Trans women have a prostate and can get prostate problems. The prostate is not usually removed during gender affirming surgery. Non-binary people assigned male at birth and some intersex people also have a prostate and can get prostate problems.

The information on this page is based on research about trans women. But some of it will be relevant to non-binary and intersex people who’ve had gender affirming surgery or taken feminising hormones.

The most common prostate problems are:

  • enlarged prostate
  • prostatitis (inflammation of the prostate)
  • prostate cancer.

An enlarged prostate and prostatitis are non-cancerous (benign) conditions. Below, we provide some information about these conditions in trans women. To find out more, read our general information about an enlarged prostate and prostatitis.

The risk of prostate problems in trans women

You can get prostate problems if you’re taking feminising hormones, even if you’ve taken them for a long time. Feminising hormones include oestrogen or drugs that block the effect of testosterone (testosterone blockers or anti-androgens).

You may have a lower risk of developing prostate cancer than cis men. That’s because feminising hormones lower your testosterone levels, and prostate cancer cells need testosterone to grow. But while oestrogen may lower your testosterone levels, some studies have shown that it may help prostate cancer cells to grow in people who have already developed prostate cancer.

Oestrogen has also been linked to benign prostate problems, including an enlarged prostate. We need more research before we can say for certain if oestrogen has an effect on prostate cancer or other prostate problems.

Diagnosing prostate problems in trans women

A change in how and when you urinate (wee) can be a sign of a prostate problem.

Urinary problems are common, especially in people over 50, and are not always a sign of a prostate problem. They can be caused by an infection, another health problem such as diabetes, or medicines you might be taking.

If you’ve had gender affirming surgery, such as vaginoplasty or vulvoplasty, you might have urinary problems as a side effect of surgery. But it’s important to tell your GP about any issues you’re having, so they can find out exactly what’s causing them and get you the right treatment, if you need it.

Enlarged prostate in trans women

An enlarged prostate is an increase in the size of the prostate. The prostate grows naturally as you get older, starting from about age 50. The size of your prostate is also affected by the balance of hormones (oestrogen and testosterone) in your body.

An enlarged prostate is the most common cause of urinary problems, but it doesn’t always cause symptoms. Symptoms are more likely to develop as the prostate grows because it can start to press on the urethra (the tube you wee through).

The symptoms of an enlarged prostate include:

  • a weak flow when you urinate
  • a feeling that your bladder hasn’t emptied properly
  • difficulty starting to urinate.

We need more research on the symptoms of an enlarged prostate in trans women. But they will be similar to the symptoms in cis men.

We also have information on how an enlarged prostate is diagnosed. You may have a urine test, blood test and prostate examination at your GP surgery. Read more about how the prostate is examined in trans women.

Your treatment options for an enlarged prostate are likely to be similar to cis men, unless you’ve had gender affirming surgery such as vaginoplasty. Having surgery for an enlarged prostate after you’ve had gender affirming surgery can increase the risk of side effects, such as leaking urine.

Prostatitis in trans women

Prostatitis is a group of symptoms thought to be caused by inflammation (swelling and irritation) of the prostate, or problems with the nerves and muscles in the surrounding area. It may also be caused by an infection of the prostate, but this is rare.

There are four main types of prostatitis:

Prostatitis can cause a wide range of symptoms. These vary from person to person and depend on the type of prostatitis you have. Symptoms may include:

  • discomfort, pain or aching in your back passage (rectum) or in the area between your back passage and genitals (perineum)
  • discomfort, pain or aching in your lower abdomen (stomach area), groin (the area between your stomach and top of the thigh), inner thighs or back
  • needing to urinate more often or urgently
  • difficulty urinating or a feeling that your bladder hasn’t emptied properly
  • pain or stinging during or after urinating
  • feeling as if you’re sitting on something like a golf ball
  • no desire for sex (lack of libido).

In rare cases, prostatitis can be severe – it can cause a high temperature and sweating. If this happens, you may need treatment in hospital.

We need more research on the symptoms of prostatitis in trans women. But they will be similar to the symptoms in cis men.

Find out about how prostatitis is diagnosed. You may have a urine test, blood test and prostate examination at your GP surgery.

We also have information for cis men on the different treatments for prostatitis, and their possible side effects. Your treatment options are likely to be similar too.

Getting support for prostate problems as a trans woman

It may feel difficult to speak to a doctor about prostate problems if you’re a trans woman. Read our tips on having the conversation, and download our checklist for talking to your GP about prostate cancer. You can also discuss your concerns with a doctor at an NHS gender dysphoria clinic, who may refer you to a urologist.

