While gender-affirming surgeries can create a vagina, doctors do not create a cervix during this procedure. For this reason, a trans woman will not require cervical cancer screening.

This article will explore whether trans females can develop cervical cancer, their potential risk of other cancers, and how to find the best healthcare.

A trangender woman wearing a bathrobe before undergoing cervical cancer screening.Share on Pinterest
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Trans females are not at risk of developing cervical cancer.

If a person has a vaginoplasty, surgeons usually use skin from the penis to create a vagina, sometimes called a “neovagina.” However, this procedure does not create a cervix.

Vaginal or vulvar cancer

According to the Canadian Cancer Society, there is a slight chance of transgender females developing cancer in the tissues surgeons use to create a vagina. However, it states that more research is necessary.

The most common cause of vaginal or vulvar cancer is the human papillomavirus (HPV), a sexually transmitted infection that spreads through vaginal, anal, or oral sex. Although HPV usually causes no symptoms, some types of HPV can develop into specific forms of cancer.

Penile skin can also contract HPV, which could lead to a trans female developing cancer in their vagina after a vaginoplasty.

Because trans females do not possess a cervix, with or without surgery, they have no risk of developing cervical cancer and no need for screening for this condition.

Cervical screenings test for the presence of HPV and precancerous cells. In the United States, testing recommendations depend on a person’s age and health history. Those ages 21 to 65 years with a cervix should receive routine testing. After this age, people can speak with a doctor about whether they still require testing.

If a person is unsure whether they need to have cervical screenings, they should speak with a healthcare professional.

It is important for a person to see a healthcare professional who is educated about their healthcare requirements.

The following organizations have tools to help people find trans-friendly doctors:

There are certain cancers that a trans female may need regular screenings for, including:

Cancer of tissues in a reconstructed vagina

Research from 2019 notes that, although it is rare, cancer can develop in the vagina after male-to-female gender-affirming surgery due to HPV. These tumors tend to develop at the back of the vagina, the deepest part known as the apex.

Researchers recommend that trans women have frequent gynecological checks to look for signs of cancer or any other vaginal health issues.

Prostate cancer

A person assigned male at birth will generally have a prostate. If a trans female decides to have a vaginoplasty, this procedure will not remove the prostate.

There are no specific recommendations on when to undergo prostate cancer screenings. The American Cancer Society advises people to make a joint decision with a healthcare professional based on their personal risk factors on whether they should get a screening.

If a person chooses to have prostate cancer screenings, they only need a test every 2 years if they have a typical result. People who receive an atypical result may need to have yearly tests.

Researchers believe prostate cancer may be more aggressive in trans females who are receiving hormone replacement therapy (HRT) or have had bottom surgery. This is because the cancer develops despite low testosterone levels.

Breast cancer

Although rare, breast cancer can develop in trans females who have not undergone any gender affirming surgeries.

The Centers for Disease Control and Prevention (CDC) notes that HRT can increase the risk of developing breast cancer.

Generally, healthcare organizations recommend screening for breast cancer every other year after a certain age. However, recommendations differ between organizations and change frequently.

In 2022, the American College of Radiology put out the following recommendations for trans females:

  • Age 40 years or older with an average level of risk and 5 or more years of hormone use: Digital breast tomosynthesis (DBT) or mammographic screening may be appropriate.
  • Age 25 to 30 years or older with higher than average risk and 5 or more years of hormone use: DBT or mammographic screening is usually appropriate.
  • Age 25 to 30 years or older with higher than average risk and little to no hormone use: DBT or mammographic screening may be appropriate.
  • Average level of risk and little to no hormone use (less than 5 years): No test is appropriate.

Cancer resources

To discover more evidence-based information and resources for cancer, visit our dedicated hub.

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Trans females do not have a cervix, regardless of whether they have undergone gender affirming surgery. These procedures do not create a cervix. This means trans women cannot develop cervical cancer.

If a trans female has undergone gender-affirming surgery, they have a small risk of developing vaginal cancer due to HPV, which can affect the penile tissues surgeons use to create the vagina.

Screening may also be advisable for other types of cancer, including prostate cancer and breast cancer. People can discuss any cancer screenings they may require with a doctor who is knowledgeable about transgender healthcare needs.