, or fallopian tubes.
Trans men can become pregnant if they have a uterus and ovaries, even if using testosterone. Pregnancy is possible if engaging in vaginal sex with someone who produces sperm.
After some surgeries like metoidioplasty or phalloplasty, natural conception may no longer be possible and preservation steps become especially important.

Option	Description	Considerations
Egg freezing	Eggs collected and frozen for later use	Usually before testosterone
Embryo freezing	Eggs fertilized, then frozen	Often paired with IVF
Ovarian tissue freezing	Part of ovary removed and frozen	More experimental
No preservation	Option for those not wanting biological kids	Closure of fertility window

Talking to a provider specializing in transgender reproductive health helps review all choices. Some insurance plans may cover parts of this care, so asking about coverage details is a good idea.

Testosterone and its Impacts on Gynecologic Wellness

Testosterone therapy helps many trans men develop masculine features and can improve gender dysphoria. It does not completely remove risks related to the uterus, cervix, or ovaries.

How Testosterone Affects the Body

Menstrual periods usually stop, but reproductive organs may still function. There’s still a risk of pregnancy and cancer unless the organs are surgically removed.
Vaginal dryness is common, leading to discomfort or pain during sex. Using lubricants or vaginal moisturizers can help reduce these symptoms.
Pap smear results may be harder to interpret, as testosterone can change the appearance of cervical tissue.
Some trans men may experience pelvic pain or spotting, especially in the first years of therapy. Report these symptoms to a healthcare provider.

Long-term Hormone Therapy

Pap smears and pelvic exams are still needed if the cervix and uterus are present.
Long-term use may lower fertility but does not guarantee infertility.

Surgeries and Testosterone

After an oophorectomy, hysterectomy, or both, cancer risk drops for those organs. Regular checkups are still necessary, especially if any tissue remains.

Effect	How Often to Monitor	Who to Consult
Menstrual changes	Every 6-12 months	Transgender health clinic
Cervix and uterus health	Per screening guidance	Gynecologist, sexual health provider
Blood hormone levels	As advised by provider	Endocrinologist/primary care

Experiences with Body and Self-Image

Trans men often face body image challenges, especially related to gynecologic exams and treatments. Feeling uncomfortable or dysphoric is common during pelvic exams, chest checks, or discussions about reproductive organs.

Ways to Support Positive Experiences

Find a gender-affirming provider who creates a more comfortable environment.
Communicate your needs—let the healthcare team know what helps (music, a support person, sedation, explanation of every step, etc.).
Use inclusive language and ask the provider to use terms for body parts that feel right for you.
Bring a friend or support person, ask for sedation, and discuss concerns ahead of time.

Providers can help reduce anxiety and support a positive medical experience.

Challenge	Helpful Actions
Discomfort with exams	Request sedation/support person, clear steps
Dysphoria during discussions	Use chosen language, take breaks, communicate
Anxiety about results	Ask for gentle communication, follow-up plan
Fear of discrimination	Choose trans-competent, affirming provider

Body image issues can influence how often someone seeks care for preventive screenings. Compassionate providers can help ensure regular checkups and better long-term health.

Note: For those considering or who have had surgeries like metoidioplasty or phalloplasty, review aftercare and ongoing gynecological needs with a specialist experienced in transgender care. Ongoing dialogue with a provider remains important.