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Do I need to have scans and x-rays?

Just like any other long-term healthcare plan, Gender-Affirming Care requires regular monitoring to ensure the best outcomes. 

Hormone therapy and puberty blockers are well-researched and generally safe, certain scans and X-rays can help detect and prevent potential health issues before they become serious.

Bone Health: Do You Need a Bone Density Scan?

If you are taking puberty blockers without hormones after the age of 16, you should consider a bone densitometry scan (DEXA scan).

Puberty blockers pause puberty, but they also temporarily slow down bone development. If blockers are used without estrogen or testosterone for an extended period, there is a potential risk of lower bone density.

A DEXA scan (dual-energy X-ray absorptiometry) is a simple, non-invasive test that measures bone strength and can detect early signs of osteoporosis. If needed, lifestyle changes, supplements, or medical interventions can help maintain strong, healthy bones.

If you’re taking standard dose hormones alongside blockers, the risk is negated, and you have the same risk as a cisgender person.

Routine Scans: Follow Screening Guidelines Based on Your Hormone Profile

Gender-affirming hormone therapy doesn’t eliminate the need for standard medical screenings. Your screening schedule should be based on your hormone profile and anatomy, ensuring you receive the right scans at the right time.

Here’s what you need to consider:

  • Breast Screening – If you have breast tissue, follow breast cancer screening guidelines for people in your age group.
  • Prostate Health – If you have a prostate and are in the recommended age range (starting around 50-55), prostate cancer screening is still important. Discuss with your doctor whether PSA testing is needed.
  • Aortic Aneurysm Screening – If you were assigned male at birth or have been on testosterone for many years, some healthcare providers recommend aortic aneurysm screening based on your cardiovascular risk profile.
  • Cervical Screening – If you have a cervix, regular cervical cancer screening is important, even if you’re on testosterone and experience atrophy. Skipping these tests can put you at unnecessary risk.

These screenings aren’t gendered healthcare, they are human healthcare. They keep you healthy, regardless of how you identify.

Ultrasound Scans

There is no evidence that routine ultrasound scans are needed for people taking gender-affirming hormones, whether you have a womb, ovaries, or not. 

The Bottom Line: Stay Informed, Stay Proactive

Gender-affirming care is about living a full, healthy life, and that includes preventative healthcare. Whether it’s a bone density scan, a routine mammogram, or a cervical screening, staying on top of your medical needs ensures that your transition supports not just your identity, but your long-term well-being.

Talk to your healthcare provider, follow the screening schedule that matches your hormone profile, and advocate for the care you deserve.

Your health matters.