Transgender preventative healthcare-an exploratory study


  • Braveheart Gillani Department of Obstetrics and Gynecology, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
  • Prakash Ganesh Center of Health Integration, Case Western Reserve University, Cleveland, OH, USA
  • Shubham Gupta Department of Urology, University Hospital, Cleveland, OH, USA
  • Michelle Caster Family Medicine, University Hospital, Cleveland, OH, USA
  • George Matar Family Medicine, University Hospital, Cleveland, OH, USA
  • Gaetan Pettigrew Department of Obstetrician and Gynecologist, University of California, San Francisco, USA
  • Rebecka Bracken Ohio University, OH, USA
  • Rachel Pope Department Urology, OB/GYN University Hospital, Cleveland, OH, USA



Transgender, Gender non-conforming, Preventative, Cancer, Affirming


Background: Transgender and gender diverse (TGGD) populations experience more health disparities than the general LGB (lesbian, gay, and bisexual) and the general cis-gender heterosexual population.

Methods: A cross-sectional survey of preventative health screenings was done across the lesbian, gay, bisexual, and transgender (LGBT) population utilizing Qualtrics. Thirty-five (36%) transgender individuals and 63 (64%) cis-gender individuals were included in the analysis. Bivariate analyses were performed using Welch's t test for continuous variables and Fisher's exact or Pearson chi-square for categorical variables.

Results: Cis-women were more likely than TGGD individuals with a cervix to have received a papanicolaou smear and reported being more up to date on cervical cancer screening via papanicolaou testing. Cisgender women were more likely to have had a mammogram than transgender men pre-breast removal. Of the 35 gender-diverse individuals, 14 did not have a PCP, 7 of whom never had one.  Fear of discrimination, fear of misgendering, inability to pay, lack of provider knowledge about transgender issues and incongruency with current name and gender with the most common causes for avoiding health care. For the most part, respondents report that these factors cause distress.

Conclusions: This study provides data regarding the statistically significant differences in preventative screening prevalence within TGGD clients as compared to LGB populations. Additionally, the study provides series of recommendations for preventative health screenings based upon organ set of individuals rather than gender identity.

Author Biography

Braveheart Gillani, Department of Obstetrics and Gynecology, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA

Mandel School of Applied Social Sciences


Meerwijk EL, Sevelius JM. Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples. Am J Public Health. 2017;107(2):e1-8.

Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgenderism. 2012;13(4):165-232.

Hughtoab JMW, Reisner SL, Pachankis JE. Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Science Direct-Social Sci Med. 2015;147:222-31.

Klein DA, Paradise SL, Goodwin ET. Caring for Transgender and Gender-Diverse Persons: What Clinicians Should Know. AFP. 2018;98(11):645-53.

Imborek KL, Nisly NL, Hesseltine MJ. Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready? J Pathol Inform. 2017;8:42.

Gonzales G. Health Insurance Coverage among Puerto Rican Adults in Same-Sex Relationships. J Health Care Poor Underserved. 2017;28(3):915-30.

Loo S, Almazan AN, Vedilago V, Stott B, Reisner SL, Keuroghlian AS. Understanding community member and health care professional perspectives on gender-affirming care-A qualitative study. PLOS ONE. 2021;16(8):e0255568.

Bockting WO, Miner MH, Romine RES, Hamilton A, Coleman E. Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population. Am J Public Health. 2013;103(5):943-51.

Bouman WP, Claes L, Brewin N. Transgender and anxiety: A comparative study between transgender people and the general population. Int J Transgenderism. 2017;18(1):16-26.

Millet N, Longworth J, Arcelus J. Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature. Int J Transgenderism. 2017;18(1):27-38.

Kenagy GP. The Health and Social Service Needs of Transgender People in Philadelphia. Int J Transgenderism. 2005;8(2-3):49-56.

Grasso C, Goldhammer H, Thompson J, Keuroghlian AS. Optimizing gender-affirming medical care through anatomical inventories, clinical decision support, and population health management in electronic health record systems. J Am Med Inform Asso. 2021;28(11):2531-5.

Edmiston EK, Donald CA, Sattler AR, Peebles JK, Ehrenfeld JM, Eckstrand KL. Opportunities and Gaps in Primary Care Preventative Health Services for Transgender Patients: A Systematic Review. Transgender Health. 2016;1(1):216-30.

Conron KJ, Scott G, Stowell GS, Landers SJ. Transgender Health in Massachusetts: Results from a Household Probability Sample of Adults. Am J Public Health. 2012;102(1):118-22.

Quinn GP, Sanchez JA, Sutton SK. Cancer and lesbian, gay, bisexual, transgender/transsexual, and queer/questioning (LGBTQ) populations: Cancer and Sexual Minorities. CA: Cancer J Clinicians. 2015;65(5):384-400.




How to Cite

Gillani, B., Ganesh, P., Gupta, S., Caster, M., Matar, G., Pettigrew, G., Bracken, R., & Pope, R. (2022). Transgender preventative healthcare-an exploratory study. International Journal Of Community Medicine And Public Health, 9(10), 3633–3641.



Original Research Articles