Do transgender women need PSA tests after an orchiectomy?

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Since you have had an orchiectomy and have been on estrogen and spironolactone for six years, your testosterone levels are likely very low, which significantly reduces the activity and size of the prostate. However, because you still have your prostate, prostate-specific antigen (PSA) testing remains relevant, although the normal reference ranges and interpretation may differ slightly for transgender women.

You did not share your PSA level, so please provide it.

In transgender women on long-term estrogen therapy and androgen blockers, PSA levels are usually much lower than in cisgender men, often undetectable or well below the standard male reference range. So, if your doctor mentioned your PSA is normal, it is essential to ask what the actual value is. A PSA considered normal in cisgender men might be unusually high for a transgender woman with suppressed testosterone levels. For example, a PSA of 1.0 ng/mL might be fine for a cisgender man but would be unexpectedly elevated in someone like you.

What matters most is not just the absolute number, but whether there is a change or upward trend over time. While prostate cancer is rare in transgender women, it is still possible, so any PSA elevation should be interpreted carefully and in context.

If you can share your PSA value, I can guide you more accurately. By staying informed and proactive, you are doing exactly what you should, and that puts you in the best position to stay healthy.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.