Prostate cancer is a common disease in older men. The growth of the tumor is stimulated by the male sex hormone testosterone. Trans women (people born as men, who identify as women) can undergo hormone treatment and surgery to adapt the body to the perceived gender. This hormone treatment can lower the risk of prostate cancer, writes physician researcher Iris de Nie of the Amsterdam UMC in The Journal of Clinical Endocrinology & Metabolism (JCEM). De Nie explains her findings.

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"Such hormone treatment, among other things, inhibits testosterone production. The prostate is not removed during sex reassignment surgery, because this would give a high chance of unwanted urine loss. The question now is what about the risk of prostate cancer in trans women undergoing hormone treatment . "

"Our research shows that hormone treatment in trans women lowers the risk of developing prostate cancer. While this does not solve men in general, it does teach a lot about the relationship between testosterone and prostate cancer."

The role of hormones in prostate cancer

"Testosterone, the male sex hormone, plays an important role in prostate cancer. Prostate cells depend on this hormone to function and grow. Therefore, doctors use drugs to lower the testosterone levels in the blood of men with prostate cancer to prevent tumor growth. But previous studies show no link between the level of testosterone and the risk of prostate cancer.In short, a higher testosterone level does not increase the risk of prostate cancer, but a sharp decrease in testosterone does inhibit growth in men who already have prostate cancer. . "

"How can this be explained? Research that has been done in trans women helps. The hormone treatment for trans women consists of a combination of anti-male hormone (anti-testosterone) and the female hormone estrogen. The anti-testosterone ensures that the testosterone level in the blood is strongly reduced and estrogen feminizes the body. "

The blue ribbon is often used as a symbol for prostate cancer involvement. (Photo: Pixabay / Marijana1)

Prostate cancer in trans women

"A total of 2,281 trans women were examined whether they had prostate cancer between 1991 and 2019. This was found in six people. Based on the figures from the general population of people of similar age, thirty people with prostate cancer were expected."

"This means that the prostate cancer risk of trans women is five times lower than the risk of men of the same age in the general population. These findings are reassuring for trans women: preserving the prostate during hormone treatment does not involve additional risks."

"A strongly reduced testosterone level is therefore associated with a protective effect on prostate cancer. This relationship disappears from a certain testosterone level, after which there is no further increasing risk with increasing testosterone levels."

"In the Netherlands, men in the general population are not routinely tested for prostate cancer because it has been shown to have few benefits and leads to many unnecessary treatments. Since the prostate cancer risk in trans women is even lower, routine testing is not necessary for them. It is important that both the trans woman and her doctors realize that the prostate remains in the body after sex reassignment surgery, because even if the risk is five times lower, prostate cancer can still occur in trans women. "

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