Under the Surface: a practical guide to health screenings for UK trans folk
- Dr Rhy Brignell
- Jul 16
- 4 min read
By: Dr Rhy Brignell
Rhy is Director of Service Delivery at Eden New Life and is responsible for ensuring all of our subscribers get fast, high quality care in accordance with our treatment protocols. They hold a PhD from the University of East Anglia and have specialised in gender services for more than four years, managing and advising on service delivery for thousands of patients. This is one of a series of articles where Rhy shares guidance and ideas with our members.
In my previous article I mentioned that one of the risks involved with changing your gender marker on your NHS records is potentially missing out on important health screening invites. In this article, I’ll cover some key information about screening and why it’s something we need to be actively aware of as transgender, non-binary, and intersex people.
What is screening?
Screening is a way of identifying people who are at risk of developing certain health conditions, even if they seem healthy or don’t have any symptoms. Health screening helps to address these conditions earlier, meaning treatment is more likely to be effective. It is offered by the NHS to certain groups of people according to their risk factors, such as age, family history, or sex assigned at birth.
If you receive a normal or negative result after a screening test, it means you are currently at low risk of developing whichever condition you were tested for (but it doesn’t mean you won’t ever develop that condition in the future). If you receive a positive result after screening, it doesn't mean that you have the condition, it just means that further diagnostic testing is required.
Why does it matter for me?
Some routine screening invitations are sent out to patients according to the gender marker on their NHS record. This means that many transgender, intersex, and non-binary people are at risk of being left off the list, even though they are eligible for screening. This is a risk for those of us who haven’t changed their NHS gender marker as well as for those that have.
Here are a couple of examples to help illustrate the issue:
If you are a trans man with a cervix who has changed their gender marker to M, you are unlikely to receive an invitation for cervical screening, even though you are eligible.
If you are a trans woman with breasts who takes oestrogen and has not changed their gender marker to F, you are unlikely to receive an invitation for breast screening, even though you are eligible.
What screening do I need?
A general rule for screening eligibility is: if you have the body part, it should be screened. The exact screening you need will depend on the gender-affirming treatment you have had, if any.
Below is a general guide for transgender and non-binary people that covers routine screening invites currently sent out by the NHS and whether or not you should need them.
If you are intersex, you are likely to need more tailored advice from a health professional (such as from our specialists at Eden New Life) that is specific to your needs.
*Some trans men who have had top surgery still retain some breast tissue.
**Lung screening is being rolled out by the NHS and will be widely available by 2029.
What if I find screening difficult?
You aren’t alone - screening is often conducted on the more intimate parts of our bodies which can be emotionally challenging, especially if we dislike touching or acknowledging those parts. Though it’s difficult, it’s important that we try to catch any potential health issues as early as we can to keep ourselves well. Remember that you have the right to be treated with dignity and respect by all healthcare providers. You can also request that certain accommodations are made for you if it would help ease your anxiety (such as having your screening appointment at the beginning or end of a session).
Can I take myself off a screening list?
It’s very possible for some trans+ people to receive screening invitations for body parts that they don’t have, which might be an uncomfortable experience. For example, trans women with F gender markers who don’t have cervixes may still receive routine cervical screening invites. If you want to remove yourself from a screening list, you can speak to your GP, or there is further information about opting out from different types of screening available on the UK Government website.
Where can I find more information?
The UK Government website has really helpful and detailed guidance for trans people on screening eligibility. You can also find further information there about the invitation process for each type of screening, what you can expect from the appointment, and any preparation that is needed.
If you are an Eden New Life subscriber, our specialists can talk you through the NHS screening programmes that may be relevant to you during your gender-affirming hormone therapy. While they don’t arrange or manage these screenings, our specialists can help you understand what’s available so you can make informed choices. You can ask our specialists any questions you may have about screening in your regular review sessions.
