A Systematic Review of the Most Frequently Mentioned Barriers and Facilitators to Cancer Screening and Care in Transgender and Gender Nonconforming Individuals Open Access

Abstract

There are approximately 1.4 million transgender people in the United States. This is a very hard to study, medically-underserved community. In this communication we examine the literature on barriers to and facilitators of cancer screening and care in transgender people. We identified and systematically reviewed 16 studies that used qualitative and quantitative methods to collect information on cancer screening and care among transgender persons, healthcare providers, and advocates for transgender healthcare. The main barriers to cancer screening and care in transgender people include avoidance of healthcare, discrimination, and lack of nationally published guidelines. The main facilitators include access to providers who are educated about transgender health and welcoming clinical environments. While there is much to learn about providing adequate cancer screening and care for transgender individuals, it is likely that issues discussed in this review are commonly experienced by the transgender community. Cancer screening and care for transgender individuals may improve through increasing exposure to transgender healthcare issues in medical schools and training programs, and by expanding healthcare services so that transgender people can be recognized as an important, relevant population with unique healthcare needs.

Table of Contents

Tables of Contents

Glossary of Terms 2

Chapter 1: Introduction 4

Chapter 2: Review of the Literature 7

A Brief History of Transgenderism 7

Cancer in the Transgender Population 9

Cancer Screening Guidelines and 9

Information for Transgender[1] Patients

Breast Cancer 10

Colon Cancer 11

Prostate Cancer 11

Cervical Cancer 12

Ovarian/Endometrial Cancers 12

Chapter 3: Manuscript 13

Abstract 13

Introduction 14

Methods 15

Results 16

Study Characteristics 17

Cancer Screening 18

Cancer Care 21

Other Factors 22

Chapter 4: DISCUSSION, Conclusions, 24

Public Health and Research Implications

Limitations 25

Research Challenges 26

Proposals for Future Research 27

Conclusions and Public Health 28

Implications: Proposals for Changes Clinical Practice

References 32

Appendix 38

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Oncology
Keyword	LGBT CANCER PREVENTIVE CARE TRANSGENDER SCREENING MEDICAL EDUCATION ONCOLOGY
Committee Chair / Thesis Advisor	Rochat, Roger, Emory University Goodman, Michael, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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