PSA Levels in Transgender Women and Non-Binary People: A Review of Current Research

What is it about?

The study reviews serum prostate-specific antigen (PSA) levels in transgender women and non-binary people with prostates (TWNBPP) undergoing gender-affirming hormone therapy (GAHT) or post-orchidectomy. A systematic review of four studies, involving 290 participants, reveals that GAHT lowers PSA levels below expected levels for age-matched cisgender men. However, due to study heterogeneity and limited data, these findings cannot support clinical recommendations or establish PSA reference ranges for TWNBPP. The need for PSA testing in TWNBPP is not universally recommended, except for those with genetic risks or symptoms of prostate cancer. The review identifies a significant gap in evidence for clinical decision-making and PSA reference ranges in the gender-diverse population.

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Why is it important?

This research is crucial as it addresses the gap in understanding serum prostate-specific antigen (PSA) levels in transgender women and non-binary individuals with prostates (TWNBPP) who have undergone gender-affirming hormone therapy (GAHT) or orchidectomy. As prostate cancer remains a significant health concern for cisgender men, understanding PSA levels in TWNBPP is vital for informed clinical decision-making and providing appropriate healthcare to this population. The study highlights the lack of clinical PSA reference ranges for TWNBPP, which is essential for evaluating and managing prostate cancer risk, ensuring equitable healthcare access and outcomes for gender-diverse individuals. Key Takeaways: 1. Data Limitation: The study identifies a significant limitation in existing data regarding PSA levels in TWNBPP, noting the low quantity, comparability, and quality of studies, which impacts the ability to make clinical recommendations. 2. Hormone Therapy Impact: The research suggests that GAHT reduces PSA levels in TWNBPP below expected levels for age-matched cisgender men, yet emphasizes the need for more robust data to establish clinical PSA thresholds for this group. 3. Evidence Gap: There is a notable evidence gap in PSA reference intervals for TWNBPP, necessitating further research to guide clinical practices and improve prostate cancer screening and management in this population.