A trans woman who has undergone full gender-affirming surgery and is on hormonal therapy should have which screening performed?

For a trans woman who has undergone full gender-affirming surgery, including vaginoplasty, and is undergoing hormonal therapy, the most relevant screening to focus on would be breast cancer screening. Trans women still possess breast tissue and, while their risk factors may differ from cisgender women, they are still at risk for breast cancer due to estrogen therapy, especially if they have been on long-term hormonal treatment.

Digital rectal exams can be relevant for screening prostate health, but since a trans woman has had a vaginoplasty and typically the prostate is entirely removed during this surgery, this screening is not necessary.

Pelvic exams are typically not needed unless there are specific health concerns or risk factors since there are generally no internal reproductive organs post-surgery for a trans woman.

Testicular exams are not applicable in this situation because, following gender-affirming surgery, the testicles would have been removed.

Ultimately, breast screening is essential as part of preventative health care for trans women who have transitioned, emphasizing the importance of regular mammograms and breast health assessments.