Our health information and services

Prostate Cancer UK’s services are free and open to everyone. Partners and family members can also use our services.

Health information

On our website, we have other information for trans women on:

Specialist Nurses

Our Specialist Nurses can answer your questions and explain your diagnosis and treatment options. All our Specialist Nurses can provide sensitive and appropriate support and information to trans women and non-binary people assigned male at birth.

Online community

Our online community is a place to talk about whatever’s on your mind – your questions, your ups and your downs. Anyone can ask a question or share an experience.

The online community is open to all, and we have a dedicated section for trans women. Here, you can talk to others who may share or understand your experiences of prostate cancer and other prostate problems.

Who else can help?

Support groups

At support groups, you can share your experiences of living with prostate cancer. You can also ask questions and share worries, knowing that people will understand what you’re going through.

These are support groups for gay and bisexual men with prostate cancer who also encourage trans women and non-binary and intersex people to attend:

OUTpatients provides support groups for any LGBTIQ+ person with and beyond cancer. They host regular peer support meetings and workshops and have a strong transgender representation.

Organisations

You may find it helpful to contact organisations that support trans, non-binary and intersex people, such as:

References and reviewers

Updated: April 2025. To be reviewed: April 2028.

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  • Blasdel G, Borah L, Navarrete R, Howland R, Kuzon WM, Montgomery JS. “Prostatectomy after gender-affirming vaginoplasty for a transgender woman with prostate cancer.” Urol Case Rep. 2024;56:102819. doi:10.1016/j.eucr.2024.102819
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  • Lafront C, Germain L, Campolina-Silva GH, et al. The estrogen signaling pathway reprograms prostate cancer cell metabolism and supports proliferation and disease progression. J Clin Invest. 2024;134(11). doi:10.1172/JCI170809
  • Manfredi C, Ditonno F, Franco A, et al. Prostate Cancer in Transgender Women: Epidemiology, Clinical Characteristics, and Management Challenges. Curr Oncol Rep. Published online November 1, 2023. doi:10.1007/s11912-023-01470-w
  • National Institute for Health and Care Excellence. Lower urinary tract symptoms in men: management. Published online 2015:26.
  • National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. Published online 2021. Accessed January 19, 2025. https://www.nice.org.uk/guidance/ng131
  • Nicholson TM, Ricke WA. Androgens and estrogens in benign prostatic hyperplasia: Past, present and future. Differentiation. 2011;82(4):184-199. doi:10.1016/j.diff.2011.04.006
  • Rees J, Bultitude M, Challacombe B. The management of lower urinary tract symptoms in men. BMJ. 2014;348(1):g3861-g3861. doi:10.1136/bmj.g3861
  • Smith EN, Ghosheh M, Porter KK. Abdominal and Pelvic Imaging of Transgender Patients. Appl Radiol. Published online July 1, 2022:7-13. doi:10.37549/AR2830
  • Vickman RE, Franco OE, Moline DC, Vander Griend DJ, Thumbikat P, Hayward SW. The role of the androgen receptor in prostate development and benign prostatic hyperplasia: A review. Asian J Urol. 2020;7(3):191-202. doi:10.1016/j.ajur.2019.10.003
  • Weyers S, De Sutter P, Hoebeke S, et al. Gynaecological aspects of the treatment and follow-up of transsexual men and women. Facts Views Vis ObGyn. 2010;2(1):35-54.
  • Xu G, Dai G, Huang Z, Guan Q, Du C, Xu X. The Etiology and Pathogenesis of Benign Prostatic Hyperplasia: The Roles of Sex Hormones and Anatomy. Res Rep Urol. 2024;16:205-214. doi:10.2147/RRU.S477396 
  • Alison Berner, Honorary Consultant and Academic Clinical Lecturer in Medical Oncology, Specialty Doctor in Adult Gender Identity Medicine, Queen Mary University of London/Barts Health NHS Trust/Chelsea & Westminster Hospitals NHS Foundation Trust
  • Ashley d’Aquino, Lecturer Practitioner, The Royal Marsden NHS Foundation Trust
  • Katherine Read, Radiotherapy Review Radiographer, The Royal Marsden NHS Foundation Trust
  • Laura Hinchliffe, Clinical Director, Cardiff Local Gender Service
  • Oliver Hulson, Consultant Radiologist, Leeds Cancer Centre
  • Shaina Tennant, Medical Writer, Wallace Health: wallacehealth.co.uk/
  • Stewart O'Callaghan, Founder & Chief Executive Officer, OUTpatients: https://outpatients.org.uk/
  • Our Specialist Nurses
  • Our volunteers.