Suzanna's story
Suzanna is a 78-year-old woman with a trans history. She had full lower surgery in 2013. Suzanna has had treatment for an enlarged prostate and bladder control issues.
My diagnosis
I started to have bladder control issues in 2015. I had to get up in the middle of the night to urinate (wee), and would get caught out sometimes before reaching the toilet.
I went to the GP. Unlike some women with a trans history, I didn’t worry about going to the GP because I had been at the practice for years and the GP knows about my trans history.
They gave me a PSA blood test and referred me to hospital for an MRI scan. The PSA test did not show anything wrong with my prostate, but the scan showed that I had an enlarged prostate. It was twice the normal size.
My treatment
At the time, I discussed this with my endocrinologist (a doctor who specialises in hormones). He suggested that I take finasteride (medication used to treat an enlarged prostate) to ease the symptoms, but it didn’t help. I was also referred to a urologist, who did another scan and prescribed me two drugs – one to calm an ‘overactive’ bladder and another to relax my urethra so that I could pass urine more easily. These worked for a few years.
In 2020, I went for another scan which showed only mild enlargement and no obvious signs of cancer, but the consultant said he wanted to keep an eye on me. He explained that it could be hard to detect prostate cancer in a trans woman. He suggested that I have repeat PSA blood tests and possibly a biopsy due to my age – but I haven’t had one yet.
Where I'm at now
Since then, my overactive bladder has become more of a problem – sometimes with annoying, if not embarrassing consequences. As a result, I am about to have a surgical procedure called sacral nerve stimulation (SNS). I have also asked to have another PSA blood test because it has been three years since my last one.
I know that some health professionals don’t understand prostate issues in trans women and that education is needed, but the various clinicians and staff I’ve seen have been very thorough and professional. There were no issues like, “Why are you here? You’re a woman."
I feel like I have received the gold standard of care.
My message to other trans women
I would encourage any woman with a trans history to be both very aware that you have a prostate, and that it can cause serious problems – sometimes very serious problems as you get older. So don’t wait to speak to your doctor if you have any of the risk factors for prostate cancer or start having any urinary problems.
Read more about an enlarged prostate and other prostate problems in trans women.
It’s a very simple message: "Don’t wait, just go!"
Published 2020 | Updated 2025
