The State of PSA Counseling in Male to Female Transgender Patients in the U.S.
Siddharth Marthi, BA, Timothy K. O'Rourke, Jr., MD, Christopher Tucci, MS RN, Gyan Pareek, MD, Elias Hyams, MD.
Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Describe prescreening PSA counseling (PPC) rates amongst male to female transgender (MtF-TG) patients and non-TG patients using the Behavioral Risk Factor Surveillance System (BRFSS).
This cross-sectional study used the survey data from the 2014-2018 BRFSS. Respondents were included if they were between 40-79 years old, completed both the “Prostate Cancer Screening” and “Sexual Orientation and Gender Identity” modules. Respondent characteristics analyzed included education level, income level, marital status, age, and race/ethnicity. Baseline characteristics were summarized using weighted percentages and compared using Pearson chi-square test. The association of PPC with MtF-TG status was evaluated using logistic regression, adjusted for respondent features.
A total of 175,383 respondents were included in our analysis. Of these, 0.3% identified as MtF-TG. Overall, 62.4% of respondents reported undergoing PPC. PPC rates were lower among MtF-TG respondents when compared to the non-TG group (58.3% vs 62.4%, p = .03). MtF-TG respondents were also more likely to report lower education level (p < .01), lower income level (p < .01), were less likely to be white (p < .01), and less likely to be married (p < .01) than non-TG respondents. Multivariable analysis adjusting for the previously mentioned respondent features demonstrated a statistically significant association between higher income level, higher education level, and marital status and increased odds of PPC, although no statistically significant association was demonstrated for MtF-TG status. No trends in PPC rates for the MtF-TG and non-TG populations were observed.
PPC was less frequently reported among MtF-TG respondents than in the non-TG group, although low education level and low income level were more predictive of PPC rates in multivariate analysis. Further research is needed to ensure equivalent access to prescreening counseling for patients across the socioeconomic and gender identity spectrum.
Back to 2021 Abstracts