Research has shown that the following are some of the most common health concerns faced by trans men and female-to-male transgender individuals (FTM). While these concerns may not all apply to everyone, they are all important concerns for trans men and their health care providers to be aware of.
Access to Quality, Compassionate Health and Transition Care
Some transgender individuals may not access health care services due to a fear of or previous experience with discrimination and/or lack of understanding on the part of the health care provider. For that reason, organizations like GLMA: Health Professionals Advancing LGBT Equality have created resources to help transgender individuals find knowledgeable, supportive, caring and compassionate providers in their community.
To receive the best, highest-quality care possible, trans men should voice any concerns to their provider and ask them any questions they may have about their health, as well as disclose information about any medications they are or have previously taken or surgeries they have had, as these may impact treatment options and preventive care screenings.
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The Center for Transgender Health Team at Johns Hopkins
Embracing diversity and inclusion, the Center for Transgender Health provides affirming, objective, person-centered care to improve health and enhance wellness; educates interdisciplinary health care professionals to provide culturally competent, evidence-based care; informs the public on transgender health issues; and advances medical knowledge by conducting biomedical research.
Sexual and Reproductive Health
Sexual and reproductive health concerns for trans men may not be addressed due to the perception that men do not require clinical Pap tests and breast exams. This stereotype and associated discrimination may make it uncomfortable for some trans men to access these important health care services. But while it may be unpleasant or even traumatic for some trans men, it is imperative that all individuals with a uterus, cervix and/or breasts be offered regular preventive and diagnostic screenings for those organs to assure early detection of any cancers or conditions.
Trans men are less likely to receive regular gynecological health care services than nontrans or cis-gender women — this includes pelvic exams and Pap tests used to diagnose cancers and other conditions early, when they have the highest treatment success rate. Because of this, gynecological conditions and cancers may go undiagnosed till it is too late to provide lifesaving treatment.
Additionally, for trans men taking testosterone, it is still unknown whether long-term use of the hormone impacts the risk of developing gynecological conditions, including cervical or ovarian cancer. Individuals should discuss possible health implications or complications with their provider before hormone use, and receive regular checkups during their use of prescribed hormones. The UCSF Center of Excellence for Transgender Health provides additional information and guidelines for hormone administration.
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Trans men and FTM individuals who do not take hormones and have not undergone “top” surgery — bilateral mastectomy, or surgical removal of both breasts — have the same risks of developing breast cancer as nontrans or cis-gender women. Therefore, it is important for these individuals to have regular clinical breast exams and screenings, like mammograms, which are used to diagnose breast cancer in its early stages, when treatment is the most successful.
Removal of the breasts reduces but does not completely eliminate an individual’s risk of developing breast cancer. Therefore, trans men who have had a bilateral mastectomy should still discuss their risk of developing breast cancer and available screening options with their provider.
Pregnancy and Fertility
Some trans individuals aspire to have children or be parents. Because of this, all reproductive options and future plans, like egg banking and pregnancy, should be discussed with individuals prior to obtaining trans-specific medical care and surgical procedures that may reduce their future reproductive options. Additionally, it’s important for trans men and their families to find a provider or center that understands their specific needs and offers services in a caring and compassionate environment.
Transgender individuals face an exorbitant amount of physical and sexual violence in our society, much of which is motivated by hate and stems from a lack of understanding and acceptance. This violence can be perpetrated by loved ones, family and friends, and/or strangers, and can take place in a number of environments, including the home, school, workplace or on the street.
Intimate Partner Violence (IPV)
Intimate partner violence can take many forms, but it usually involves physical or emotional harm by a significant other — usually a boyfriend, girlfriend, ex-boyfriend, ex-girlfriend or date. Typically, intimate partner violence begins with verbal threats and escalates to physical abuse, which is why it’s important to recognize it early and get help as soon as possible.
Some of the barriers faced by trans men who are survivors of IPV include access to support services, a lack of training on the part of service providers and discrimination in shelters. The National Coalition Against Domestic Violence has information on services and organizations that are inclusive and supportive of trans survivors of IPV.
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LGBT Resources at Johns Hopkins Medicine
Johns Hopkins Medicine values and embraces the diversity of its community — neighbors, patients, families, faculty, staff, students and trainees. We are committed to ensuring that patient care, service delivery and the healing environment are designed in a way that respects the individuality of all employees, patients and visitors.
View a listing of resources available to LGBT students, researchers and allies at Johns Hopkins Medicine.
Higher rates of drinking and smoking have been found among transgender individuals than the general population, and they are often linked to the high levels of discrimination and lack of acceptance faced by transgender individuals in our society. This is a very important health concern because the use and abuse of these substances is linked to multiple forms of cancer and conditions of the heart and lungs. Alcohol and tobacco use can also interfere negatively with hormone use, putting some individuals at even greater risk for certain diseases and conditions.
Additionally, trans men who do not have reliable access to male hormones from their doctor may try to obtain them elsewhere. In proper doses, testosterone is safe, but it should be prescribed and monitored by a physician to check for dangerous side effects.
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